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04/06/2009

This chart compares specialty-specific denial rates from 2005 to those in 2007, listing the major specialties with the highest denial rates. Overall, the reductions in denial rates are greater than the increases; the good news is huge for high-volume specialties like primary care and general surgery. However, the data shows that lower overall utilization played a major role in lower denial rates.

04/06/2009

Speed your Medicare enrollment process by following these 5 enrollment tips offered directly by a top CMS official at March 26 public forum. Part B News  attended the conference, sponsored by the American Health Lawyers Association (AHLA), and compiled the following list of tips from Jim Bossenmeyer, CMS's director of provider and supplier enrollment.

04/06/2009

CMS has amended a recently released transmittal that would've banned you from using out-of-state banks to receive Medicare payments electronically, reversing long-standing policy. CMS had disallowed out-of-state banks for electronic funds transfer (EFT) deposits in Transmittal 286, released on March 13. The most recent Transmittal 288 was issued as Part B News went to press April 2 and allows out-of-state accounts to be used.

04/06/2009

This week's question is answered by John Bishop, senior consultant for DecisionHealth Professional Services.

Q.   We are a primary care practice with a sleep lab. We are trying to determine if the primary care doctor needs an initial consult from a board-certified physician first in order for the sleep test and the continuous positive airway pressure (CPAP) to be paid. Is it OK for a primary care physician to order the sleep study as long as he performs the initial assessment (sleep scale, BMI, neck circumference, etc.)? He isn't board-certified. Is it all right if a sleep, board-certified physician reads the actual test?

04/06/2009

Looking to buy electronic medical records? You could call a bunch of vendors and schedule site visits. You could enlist a consultant. Or you could buy it at Sam's Club. Wal-Mart Stores is joining with EMR developer eClinicalWorks and computer-maker Dell to sell physician office systems at a discount through its Sam's Club warehouse-club division.

04/06/2009

Medical Group Management Association consultants Rosemarie Nelson and Cindy Dunn have identified 10 lessons for those considering electronic health records (EHRs).

04/06/2009

By now you know plenty of acronyms. When it comes to information technology alone, there's EHR, EMR, PMS, EDI and EFT. If a new report on the state of physician office technology is any indication, get ready to learn two more: ICE and DRT.

04/06/2009

You need to actively monitor key performance data and respond accordingly - if you want to do more than just scrape through the economic hurricane, experts say. Most practices know when they're losing money, but there's more to running a business than just knowing when you're in the red, says Larry Gold, a practice management expert with DecisionHealth Consulting Services. "Doctors tend to make emotional decisions," Gold says. "But you need to look at the data on a weekly basis, then ask yourself dispassionately, ‘what's changed and what do I about it?'" 

04/06/2009

Meaningful use of electronic health records (EHRs) is one obstacle that will stand between you and up to $44,000 per provider in incentives for adopting health information technology (HIT) at your practice (PBN 2/23/09). This year's stimulus bill, the American Recovery and Reinvestment Act, gives you some idea of what "meaningful use" is, but the full definition has yet to be articulated by CMS - the agency likely to administer the HIT incentive program beginning in 2011.

04/06/2009

CMS will use the most favorable outcome of two calculations for providers reporting the Physician Quality Reporting Initiative (PQRI) fluoroscopic measure that erroneously contains 22 CPT codes for non-fluoroscopic procedures (PBN 3/30/09). 

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