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Practices thirsting to ‘reopen’ must play smart, go slow, heed regional COVID-19 guidance

05/04/2020

While both CMS and the White House have issued documents on how to reopen practices that have curtailed operations during the COVID-19 public health emergency (PHE), your main legal guidance is at the state level — and in federal laws regarding your treatment of employees.

CMS stops Accelerated and Advance Payments, steers providers to Relief Program

05/04/2020

by: Roy Edroso

In a surprise announcement on April 26, CMS announced it was stopping the Accelerated and Advance Payments (AAP) program it recently offered as a solution for providers cash-strapped by COVID-19 closures.

Put modifier CR on waiver-related claims — but not telehealth

05/04/2020

by: Roy Edroso

A Bush-era modifier has been revived to let contractors know when you’ve posted a claim for a service that’s only allowed because of waivers employed for the COVID-19 public health emergency (PHE).

Providers will need to act to receive their share of $20B relief fund

05/04/2020

by: Richard Scott

Starting April 24, a second wave of relief payments — totaling $20 billion — is on its way to health care providers and hospitals. But take note: To access and keep the relief funds, providers must verify their 2018 payment receipts with the federal government.

89% of practices report steep decline in patient volume: Survey

05/04/2020

by: Richard Scott

The financial fallout of the ongoing COVID-19 public health emergency (PHE) continues to plague frontline medical practices, with nearly nine out of 10 groups reporting “large decreases” in patient volumes.

Be careful of HHS’ terms and conditions behind your provider relief payment

04/27/2020

by: Roy Edroso

You may be excited about the money you’re expecting — or have already received — from the feds from the Provider Relief Fund program. But be aware that you’re required to attest to certain terms and conditions, and not all of them are obvious.

Large telehealth denials should prompt practices to review evolving billing rules

04/27/2020

by: Jim Dresbach

While you may be flying by the seat of your pants in your office or from a remote telework location, that shouldn’t stop you from buckling down to get the most reimbursement possible for your practice. Those who dole out reimbursements passed along some unwelcome news in recent days, and reports have shown coders are having a difficult time navigating paper telehealth insurance claim forms.

CMS lets MA providers do telehealth risk adjustment; tight documentation advised

04/27/2020

by: Roy Edroso

Medicare Advantage (MA) providers can now do risk adjustment by telehealth, but you are advised to tighten up on your documentation and not go further than good judgment allows.

Continuing presence of coronavirus brings new obligations related to OSHA

04/27/2020

by: Tammy Binford

As employers begin looking beyond the immediate effects of the COVID-19 pandemic and start thinking of bringing people back to work, they will be wise to realize the new virus means permanent changes related to their obligation to provide a safe workplace.

Enrollment growth slows, but ‘Welcome to Medicare’ rises steadily

04/27/2020

by: Roy Edroso

Though the rate of Medicare enrollment growth has slowed, the Initial Preventive Physical Examination (IPPE) meant to welcome patients to the program continues to grow steadily.

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