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Health apps, wearable fitness trackers may trigger HIPAA, need for BAA

11/07/2016

As patients increase their use of personal health tools, health care providers need to understand when HIPAA applies to the information patients store on their phones and tablets and around their wrists.

Stay alert for home sleep study payer policies that vary from CPT

11/07/2016

by: Laura Evans, CPC and Julia Kyles, CPC

Question: We have a provider who is billing for home sleep studies with 95800. However, CGS Administrators is denying the service with claims adjustment reason code CO-5 (The procedure code/bill type is inconsistent with the place of service). Can you tell us why we’re getting this denial?

Many chiropractors, NPPs projected to be excluded from MIPS in 2017

11/07/2016

by: Richard Scott

About 41% of the approximately 1.2 million clinicians providing care during the merit-based incentive payment system’s (MIPS) transition year of 2017 will gain an automatic exclusion from the program, but exclusion rates are projected to vary significantly per specialty.

Correction: Updated MIPS exclusion data

11/07/2016

by: Part B News staff

Correction: The benchmark of the week in the Oct. 24, 2016, Part B News contained incorrect percentages of total exclusions from the merit-based incentive payment system (MIPS). The corrected percentages are 51.6% for practices with one to nine clinicians, 50.1% for 10 to 24 physicians, 46.3% for 25 to 99 clinicians and 27.3% for 100 or more clinicians.

The Stark Reality: Costly mistakes with collections, contract review, communication

10/31/2016

by: Stark Medical Auditing and Consulting

Implement hands-on billing tips that you can use to improve your collections, monitor your contracts and more.

5 tips to get your patients to take flu shots, earn reimbursement for your practice

10/31/2016

by: Roy Edroso

Happy flu season! Every year around this time, physicians push to have more of their patients get vaccinated – and earn the practice up to $42.72 for each shot, according to recently released flu vaccine prices. But what makes it happen? Here are five tips:

5 tips from QPP final rule to prepare for the first year of MIPS

10/31/2016

by: Roy Edroso

Use these insights from expert analysis of the 2,200-page Quality Payment Program final rule to come out ahead in the new system:

Scoring boost, value-based dollars back up the medical home model

10/31/2016

by: Richard Scott

You’ll find some added comfort as a patient-centered medical home (PCMH) in 2017 under Medicare’s coming Quality Payment Program (QPP), including automatic scoring on a slice of quality reporting and perhaps an easier path to earning extra dollars.

Value-based models tied to 25% of payment, as CMS expands scope

10/31/2016

by: Richard Scott & Roy Edroso

While most providers operate in a strictly fee-for-service world, a new study shows that value-based models are gaining ground — in 2016, about 25% of payments made in commercial, Medicare Advantage and Medicaid plans are funneled through an alternative payment model (APM).

The Stark Reality: Costly mistakes with collections, contract review, communication

10/31/2016

by: Mick Raich

The latest revenue audit findings from Stark Medical Auditing and Consulting.

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