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Case No. 4: The case of incorrect carrier payments

01/11/2016

Discover strategies to overcome incorrect carrier payments through this case study, replete with practical guidance.

When handling workers’ comp cases, make sure to have a payment backup

01/11/2016

Question: Our patient had a work injury claim for which he needed timely surgery. A workers’ compensation claim was submitted, but we've encountered insurance issue. Can we hold the patient responsible for the bill or at least a portion of it?

Review rules for home visits as OIG focuses on these E/M codes

01/11/2016

by: Julia Kyles, CPC-A

Home visits have caught the eye of the HHS Office of Inspector General (OIG) and landed on the OIG’s 2016 Work Plan. Providers who report these services may receive record requests sometime this year.

2016 predictions: Use of ACP codes lags, docs struggle with quality reporting and more

01/04/2016

by: Roy Edroso & Richard Scott

Part B News asked several industry sources to predict 2016 trends on a variety of topics. Prepare your practice for the new year with these insights.

Our 2015 predictions: SGR was a shock, ICD-10 a breeze; the rest PBN called

01/04/2016

by: Roy Edroso

By and large, our predictions for 2015 came true. Granted, we were surprised by the relatively smooth ICD-10 premiere and the end of SGR, but then so was everyone else. Read more about how Part B News fared with its 2015 predictions.

M&A outlook: More big deals; insurers, private equity stepping in

01/04/2016

by: Roy Edroso

Mergers-and-acquisition experts predict that the recent buying spree in the health care industry will continue and perhaps accelerate in 2016, with some new players joining the hunt and specialties getting fresh attention.

Congress eases way for providers to obtain meaningful use hardship exception

01/04/2016

by: Richard Scott

The Patient Access and Medicare Protection Act would give meaningful users a break; will Obama sign?

Modifier 25 denial rates hold steady for most heavy hitters

01/04/2016

by: Richard Scott

You’re losing out on big money if your notes supporting the use of modifier 25 (Significant, separately identifiable E/M services) are not up to snuff.

Case study part 2: Overcome operational challenges to succeed as a medical home

12/21/2015

by: Richard Scott

After you’ve taken the leap to become a patient-centered medical home (PCMH), keep an eye on ways to continually fine-tune your workflow — particularly around shared resources such as care management — to elicit long-term success.

Protect your practice, don’t overexplain when voluntarily repaying overpayments

12/21/2015

by: Roy Edroso

If you’ve discovered a Medicare overpayment and want to return it, be careful to pick the least suspicious accurate reason code and pay attention to details — especially the date.

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