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Strategies to treat patients under old, new Medicaid without breaking the bank

05/02/2014

Take steps to determine which Medicaid plan your patients have before treating them to avoid providing care that isn’t covered and eating the bill.

Save time verifying enrollment of Medicaid patients with websites, phone numbers

05/02/2014

by: Ben Hartman

Here's a list of the states that expanded their Medicaid programs, alomg with contact information.

Denial rates for less frequently used allergy tests soar from 2011 to 2012

05/02/2014

Practices billed 95071 (Inhalation bronchial challenge testing [not including necessary pulmonary function tests]; with antigens or gases, specify) just 16 times in 2012 but 11 of those claims were denied for a 68.8% denial rate.

CMS breaks silence on ICD-10 delay but offers no new deadline yet

04/28/2014

by: Julia Kyles and Roy Edroso

In some of CMS’ first comments since the ICD-10 delay was announced, an official said the agency is working on a response and will issue a final statement in the near future.

Watch documentation, signatures on home heath certs as CMS cracks down

04/28/2014

by: Roy Edroso

Heads up — if you certify patients for home health services, expect a wave of calls from agencies requesting more rigorous face-to-face documentation, thanks to a CMS crackdown.

OIG sets its sights on questionable billing of nerve conduction, EMG tests

04/28/2014

by: Scott Kraft

Expect more scrutiny of claims when you bill nerve conduction tests (NCTs) and electromyography tests (EMGs) after an HHS Office of Inspector General (OIG) report charges that almost one-quarter of all providers who bill those services do so under questionable circumstances.

Little-noticed provision of Medicare bill may change how services are valued

04/28/2014

by: Scott Kraft

A provision buried in the “doc fix” bill may change the way work and practice-expense relative values are set by giving CMS $2 million in annual funding to collect its own work and practice expense data.

Keep physicians on board with respect, truth — and sometimes money

04/28/2014

by: Roy Edroso

If you want to retain your physicians, contracts can do only so much, our experts warn — they should be supplemented with good communication and a willingness to make changes.

OIG terminates advisory opinion on physician network data sharing

04/28/2014

by: Marla Durben Hirsch

OIG reversed its position on a referral arrangement involving physician electronic health record (EHR) data exchange.

CMS to initiate fingerprint background checks

04/28/2014

by: Marla Durben Hirsch

CMS selected a contractor to handle fingerprint background checks and will begin conducting them on a phased-in basis in 2014.

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