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MACs may not test ICD-10 with providers; experts say make other plans

07/01/2013

CMS has been signaling that it would not authorize contractors to do end-to-end ICD-10 testing with providers. They may relent — but you should take advantage of other testing opportunities before the Oct. 1, 2014, deadline.

Save money, avoid claims headaches with a proper pre-authorization process

07/01/2013

by: Karen Long

Set up your practice’s workflow to obtain prior authorization for all codes that you might bill for a certain service to avoid retro-authorizations and more work on the back end. That can reduce the up to 14% of revenue the average practice spends just to get paid.

OIG nixes lab service arrangement — but lets podiatrist sell to footsore employees

07/01/2013

by: Roy Edroso

Two recent Advisory Opinions from the Office of Inspector General (OIG) show that if physicians hope to make money with ancillary businesses, the usual regulatory hurdles regarding intent and structure haven’t gotten any lower — but, with proper planning, it can be done.

Top 5 meaningful use myths that could cost you, lead to reimbursement cuts

07/01/2013

by: Karen Long

Whether you successfully attested for the electronic health records (EHR) meaningful use program or plan to in the future, several common misunderstandings could mean you lose out on incentive payments or become subject to penalties.

Keep track of your claims during MAC transitions to ensure payment

07/01/2013

by: Jennifer Clampet

Don’t let your Medicare claims get lost in the shuffle of a Medicare administrative contractor (MAC) transition.

Benchmark: AMA: Practices miss more than $3 of revenue for some reworked claims

07/01/2013

by: Karen Long

A practice loses $3.32 for each claim for which it has to send additional documentation, make phone calls or appeal denials for payer Health Care Services Corporation (HCSC), a new AMA report shows.

QualityNet: N365 disappearance no cause for PQRS alarm when quality code present

06/24/2013

by: Scott Kraft

Don’t be alarmed if you don’t see remittance advice remark code N365 (This procedure code is not payable; it is for reporting/informational purposes only) on your explanation of benefits when attempting to qualify for Physician Quality Reporting System (PQRS) bonuses, according to a QualityNet statement.

CMS: G-codes not required until next reporting if practice reported during testing

06/24/2013

by: Karen Long and Laura Evans

Practices that have reported functional G-codes for therapy patients during a testing phase will not have to restart functional reporting for those patients on the first date of service on or after July 1, CMS says in an email to Part B News.http://pbn.decisionhealth.com/Articles/Detail.aspx?id=515689

Use of patient form fees hinges on customer behavior, your financial need

06/24/2013

by: Lauren C. Williams

Your doctors’ time spent on administrative tasks such as filling out patient forms deserves to be compensated – especially with all of the payment challenges you face. But be judicious when you decide to charge patients for forms that need to be filled out by the physician to keep a good relationship with your patients.

Make documentation legible with pre-printed sheets to avoid 99309 denials

06/24/2013

by: Jennifer Clampet

Use pre-formatted exam forms to beef up physician documentation and improve chart legibility to prevent Medicare denials of 99307–99310 (Subsequent nursing facility care).

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