Delete or throw out copies of any blank Electronic Fund Transfer (EFT) Authorization Agreement forms on your computer or in your office. CMS has updated the CMS-588 form you use to enroll in the Medicare program or update your banking information.

You're once again just a few weeks away from Medicare physician reimbursement rates dropping 21.3%. Congress needs to fix the payment formula with a bill known as a "pay fix" or "doc fix" by the end of the month. Otherwise, you'll risk CMS holding claims or paying for services at the reduced rate (PBN 4/26/10).

How quickly are you getting paid by payers? Find out by using the Part B News' Tool of the Month, a Documentation of Insurance Turnaround worksheet, to see how quickly a payer or payers are paying your claims.

Surgical specialties and those associated with major procedures have the greatest denial rates in the two major inpatient settings, CMS data shows. The place of service (POS) doesn't appear to make a major difference in denial rates by specialty in the inpatient settings, similar to last week's analysis of outpatient settings (PBN 5/3/10).

Can ancillary staff record the chief complaint for an E/M visit as long as the physician is clear in notes that he reviewed and possibly expanded upon the information?

Your peers tend to fight denials only when confident CMS was wrong, which results in high levels of success on appeals and avoids wasting time and money on lost causes, a Part B News survey shows. Nearly 86% of survey respondents say more than half of their appeals are successful, with about 53% reporting success in 75% of appeals filed.

Survey data shows the key to a successful appeals strategy is to focus your efforts on the denials you know you can win and avoid wasting time when the payer's decision is most likely correct (see survey results and analysis). Your challenge is to quickly spot winnable denials.

We're having difficulty determining when it is appropriate to bill for a skin biopsy. Some of our clinicians believe they can bill a biopsy only when they use specific methods for removing the suspect lesion. I don't believe this is correct. Could you point me to some documentation that provides guidance?

Denial rates for most specialties don't seem to differ significantly whether their services are done in the office or outpatient hospital setting. This chart shows how specialty-specific denial rates compare to the average or baseline denial rate for the office and outpatient hospital settings. The five specialties with the greatest positive and negative deviations from the baseline denial rate in a given place of service (POS) were chosen.

The Medicare Administrative Carrier (MAC) Highmark processed Medicare claims with a conversion factor using the 21% sustainable growth rate (SGR) cut - costing you and your peers time and money. Double check to make sure your own carrier didn't process claims at the lower rate just to be sure. Initially, Highmark announced the MAC held claims and none were processed at the reduced rate.