Specialty societies have submitted dozens of codes - including some high utilization psychiatric codes - for what experts believe will be a relatively lean AMA RVS Update Committee (RUC) five-year review in 2012. The five-year review is a process where specialty societies and CMS submit codes to the RUC that they believe have incorrectly valued relative value units (RVUs).

Beware of revenue shortfalls showing up in your accounts receivable department - you may have CMS to blame. A billing glitch failed to automatically send certain Part B claims to secondary payers during the first six weeks of 2010 - even though the explanation of benefits (EOBs) sent to your practice said these claims did cross over, CMS says.

You are about to have your Medicare payments slashed 21%, but the Senate is racing against the clock to pass a temporary pay-fix bill to delay implementation of the cut now set to hit your wallet on March 1. Historically, Congress has delayed payment cuts caused by a "flawed" payment formula - and there's no reason to believe it won't delay the cut set for March 1 (PBN 2/1/10). However, in the past Congress has adjusted payments for one or two years at a time. The previous fix passed in December was for just two months and this proposed reprieve is for less than one month.

The 21% cut to Medicare reimbursements set by the 2010 Medicare Physician Fee Schedule will be applied to your payments March 1, but Part B News has learned CMS will hold on to claims for 10 working days starting March 1 to avoid processing claims at that rate.

You and your peers have seen a mixed payment record on the top codes you billed to Medicare over the last three years. This chart shows the top three high-utilization, high-denial codes billed by the four specialties that bill the most codes overall to Medicare. The percentages above the bars show the denial rate for each code in 2008. Data from 2006 is not shown, but will be used as a point of comparison.

CMS backed off its April 5 deadline to enforce a new mandate requiring ordering and referring physicians be in the agency's Provider Enrollment Chain and Ownership System (PECOS) in order to pay a claim for the ordered or referred service. But don't breathe easy just yet. CMS hasn't backed away from the rule change entirely.

Recover more of your practice's hard-earned money and send fewer patients to collections by effective use of patient payment plans, experts say. High, persistent unemployment numbers mean you and your peers are likely to see an increasing number of patients who can't come up with the cash to cover their share of the balance.

Protests filed against five Medicare Administrative Contractors (MACs) in 2009 are still holding up MAC transitions in 14 states this year. Ten of 15 MAC contracts have been awarded and implemented, but CMS is working to address issues raised in protests filed against the five remaining MAC awards, an agency official tells Part B News.

You can recover money owed to your practice quickly by taking non-paying patients to small claims court rather than sending them to collections, experts tell Part B News. Local laws control the maximum amount of money in controversy for a case to be decided in small claims court, but it's not unusual to win back $10,000 or even $20,000 for the trouble of filing just 10-15 small claims.

You have the option of taking non-paying patients to small claims court, so long as you know they aren't actually indigent and have failed to make a good-faith effort to pay, experts say. Here are the steps needed to see this route through to the end.