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Don’t try to DIY when you need alternative language options for ABNs

01/09/2023

Question: Medicare creates advance beneficiary notices of noncoverage (ABN) in English and Spanish, but the majority of our limited English proficiency patients speak Korean. Does our practice need to create an ABN in the appropriate language when an official version isn’t available?

All in the data: Watch OCR release of common HIPAA issues triggering enforcement

01/09/2023

by: Dom Nicastro

On Sept. 30, the Office for Civil Rights (OCR) released its fall 2022 data for enforcement. Covered entities (CE) and business associates (BA) should review this data to determine areas that most commonly trigger enforcement on behalf of the government’s regulator for the HIPAA Privacy and Security rules.

Diabetes education services recover slightly; DSMT, MNT beat MDPP

01/09/2023

by: Roy Edroso

Despite much CMS fanfare, the Medicare Diabetes Prevention Program (MDPP), never very popular to begin with, continued its dismal utilization numbers in 2021. Medicare’s other, less heralded diabetes education services, diabetes self-management training (DSMT) and medical nutrition therapy (MNT), have done better, but still took a hit in the pandemic.

Glimpsing the future: Legal challenges, COVID rules (again), new codes and more

01/02/2023

by: Part B News Staff

Welcome to our annual predictions issue, where Part B News attempts to peer through the chaos and pick out the pivotal events that will define the new year for medical practices. After scouring the minds of a host of industry insiders and asking our readers for their take on looming events, Part B News compiled 10 predictions touching on coming changes, updates, upheavals and trends.

PBN’s 2022 predictions: PHE, NSA? Yes. Vaccines, telehealth? Not quite.

01/02/2023

by: Part B News Staff

In our annual predictions issue, Part B News looks back on how well we fared calling shots during the previous calendar year. Heading into 2022, we staked a claim on the duration of the COVID-19 public health emergency, the fate of split/shared services, revenue projections and more. Here is an unabashed look at our 2022 results.

Online exclusive: 3 more PBN predictions for 2023

01/02/2023

by: Part B News Staff

Anticipate how to grapple with social determinants of health (SDOH), Medicare's split/shared billing policy and more.

Practices to dial up denials, collections strategies to offset pay cuts

01/02/2023

by: Richard Scott

Practices are on the verge of stepping up their denials management strategies in 2023 as Medicare Part B rate cuts are expected to impact revenue. On the delivery side, most practices plan to continue their telehealth operations in the new year.

Patient insured, but can’t afford care? Seek terms with payer for a cost break

12/19/2022

by: Roy Edroso

With high-deductible plans on the rise, it’s increasingly likely that you’ll see patients who, though insured, can’t afford their coinsurance payments. You can offer help, but take care not to run afoul of your payers.

Billing incident-to? Block 3 threats to the direct supervision requirement

12/19/2022

by: Julia Kyles, CPC

When physicians push for new and creative definitions of incident-to billing, it is up to coding and compliance staff to explain the rules. Watch out for mistake-prone areas to avert billing errors.

New prior auth rule aims for API adoption, 7-day turn by 2026

12/19/2022

by: Roy Edroso

Prior authorization, longtime bane of providers, is on track to get less burdensome thanks to a new proposed rule. The good news is it includes Medicare Advantage, left out of a previous version. But results, already delayed once, may still come slowly.

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