Part B News | Editors' Blog

Help get rid of burdensome federal regulations

by: Charles Fiegl Feb 10, 2011

Politicians from President Barack Obama to House Republicans want to get rid of burdensome federal regulations. Eliminating regs (including rules about salmon or r ed meat) is a hot topic in Washington.

Lawmakers have solicited input from various stakeholders and groups. The AMA has responded by creating a new survey to funnel physician input on how federal rules impact their practices.

Bugged wellness visits may take until March to fix

by: Grant Huang Feb 2, 2011

If you received a denial on your annual wellness visits (AWVs) on your first round of remittance advices for 2011, it could take until mid or late March for affected carriers to pay you back. At least one carrier that experienced the issue -- which caused their systems to automatically deny many AWVs -- gave me the mid-late March date. That would be First Coast Service Options, with jurisdiction over Florida, Puerto Rico and the U.S. Virgin Islands. First Coast officials also revealed that around 1,000 claims were impacted.

NGS will automatically reprocess AWV claims

by: Charles Fiegl Jan 25, 2011

The Medicare Administrative Contractor (MAC) National Government Services (NGS, New York, Connecticut) sent out the following message regarding the new annual wellness visit service this afternoon.

eClinicalWorks unveils 5010 transition plans

by: Grant Huang Jan 24, 2011

CMS is preparing to test electronic claims transmission using the new 5010 HIPAA standard -- a secure electronic format that all your software must use. This will impact your practice management software, your electronic health record (EHR) system if you have one, and your clearinghouse, if you use one.

Remember: All claims must be transmitted using the 5010 standard, rather than the current 4010 standard, starting Jan. 1, 2012. This change spans all health plans bound by HIPAA, which basically means you've got to comply not just for Medicare, but for private payers as well.

One piece of advice you've been getting from CMS and us is to call your vendor and make sure they're ready. Well, at least one vendor has a letter explaining their 5010 transition plans, which they sent to me last week. Here is what eClinicalWorks has to say about the transition. If you are using their software, this gives you a great idea of what to expect. If not -- their answers are the ones you want to get out of your vendor.

CMS statement on AWV denials

by: Charles Fiegl Jan 20, 2011

Here's CMS's full statement on claims denials involving providers billing the new annual wellness visit exam. CMS has investigated complaints that claims submitted by physicians for the new Annual Wellness Visit that went into effect on January 1, 2011, are being improperly denied, and has determined that this is not a national problem, but that there are a few contractors that have improperly denied these claims.

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