Part B News
01/02/2012

These graphs compare how paper-based practices performed against EHR practices in two categories – total medical revenue and days gross FFS charges in A/R – based on 2010 survey data by the Medical Group Management Association (MGMA). NOTE:EHR practices are separated by those that implemented EHR for a year or less and those that have had EHR for two to four years. NOTE:Both graphs make the comparisons for three physician types: Primary care, surgical specialists and nonsurgical specialists.

01/02/2012

This week’s question is answered by Regan Tyler, CPC, CPC-H, CPMA, CEMC, ACS-EM, content manager for DecisionHealth and consultant for DecisionHealth Professional Services.

Q: A patient comes in for a spinal injection. On that same day, the patient is evaluated before the procedure to determine that it is appropriate for the patient, which may differ from what is requested from the ordering physician. Can you bill for an office visit as well as the procedure since a medical examination is done prior to it?

01/01/2012

Changes in Medicare and Medicaid reimbursement, healthcare reform, and market competition are all driving change not only in how hospitals and health systems approach patient care, but also in how physician compensation models are taking shape, according to a new HealthLeaders Media Intelligence Report, Physician Compensation: Shifting Incentives.

01/01/2012

Patient after patient asks for relief for sinusitis. Doctor after doctor gives them a prescription for medication-even though most infections are viral, not bacterial, needing no drugs to treat.

01/01/2012

It is easy to say that patients are at the center of healthcare, but a challenge healthcare leaders face centers on the question of responsibility for the patients' care. Some providers are evaluating the patients' role, committing resources to help educate them as to their central place in healthcare. Others are still struggling to understand the impact of patient-centered approaches.

01/01/2012

Something went very wrong a few years ago when ­Michelle Malizzo Ballog underwent surgery to replace a temporary stent in her liver at the University of Illinois Medical Center (UIMC) in Chicago. Tim McDonald, MD, chief safety officer, says he remembers vividly the text he received from a nurse as Ballog stopped breathing: Come quick. Things going badly. Cardiac arrest.

01/01/2012

Health insurance exchanges will shake up the healthcare system, and physician practices will feel the effects directly in their managed care contracts and reimbursement. Don't be misled by the fact that the big impact from exchanges won't happen until 2014, because now is the time to influence how the systems are designed and soften the blow to your practice.

01/01/2012

Dave Gans thinks every physician group needs to be an HRO-a high-reliability organization. HROs handle emergencies well because they recognize danger signals and respond in such a way that their systems continue to function and catastrophic outcomes are avoided.

01/01/2012

Physician groups looking to be more efficient should develop patient safety lists that address emergent events and routine activities, according to Elizabeth Wertz Evans, RN, executive director of professional practice for the Oncology Nursing Society in Pittsburgh.

12/19/2011

You now have an extra 30 days to get ready for the HIPAA 5010 transition regardless of whether you’ve successfully tested your claims by December 31, CMS announced in a MLN Matters article on Dec. 14. Providers who haven’t tested 5010 claims can send 4010 claims after Jan. 1, 2012 but only after submitting a transition plan to CMS in the next 30 days.

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