Part B News
Got heavy Medicare Advantage record requests? Stop them in the contract stage
05/08/2017
by: Roy Edroso
If your Part C payers are bombarding you with record requests, there are only a few ways out — and your best course is to fix it in your contract.
Obamacare replacement passes in House; budget may further strain ACA insurers
05/08/2017
by: Roy Edroso
On May 4 the AHCA passed the House of Representatives 217-213 after a dramatic late push that changed key votes. The Obamacare replacement had previously gone down to defeat in the Republicans’ first attempt to push it through the House.
Strengthen lab referrals, cut denials with focus on billing details
05/08/2017
by: Richard Scott
Firm up several required parts of your office’s lab-referral process, including a signed note and sufficient documentation, to avoid getting rejected on what should be an easy lay-up.
Adopt 4 changes to increase your success with MIPS
05/08/2017
by: Marla Durben Hirsch

Be prepared to revise how your practice runs so that you can maximize your chances of earning an incentive payment under the new merit-based incentive payment system (MIPS).

Use 3 checklists to affirm correct use of common E/M modifiers
05/08/2017
by: Richard Scott
Identifying problem areas for a trio of E/M modifiers — 24 (Unrelated E/M service by the same physician during the postoperative period), 25 (Significant, separately identifiable E/M service) and 57 (Decision for surgery) — can help you avoid pitfalls and improve your reporting accuracy.
Post-op E/M codes tied to modifier 24 show fluctuating denial rates
05/08/2017
by: Richard Scott
During the three-year span from 2013 to 2015, providers generally achieved an increasing degree of success when reporting post-op E/M services with modifier 24 (Unrelated E/M service by the same physician during a postoperative period).
Do all the groundwork to avoid employing fraudulent staff, paying back charges
05/01/2017
by: Roy Edroso

The case of the registered nurse who wasn’t serves as a reminder to keep your licensure checks tight.

Spruce up your MIPS scores for the public as CMS sends them to consumer sites
05/01/2017
by: Roy Edroso

Here’s a reason to achieve the best scores you can in the merit-based incentive payment system (MIPS): Your MIPS data will be made public, and your weaker category scores may look worse than they really are.

Amendment may breathe new life into ACA repeal; shutdown fears dim
05/01/2017
by: Roy Edroso

Congress appears set to revive the bill that would repeal the Affordable Care Act (ACA), and fear that a government shutdown will interfere with critical Medicare operations eases in our latest Washington roundup.

Cut IPPE denials with a concerted focus on CMS’ 7-pronged requirements
05/01/2017
by: Richard Scott

Focus more on the preventive aspects of the “Welcome to Medicare” visit instead of the physical exam components and you may steer your practice to more success with this oft-denied service.

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