Part B News
04/17/2017

Get ready to switch to the new advance beneficiary notice of noncoverage (ABN), and use the new form as an opportunity to go over the ABCs of ABNs with administrative and clinical staff.

04/17/2017
Watch your Medicare administrative contractor (MAC) for instructions about how to bill the topical application of oxygen when treating chronic wounds after Medicare revised its national coverage determination (NCD) on hyperbaric oxygen therapy.
04/17/2017
Following the repeal-and-replace plan that didn’t muster a vote, reports circulated that Republican lawmakers were seeking to resuscitate the American Health Care Act (AHCA) or a revised version of the bill.
04/17/2017

Experts recently warned about the increasing odds that False Claims Act (FCA) charges, with the threat of conviction and imprisonment, will be brought against providers and other personnel who previously might expected just fines and takebacks. In this interview, an author of a new book about health care and the FCA talks about what practices should know.

04/17/2017
Watch for simple errors such as proper signatures and dates when providers amend their medical records, as a Medicare administrative contractor (MAC) put out word that auditors are catching mistakes.
04/17/2017
Question: Has anyone seen any information regarding commercial payers and reimbursement for transitional care management (TCM) services? I thought I saw an article stating that these codes would now be reimbursed by commercial payers, but I am unable to confirm this information. Please help.
04/17/2017
Medicare allows hyperbaric oxygen therapy for conditions ranging from cyanide poisoning to necrotizing fasciitis to decompression illness. But a remarkable number of the Medicare claims for 99183 (Physician or other qualified health care professional attendance and supervision of hyperbaric oxygen therapy, per session) were supplied under primary care in 2015, according to the most recent Medicare claims data. And for providers of any kind, the denial rates weren’t so hot.
04/14/2017

While proponents promote telemedicine as a way to reduce costs, a new study suggests telemedicine may actually generate higher healthcare costs when offered as an alternative to face-to-face visits.

The study, released in March by RAND Corporation and published in Health Affairs, analyzed the behavior of more than 300,000 people with access to telemedicine services and found they spent an average of $45 more per year than patients without access to telemedicine. The study authors concluded that access to telemedicine generates additional physician visits and the use of services that patients would not have otherwise pursued.

04/10/2017

Shorten your revenue cycle and keep cash flowing by taking a close look at how you’re collecting out-of-pocket fees from patients as cost-sharing continues to shift away from insurers.

04/10/2017

Practices that do risk-adjustment coding for Medicare Advantage plans should watch their step as the government pursues two big fraud cases that hinge on risk-adjustment issues. So far, only insurers are in the line of fire — but that may not last.

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