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Consider care management, EHR readiness before jumping into CPC+

08/15/2016

Weigh several elements, including your staffing structure, your use of electronic health records (EHR) and how quickly you’re ready to embrace change to determine if you should get behind CMS’ latest value-based model for primary care.

Keep an eye out for incident-to audits

08/15/2016

by: Roy Edroso

Heads up: Some action on the physician-supervision front may warn of a clampdown on incident-to and other supervisory claims.

Avoid balance billing – and sanctions – when you treat Medicare, Medicaid duals

08/15/2016

by: Richard Scott

Take a closer look at your billing practices for patients who are dually eligible under Medicare and Medicaid so that you’re not collecting cost-sharing or coinsurance unduly – an event that can lead to sanctions.

Follow these 8 tips to handle ransomware risk in light of OCR HIPAA guidance

08/15/2016

by: Marla Durben Hirsch

HHS’ Office for Civil Rights (OCR) has made it clear HIPAA is yet another headache to deal with if a provider is hit with ransomware. To reduce your risks, take these eight steps:

2015 Medicare round-up: Top codes, denials mainly flat; $1.58 raise per claim

08/15/2016

by: Roy Edroso

The 2015 Medicare utilization numbers are out, and for the most part they show only modest changes from the previous year. But on the whole providers got more money out of the system than in 2014.

New bundled payment programs may have hospitals seeking your help

08/08/2016

by: Roy Edroso

Experts say three new bundled payment models affecting hundreds of hospitals across the U.S. will not only push medicine deeper into value-based territory but also change the way many hospitals handle patient after-care — and encourage them to reach out to practices for help.

Now open: Comprehensive Primary Care Plus in a location near you

08/08/2016

by: Richard Scott

Providers working in 11 states and several other markets are now eligible to apply for an advanced primary care model that will dole out up to $100 per patient, per month in upfront payments.

Heed new testing guidelines; plan for discussions as Zika spreads

08/08/2016

by: Richard Scott

Take note of new national guidelines that call for expanded Zika testing to help providers more accurately diagnose patients who possibly have been exposed to the virus.

OCR: Ransomware attack is presumed a reportable breach under HIPAA

08/08/2016

by: Marla Durben Hirsch

It’s bad enough to become the victim of a ransomware attack. But now providers need to treat the attack as a potential breach under HIPAA — even though the whole premise of ransomware is to deny access to patient data.

Check state law when determining how to handle guns at your practice

08/08/2016

by: Roy Edroso

Question: We’re in Texas, a state with open-carry gun laws, and one of our patients wants to bring his gun to the office. He says he would be satisfied if we stored his gun in a gun locker while he’s here. What do you think?

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