Part B News | Part B News

Patients can keep you from sending claims to insurers — but must pay themselves

08/24/2015

Question: A patient says he doesn’t want us to file his visit with his insurance and wants to pay out of pocket. Can we do that?

Answer: Yes. In fact, you have to, according to the HIPAA mega-rule, but only if the patient pays in full...

Outpatient POS on established E/M claims creeps up

08/24/2015

by: Roy Edroso

Established patient E/M claims with a place of service (POS) of 22 (Outpatient hospital) rose faster from 2009 to 2013 than claims made for services in the doctor’s office (11), according to Medicare data.

Expect more scrutiny of provider address, license data as GAO report hits CMS

08/17/2015

by: Roy Edroso

Make sure enrollment data on your providers’ locations and licensure are airtight: The GAO put HHS on notice that CMS has holes in its enforcement of enrollment standards, and the Medicare agency says it’s on the case.

Act fast, be polite to get patients to advertise your practice through online reviews

08/17/2015

by: Roy Edroso

Exert a little effort without being intrusive to get your patients to make online reviews about your physicians and you could reap the rewards by recruiting new patients.

Common Pap smear tests billed less frequently as HPV co-testing enters fold

08/17/2015

by: Richard Scott

Your practice might be losing out on a new payment for screening human papillomavirus (HPV) if you’re part of the trend of declining Pap smear test administration.

Watch for new payment when you perform HPV testing during cancer screening

08/17/2015

by: Richard Scott

Get up to speed on human papillomavirus (HPV) testing and pathology to take advantage of Medicare’s latest covered benefit for which you’ll likely need to provide some education to your patients.

NPPs exempt from value modifier will count when CMS tallies group data

08/17/2015

by: Julia Kyles, CPC-A

You’ll need to count all of your practitioners to determine whether your practice will be subject to the 2% or 4% value-modifier adjustment in 2018, CMS clarified during an open door call on quality reporting requirements in the proposed 2016 Medicare physician fee schedule.

CMS will cover Internet-, eye-gaze-enabled speech-generating devices

08/17/2015

by: Roy Edroso

A new national coverage determination (NCD) and a new law should make it easier for you to get Medicare to pay for speech-generation devices for your patients.

You can bill TCM if patient readmitted — but watch rules on timing the claim

08/17/2015

by: Roy Edroso

Question: Our contractor denied our transitional care management (TCM) claim (99495) on the grounds that the patient was an inpatient at the time of the claim. He’d been readmitted to the hospital during the 30 days of TCM. What can we do?

Verify J codes and units of service, prepare for more MUEs after OIG report

08/10/2015

by: Laura Evans

Make sure you are billing your injectable Part B drugs appropriately in light of a recent HHS Office of Inspector General (OIG) report that recommends placing new Medicare limits on J code reimbursement.

Login

User Name:
Password:
Remember me Forgot password
Welcome to the new Part B News Online. If you are a returning user having trouble logging in, please click here.