Part B News
How to make good legally on spoiled visits to increase patient satisfaction
06/30/2014
by: Roy Edroso
Solve big customer service headaches by offering to cover the patient’s bill — but do it carefully to comply with Medicare regulations.
 
New modifier 59 guidance suggests crackdown, offers clues to beat it
06/30/2014
by: Roy Edroso
Look to new CMS examples of appropriate use of modifier 59 (Distinct procedural service) to withstand likely scrutiny.
 
Payers, practices pressed to find savings look to reduce administrative costs
06/30/2014
by: Scott Kraft
Physician practices and insurers are focusing on ways to control administrative costs as doctors’ reimbursement stagnates and the Affordable Care Act (ACA) requires insurance plans to spend at least 80% of premium dollars on the costs of care.
 
Plan to fingerprint high-risk Medicare enrollees could impact practices
06/30/2014
by: Scott Kraft
The recent announcement that Medicare would begin to fingerprint new enrollees defined as high risk — at their own expense — for background checks has the potential to implicate some physician practices, even though physician groups generally are not considered high risk.
 
Modifier 50 causes problems with bundled services in 2012
06/30/2014
by: Roy Edroso
Be careful of bundled codes when trying to use modifier 50 (Bilateral services) or risk costly edits. Medicare administrative contractor (MAC) Palmetto recently gave a heads-up on modifier use with bilateral procedures, reminding providers that the modifier cannot be used with codes that are “inherently bilateral by their description.”
 
Find solutions to those pesky, persistent provider enrollment problems
06/23/2014
by: Ben Hartman
During DecisionHealth’s National Provider Enrollment Workshop in April, attendees received answers to their most pressing enrollment questions. Below is a list of the questions and answers that apply to practices regardless of size and specialty.
 
HHS projects more than 1 million appeals caught in the ALJ swamp
06/23/2014
by: Burt Schorr
Providers who have had denied Medicare claims snagged in what’s now a nearly three-year wait for administrative law judge (ALJ) reviews will have more company by Sept. 30, when federal fiscal year 2014 ends.
 
Tolerance, initiative among top attributes to look for in nonclinical staff
06/23/2014
by: Roy Edroso
Don’t lose time and money by making the wrong hires for your non-clinical staff. Look for key attributes in candidates that predict good performance, consider newcomers to the field and prepare to invest time and money to bring the best people to your practice.
 
How to catch delinquent patient dollars on the ‘last mile’ before collections
06/23/2014
by: Roy Edroso
When patients are behind on their bills, talk to them before abandoning their debt to collections – or you’ll leave money on the table.
 
Charge patients correctly when billable, non-covered services done for same visit
06/23/2014
by: Scott Kraft
Use your actual charges when calculating how much a patient owes you out-of-pocket when the patient receives non-covered preventive and covered services on the same date. Medicare requires that process, known as a carve-out of the covered visit, to ensure the patient pays fairly.
 
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