Part B News | Part B News

01/31/2014

Health care, hospital fraud news worth noticing.

AWV denial rates increase when visits billed with modifier 25

01/31/2014

Many specialties that bill annual wellness visits (AWVs) most often see higher denial rates when they also bill a separate significant E/M service with modifier 25.

CMS to look at release of individual physician data on a ‘case-by-case’ basis

01/27/2014

by: Scott Kraft

The amount of money your practice — or individual providers in your practice — was paid by Medicare could become public knowledge now that CMS has said it will consider the release of individual provider payment information.

Exercise your right to receive payments electronically from payers, experts say

01/27/2014

by: Scott Kraft

Save your practice time and money by insisting on receiving payments electronically from all payers.

Avoid Medicare denials with proper modifiers for services to hospice patients

01/27/2014

by: Jennifer Clampet

Use modifiers GW (Service unrelated to terminal condition) and GV (Attending physician not employed or paid under agreement by the patient’s hospice provider) for your hospice patient-related claims to avoid Medicare denials as payers eye hospice claims for wrongful payments.

Use safety guides to get improved performance from your EHR, vendor

01/27/2014

by: Roy Edroso

New electronic health records (EHR) safety guides from the Office of the National Coordinator for Health Information Technology (ONC) show that even a system that appears to be in good working order is only as good as its back-up.

New Senate Medicare plan shows more support for coordinated care

01/27/2014

by: Roy Edroso

A bill unveiled on Jan. 15 by Ron Wyden, D-Ore., the soon-to-be new chairman of the Senate Finance Committee, suggests that the future of the federal health care program is in coordinated care models and pay for performance.

Benchmark: Denial rates by specialty for high-level, established E/M visits, 2010-2012

01/27/2014

by: Karen Long

Denial rates for 99214 (Level 4 established patient office visit) and 99215 (Level 5 established patient office visit) increased almost across the board for the 10 specialties that billed the codes most often in 2012.

2014 90-day global calendar

01/27/2014

by: Laura Evans

Save time calculating the date when your 90-day global period has ended by using this calendar for 2014.

How to prove you are in PECOS to avoid new ordering, referring denials

01/17/2014

by: Scott Kraft

Your practice’s claims now will be denied when the ordering or referring provider information on the claim is either missing or not valid, an error that previously only got you an informational warning.

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