Part B News
Watch for higher Medicaid E/M, vaccine payments as states start doling them out
08/05/2013
by: Karen Long
Increased payments for Medicaid primary care services have started reaching providers more than six months after the two-year program began.
 
Avoid denials, overpayments with 5 tips for proper prolonged services billing
08/05/2013
by: Karen Long

Look at the total time of an E/M visit and whether it was dominated by counseling to know whether you are able to bill prolonged services codes.

 
Implement a 3-point approach to NPP diagnostic tests to avoid denials
08/05/2013
by: Jennifer Clampet
Don’t let confusing requirements for diagnostic tests performed by non-physician practitioners (NPPs) stop your office from pursuing a new revenue opportunity.
Benchmark: Denials up for longer in-office prolonged service codes, down for others
08/05/2013
by: Karen Long
Make sure you have complete documentation to support billing 99355 (Prolonged service in the office ... ; each additional 30 minutes) for at least 75 minutes of prolonged services because denial rates jumped to 35.5% in 2011 from 29.8% in 2010.
Primary care brings in more hospital revenue than specialists
08/01/2013
by: John Commins

A survey of hospital CFOs shows primary care physicians generated a combined average of $1,566,165 for their affiliated hospitals in the last year. Other specialties generated a combined annual average of $1,424,917, the lowest average in five years, data shows.

Access to EHR notes lauded by patients, providers
08/01/2013
by: Scott Mace

In a pilot, a system which permits patients to view all the notes in their electronic health records was such a hit with hospital patients and physicians that Beth Israel Deaconess Medical Center and Geisinger Health System are dramatically expanding their OpenNotes programs.

Senate hears more 'doc fix' testimony
08/01/2013
by: Margaret Dick Tocknell

The sustainable growth rate formula's days may be numbered, but the SGR won't be repealed until an alternative system for making Medicare payments to physicians is found.

Doctors, trial lawyers back 'Provider Shield' law in Georgia
08/01/2013
by: John Commins

Physicians and attorneys—uncommon allies—support a Georgia law that creates a barrier between doctors and "ancillary" payer guidelines in the Patient Protection and Affordable Care Act which could potentially be used as evidence in medical malpractice lawsuits.

AMA raises concerns over EHR workarounds
08/01/2013
by: Scott Mace

Arguing that documenting a full clinical encounter in an electronic health record "can be pure torment," an American Medical Association official describes three time-saving methods physicians have turned to, each of which has the potential for abuse leading to the denial of CMS payments, he says.

Medical school enrollment forecast tempered by residency concerns
08/01/2013
by: John Commins

Despite a rosy enrollment forecast, 40% of medical school deans surveyed have expressed "major concern" that the number of available residency training positions will fall short, says the Association of American Medical Schools.

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