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Benchmark: Don’t charge patients who exceed therapy cap without signed ABN

06/06/2013

This week’s benchmark shows you the top 10 therapy codes billed under Medicare for 2011, the most recent data year available. Be especially vigilant to double-check the patient’s status against the therapy cap when billing any of these services and use an ABN when you believe the patient will exceed the cap.

Experiment engages primary care patients and providers

06/01/2013

by: Chelsea Rice

At the 2013 Association for Health Care Journalists Conference, a panel of New England primary care providers highlighted what needs to be done for the future. One panelist outlined an experiment happening at one of the oldest and largest hospitals in New England-one that, if successful, could redefine the provision of primary care.

Does primary care need to be retooled?

06/01/2013

by: Joe Cantlupe

The president of Partners Healthcare and a Harvard University economist contend that primary care in the U.S. needs to be restructured to improve physician business practices and provide more value for patients.

Physicians say quantity of EHR alerts 'excessive'

06/01/2013

by: Chelsea Rice

Doctors are missing three in 10 patient test results generated by electronic health record systems, research shows. The problem is a matter not only of volume, but of how alerts are communicated.

The rush and resistance to tech

06/01/2013

by: Scott Mace

Resistance to new technology may be futile, but it remains an issue for healthcare.

IPAB repeal arguments weak, for now

06/01/2013

by: Philip Betbeze

Removing Congress from the process of making decisions about Medicare payments might be a way to get some control over healthcare costs.

Colonoscopy 'potentially inappropriate' for 30% of seniors

06/01/2013

by: Cheryl Clark

Some providers are overusing colonoscopy for screening purposes in older adults. Research shows wide regional variations in the practice.

EHR a money-loser for most physicians

06/01/2013

by: John Commins

Adopting electronic health records (EHR) appears to be a money-losing proposition for most physicians, especially specialists and those in smaller physician groups.

SGIM calls for end to fee-for-service

06/01/2013

by: John Commins

Fee-for-service medicine is a financially unsustainable payment model that should be phased out by the end of the decade, a study commissioned by the Society for General Internal Medicine (SGIM) recommends.

Is sequester cut allowed on Medicare Advantage payments? Check your contract

05/24/2013

by: Roy Edroso

Some Medicare Advantage payers are passing along the 2% sequester cut to providers. Experts say that, in some cases, they shouldn’t — but it will be difficult to challenge the pass-through, especially if you haven’t been careful about the language in your contracts.

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