Part B News
Take preliminary HIE precautions now that HHS has released proposed rule
12/03/2012
by: Ben Penn
Prepare your practice to treat patients covered in a vastly different private insurance structure in 2014, now that HHS has defined the list of essential health benefits and other provisions of health insurance exchanges (HIEs) in a proposed rule.
 
Map out next year’s Medicare revenue in 2013 with or without SGR cut
12/03/2012
by: Lauren C. Williams
To help determine how much revenue your practice will collect for certain codes in 2013, the following chart contains current and projected payments for 20 misvalued codes that will see a drop in relative value units (RVUs) – and pay – next year.
Take note of OIG 2013 Work Plan repeat targets
12/03/2012
by: Julia Kyles
Repeat targets on the HHS Office of Inspector General’s (OIG’s) 2013 Work Plan indicate that OIG is warning you that auditors are less likely to be understanding if they find these errors in your claims. That could leave your practice owing CMS thousands of dollars for botched claims.
 
Benchmark of the Week: Top 10 high-growth, high-denial codes, 2010-2011
12/03/2012
by: Ben Penn
A variety of procedures top the list of high-denial codes that also saw a big jump in utilization from 2010 to 2011, the latest year for which CMS claims data is available. Note: Lab codes and supply codes were excluded from analysis, as were codes with low utilization, low denial rates and/or low utilization growth over the one-year period.
How to make a medical home deliver
12/01/2012

by Philip Betbeze

Family physicians rap 'stopgap' use of nurse practitioners
12/01/2012

by John Commins

ACA could have dramatic effect on physician reimbursement
12/01/2012

Brace now for what is sure to be a major upheaval in your payment system. The Affordable Care Act (ACA) will change American healthcare in countless ways, but one of the most direct may be how it affects managed care reimbursement for physicians.

Physician fee proposal generates calls for changes
12/01/2012

by Margaret Dick Tocknell

Data changes the doctors' game
12/01/2012

by Joe Cantlupe

Update the medical staff's definition of active category to ­promote leadership opportunities
12/01/2012

Back in the "old days," physicians who practiced in the community also practiced in the hospital, so defining who belonged in the active category was a breeze. But with the advent of hospitalists, medical staff categories have blurred, and it's beginning to affect which physicians can serve as medical staff leaders. Traditionally, medical staff bylaws require leaders to be in the active medical staff category, but as more physicians are handing their patients off to hospitalists, fewer and fewer meet the required number of patient contacts to qualify for the active category.

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