Independent physician practices are slowly fading away, and with the advent of healthcare reform, the pace may be about to get much quicker. It's only one of a few troubling signs about the physician labor pool, which seems increasingly dissatisfied with their career choice and the direction of the healthcare industry.

When it all becomes too much-the falling revenue, the long hours, the hassle of working with third-party payers, the uncertainty of what the healthcare system will look like five years from now-many physicians dream of getting out. But there is another option that might appeal to them.

The AMA's House of Delegates' vote in November 2011 to "vigorously work to stop" the "onerous" implementation of ICD-10, due in just 22.5 months, caught some healthcare leaders by surprise.

When physician practices merge or integrate with hospitals or health systems, healthcare leaders say integration of practice teams and compensation are the biggest challenges. Trust ranks well down the list, according to a recently released HealthLeaders Media Intelligence Report. In reality, though, trust is at the heart of successful mergers of physician practices-and lack of trust contributes greatly to failure.

Diamantoni & Associates of Lancaster, PA, attested to Stage 1 of meaningful use recently, resulting in the five-office practice and 18-provider group receiving more than $300,000 in federal incentive payments. Along the way they learned a few lessons that might help other practices, says health information technology consultant Christine Kelly of CMK Consulting, who helped Diamantoni with its EMR implementation.

Your Medicare payments will be docked 1% if your e-Prescribing (e-Rx) hardship exemption request for the e-Rx Incentive Program is still pending or if you listed your group national provider identifier (NPI) instead of your individual NPI on your exemption, Part B News has learned.

Your Physician Quality Reporting System (PQRS) bonus payment for services rendered in 2011 is at risk if you don’t act by Feb. 24, Part B News has learned. Seven G-codes related only to the PQRS measures were inadvertently deleted during CMS’ transition to HIPAA version 5010 last year, resulting in rejected claims, CMS says.

You can turn annual wellness visits (AWVs) into part of your revenue solution, not part of the problem, by billing Medicare for this non-deductible service repeatedly, offsetting the financial woes typically seen in the first quarter. A two-physician primary care practice in Georgia got $25,000 alone from AWVs in last year's Q1.

While it’s no fun undergoing a routine billing audit from a private payer, it’s usually just part of doing business. But your relationship with a payer can really take a nosedive if you end up investigated by a payer’s “special investigations unit” (SIU). Unlike a general payer audit, SIUs specialize in combating fraud, waste and abuse, typically launching an investigation once a larger billing problem has been identified by the payer.

This chart presents 10 heavily-billed codes along with the potential Medicare payment increase these codes would have seen nationally were it not for denials. The data labels represent 2010 potential increases, but are graphed alongside the 2009 figures as a comparison. These percentages were derived by dividing the total denial amount for each code by the total Medicare payment for that code. The resulting percentage represents how much the overall Medicare payment for the codes would have increased if zero denials were issued.