Part B News
04/01/2011

Many physician practices have embarked on creating the structures and procedures that constitute a patient-centered medical home and are convinced the concept not only provides better care for patients, but also reduces costs for the practice, patients, and payers in the long run.

04/01/2011

Making your physician practice into a patient-centered medical home can seem like a daunting proposition.  But don't let being "too small" be your excuse to avoid the medical home model. Practices don't get much smaller than that of ­Joseph Mambu, MD. And he's doing it.

 

 

04/01/2011

With practices struggling to get every possible dollar out of their managed care contracts, sometimes the idea of ­capitation can be appealing. Why not agree to a set amount for each patient rather than hoping to make enough on ­procedure charges?

04/01/2011

The Southern California Permanente Medical Group's patient care system, known as "The Proactive Office Encounter Approach," appears to reflect what healthcare reform is all about, with designs on improving quality and establishing data to back up what it does, working toward a clean slate of transparency.

04/01/2011

Eight guidelines to establish a high performing patient-centered medical home.

04/01/2011

After 25 years of capitation, one Texas physician practice has found that it can be the key to financial success, but only when structured just right.

04/01/2011

As further proof that Americans need to be enlightened on how to access effective healthcare, a new survey from the AMA finds far too many patients don't know which providers have physician credentials and which do not.

 

03/28/2011

You are not required to convert any of your existing paper records to electronic records in order to show meaningful use and earn $18,000 of federal incentive money in 2011 or 2012, Part B News has learned. Previous coverage had stated that you needed to convert at least 50% of your paper records into electronic health records (EHRs) in order to meet meaningful use.

03/28/2011

You must furnish to your Medicare Administrative Contractor (MAC) as part of the enrollment process every CPT code for advanced imaging your providers bill, a change that hits in 2012 thanks to the advanced imaging accreditation rule. You would also need to enter every type of scanning modality (e.g., CT of sinuses and CT of abdomen are two separate modalities that must be entered separately) you use.

03/28/2011

You are allowed to bill an E/M visit in the same encounter as the new annual wellness visit (AWV) when you can prove medical necessity. CMS has softened its threat to prohibit this, Part B News has learned. The key: To bill the E/M with the AWV, append modifier 25 (significant, separately identifiable E/M, same physician/same day) to the E/M code and be able to show that clinical circumstances warrant this in your documentation, CMS says.
 

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