Your chances of defeating an overpayment demand from one of CMS's Recovery Audit Contractors (RACs) is very high when you can show the claim should be paid, according to the latest data on appeals filed against RACs during the program's three-year demonstration.

This chart examines states with a high intensity of specialty work, as measured by the number of services billed by specialists versus those billed by primary care practices. This figure is represented by the ratios that appear above each bar in the chart.

You are required to select five of these 10 objectives when attempting to earn the EHR incentive of up to $18,000 in 2011. Part B News featured the 15 core objectives for the program in last week's issue (PBN 7/19/10).

You won't easily find electronic health record (EHR) products on the market right now that will meet CMS's meaningful use requirements (see story), industry insiders say. The AMA says this remains a prominent challenge for you and your peers to meet the meaningful use requirements despite the simplification of EHR measures.

We continue to have problems understanding the correct billing process when a patient is in observation, then admitted to the hospital. Example: We billed 99218 ($64.90), for observation care for June 10. The patient is admitted to the hospital and on June 11, we bill 99221 ($97.34) for the initial hospital care done by the same physician.

Your non-physician practitioners (NPPs) stand to benefit from a major health reform provision in the proposed 2011 physician fee schedule (PFS). Physician assistants, nurse practitioners and certified clinical nurse specialists are eligible for a 10% bonus to their payments for primary care services, but there's a catch, an NPP Report analysis shows.

This chart looks at the intensity of non-physician practitioner (NPP) work, as measured by the average number of claims billed by each type of NPP. NOTE: Because Medicare claims data only shows NPP utilization when NPPs bill under their own national provider identifier (NPI), this data excludes all NPP services that were billed incident-to.

New CMS signature requirements can trigger retroactive incident-to denials when a plan of care authored by a physician doesn't contain a valid signature (PBN 3/22/10).

Does a PA have to be credentialed with Medicare to see patients "incident to" a medicare credentialed physician in the practice?

CMS softened several meaningful use requirements in its final rule released July 13 for the Electronic Health Record (EHR) Incentive Program. Your physicians will have an easier time getting up to $44,000 in Medicare bonuses for using health information technology (HIT). The biggest change: The final rule reduces the number of meaningful use requirements you must satisfy to earn incentive payments.