Physician practices facing Medicare Administrative Contractor (MAC) transitions suffered from millions of dollars in delayed payments and lengthy hold ups appealing denied claims, according to a new Government Accountability Office (GAO). Outgoing carriers left new MACs with significant enrollment application and appeals case workloads, according to the report. Let it serve as a warning to you and your peers facing future MAC transitions.

Stay connected to the Part B News team by following @PartBNews on Twitter. The Part B News Twitter service is an extension of the news coverage you receive in the weekly newsletter and daily updates to www.partbnews.com. On Twitter you will be notified of the latest CMS news, blog posts and physician practice information from medical societies and your peers. Twitter also allows you to interact with Part B News editors and network with your peers.

Delete or throw out copies of any blank Electronic Fund Transfer (EFT) Authorization Agreement forms on your computer or in your office. CMS has updated the CMS-588 form you use to enroll in the Medicare program or update your banking information.

You're once again just a few weeks away from Medicare physician reimbursement rates dropping 21.3%. Congress needs to fix the payment formula with a bill known as a "pay fix" or "doc fix" by the end of the month. Otherwise, you'll risk CMS holding claims or paying for services at the reduced rate (PBN 4/26/10).

How quickly are you getting paid by payers? Find out by using the Part B News' Tool of the Month, a Documentation of Insurance Turnaround worksheet, to see how quickly a payer or payers are paying your claims.

Surgical specialties and those associated with major procedures have the greatest denial rates in the two major inpatient settings, CMS data shows. The place of service (POS) doesn't appear to make a major difference in denial rates by specialty in the inpatient settings, similar to last week's analysis of outpatient settings (PBN 5/3/10).

Can ancillary staff record the chief complaint for an E/M visit as long as the physician is clear in notes that he reviewed and possibly expanded upon the information?

Your peers tend to fight denials only when confident CMS was wrong, which results in high levels of success on appeals and avoids wasting time and money on lost causes, a Part B News survey shows. Nearly 86% of survey respondents say more than half of their appeals are successful, with about 53% reporting success in 75% of appeals filed.

Survey data shows the key to a successful appeals strategy is to focus your efforts on the denials you know you can win and avoid wasting time when the payer's decision is most likely correct (see survey results and analysis). Your challenge is to quickly spot winnable denials.

We're having difficulty determining when it is appropriate to bill for a skin biopsy. Some of our clinicians believe they can bill a biopsy only when they use specific methods for removing the suspect lesion. I don't believe this is correct. Could you point me to some documentation that provides guidance?