You and your peers show greater frustration with carriers over enrollments and appeals when compared to other services such as claims processing. The latest Medicare Contractor Provider Satisfaction Survey details your carrier's strengths and weaknesses - and carriers ranked the worst in the areas of enrollment and appeals. When you know your carrier struggles in a specific area, you may need to spend more time and effort when you engage the carrier in that area.

Don't be surprised when your new provider receives a reminder regarding enrollment from CMS soon after he or she begins providing services. CMS wants providers to close out enrollment at previous employers by using the CMS-855I application, according to Transmittal 307.

Providers heavily utilized these measures when attempting to meet requirements to earn bonus payments from the Physician Quality Reporting Initiative (PQRI) in 2008 (see story, pg. 1), according to a Part B News analysis of CMS billing data for that year.

This week's question is answered by Regan Bode, CPC, senior consultant for DecisionHealth Professional Services.

Q.   Help us settle this dispute. A colleague insists it could be fraud if we don't take and note the patient's vitals at every office visit. I can't find anything in the 1995 E/M guidelines that indicates we must get the patient's vitals for every visit and I can't find anything on the Medicare website. Could you direct us to some guidance?

Juries are ready and eager to shower aggrieved litigious former employees with millions of dollars at your business’ expense.

Because of CMS, providers have access to free resources to help them prepare for the transition to ICD-10. CMS and the CDC have created a set of tables that crosswalk the two versions of disease classifications.

As lawmakers toy with potentially massive healthcare reform this year, it is becoming increasingly clear that changing financial incentives, digitizing records, and tracking outcomes can only go so far in reducing healthcare costs and improving quality. Fixing the healthcare crisis will only be effective if everyone—patients, providers, payers, and politicians—start paying more attention to the health crisis.

Hiring the right physician to work in your practice for the long haul can be daunting, especially if you’re replacing a successful partner who is retiring or if your practice has a high turnover rate. Before you write a job description or call any candidates for an interview, take the time to create a detailed plan for effective and sustainable physician recruitment and retention.

Health insurers are paying physicians 5% faster and denying 9% fewer medical claims than in 2008, but there is still room for improvement for some payers, most notably state Medicaid programs, according to athenahealth’s fourth annual PayerView Rankings.

The final version of the 2010 Medicare Physician Fee Schedule (PFS) will eliminate consultation codes and sets the conversion factor at $28.4061 -- a drop of 21.2% as mandated by the sustainable growth rate (SGR) formula.