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Billing & collections

Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing

August 4, 2020

CMS and the Centers for Disease Control and Prevention (CDC) have announced that payment is available to physicians and health care providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the onset of symptoms. The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and … [Read more...] about Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing

Protecting your medical practice during uncertain times

April 9, 2020

By John W. McDaniel bio Given the recent disruption and decreased demand for physician office services, coupled with the foreboding predictions associated with the COVID-19 pandemic, both hospital- affiliated and private medical practices are having to adjust their operations in order to provide billable patient care services while salvaging the cash flow/liquidity of the … [Read more...] about Protecting your medical practice during uncertain times

CMS to launch new MIPS Participation Framework in 2021 Performance Period

January 21, 2020

CMS is implementing a new participation framework for the Merit-based Incentive Payment System (MIPS), called the MIPS Value Pathways (MVPs), starting with the 2021 performance period. The goal of this new framework is to move away from siloed performance category measures and activities, and move toward an aligned set of measures and activities that are more meaningful to … [Read more...] about CMS to launch new MIPS Participation Framework in 2021 Performance Period

MIPS 2020 payment adjustments in effect based on 2018 performance

January 15, 2020

In July 2019, each Merit-based Incentive Payment System (MIPS) eligible clinician received a 2018 MIPS Final Score and associated payment adjustment factor(s) as part of their 2018 MIPS performance feedback, available on the Quality Payment Program website. 2020 MIPS payment adjustments, based on each MIPS eligible clinician’s 2018 MIPS final score, will now be applied to … [Read more...] about MIPS 2020 payment adjustments in effect based on 2018 performance

5 ways to break down bureaucracies to get payer contracts

January 4, 2020

By Steve Selbst bio It is important to remember that payers are large companies, with protocols, policies and business practices. As with any large company, there are bureaucracies, and they are necessary to maintain the order and success of these organizations. Therefore, the first tip is to understand that to get contracted you need to identify the right department and … [Read more...] about 5 ways to break down bureaucracies to get payer contracts

Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme

November 18, 2019

You know that a branch of lab testing has gone from fad to mainstream when it becomes the subject of a major federal enforcement takedown. Accordingly, the newly announced breakup of a $2.1 billion genetic billing fraud scam, one of the largest Medicare frauds ever undertaken, signifies that genetic testing has officially arrived. Operation Double Helix Known as Operation … [Read more...] about Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme

Improving your revenue cycle efficiency

October 4, 2019

Modern medical practices are experiencing immense pressures as a result of increased regulatory scrutiny, changing reimbursement mechanisms, and a shift toward more patient-focused care. Revenue cycle management is particularly challenging, given all the complex rules, the number of people involved, and the tools and systems used to capture and process the information, … [Read more...] about Improving your revenue cycle efficiency

Getting that new patient info into EHR before appointment

September 27, 2019

Here are some reader tips for getting new patient information into the electronic health records prior to an appointment. They come from Tina Wheeler, Practice Manager for General and Laparoscopic Surgical Associates in Maryville, Il. This busy multi-physician general surgery office has four physicians and one nurse practitioner, with patients scheduled among these five … [Read more...] about Getting that new patient info into EHR before appointment

CMS releases 2020 Proposed Rule for the Quality Payment Program

September 20, 2019

The Centers for Medicare & Medicaid Services (CMS) has released its proposed policies for the 2020 performance year of the Quality Payment Program via the Medicare Physician Fee Schedule (PFS) Notice of Proposed Rulemaking (NPRM). Key proposals for 2020 performance year of the Quality Payment Program include: Increasing the performance threshold from 30 points to … [Read more...] about CMS releases 2020 Proposed Rule for the Quality Payment Program

MIPS bonuses are easy to earn—IF you can get into the program

September 20, 2019

The Centres for Medicare and Medicaid Services (CMS) has announced the results of 2018, Year 2 under the Merit-based Incentive Payment System (MIPS). Bottom line: The total number of clinicians participating declined from 1.06 million to 916,058. However, the success rate of participants was higher with 97.6% earning an upward payment adjustment on their Medicare Part B claims … [Read more...] about MIPS bonuses are easy to earn—IF you can get into the program

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