By Dr. Richard E. Wild, M.D., FACEP Chief Medical Officer Centers for Medicare and Medicaid Region IV (AL, Fl, GA, KY, MS, NC, SC, TN) Medicare is taking steps to remove Social Security numbers from Medicare cards. Through this initiative the Centers for Medicare & Medicaid Services (CMS) will prevent fraud, fight identity theft, and protect essential program funding and … [Read more...] about 5 ways for healthcare providers to get ready for new Medicare cards
Billing & collections
Pain clinic agrees to pay $1.78 million to settle whistleblower lawsuit
Ross Feller Casey, LLP, recently announced that the Atlantic Spine & Joint Institute and its owners, Robert C. McGrath, Sr., D.O., and Robert C. McGrath, Jr., have agreed to pay $1.78 million to settle a whistleblower lawsuit alleging they billed Medicare for procedures that were not medically necessary or were not actually performed. The father and son also pleaded guilty … [Read more...] about Pain clinic agrees to pay $1.78 million to settle whistleblower lawsuit
How to determine your MIPS participation status
Are you unsure of your participation status in the Merit-based Incentive Payment System (MIPS)? Clinicians can now use an interactive tool on the CMS Quality Payment Program website to determine if they should participate in the MIPS track of the Quality Payment Program in 2017. To determine your status, enter your national provider identifier (NPI) into the entry field on … [Read more...] about How to determine your MIPS participation status
3 legal protections to include in your patient debt collection agency services contract
Outsourcing can be an effective way to overcome patient collection challenges. But it can also backfire if the collection agency you contract with uses illegal, unethical or insensitive collection tactics. One of the keys to managing these risks is to include proper legal protections in your services contract. This article covers the three legal protections you should include … [Read more...] about 3 legal protections to include in your patient debt collection agency services contract
CMS extends 2016 PQRS EHR submission deadline
CMS is extending the submission deadline for 2016 Quality Reporting Document Architecture (QRDA) data submission for the Electronic Health Record (HER) reporting mechanism. Individual eligible professionals (EPs), physician quality reporting system (PQRS) group practices, qualified clinical data registries (QCDRs), and qualified EHR data submission vendors (DSVs) now have … [Read more...] about CMS extends 2016 PQRS EHR submission deadline
Don’t know what MACRA will require of your practice? You’re not alone
According to a recent survey conducted by Kareo, a provider of clinical and business management software for independent medical practices, 84% of independent physicians and staff aren't sure what MACRA's Quality Payment Program (QPP) will require of their practice. Despite this uncertainty, most of these same physicians expect to participate in it to the best of their … [Read more...] about Don’t know what MACRA will require of your practice? You’re not alone
4 steps to preventing medical claim denials
By Ricki Ransom bio It's no secret that the relationship between health care providers and insurance companies is complicated. Healthcare providers are spending a significant amount of time and energy with patients just to find out that an insurance company will fight them on paying for the services provided. Preventing claim denials helps ease the complications … [Read more...] about 4 steps to preventing medical claim denials
By following strict procedures, New York office has ‘a stellar year’
A three-physician New York City surgery practice had a stellar year. It attributes its success to the fact that everybody follows strict and detailed procedures. Procedures produce efficiency, says Veronica L. Mogerman, administrator at Manhattan Surgical Associates. And efficiency means the office operates at top capacity and staff give patients top quality service, which … [Read more...] about By following strict procedures, New York office has ‘a stellar year’
Answering your questions about MACRA
Understanding the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is vital because it changes how Medicare pays physicians for services as well as care delivery. It moves away from fee for service to value-based care. Not understanding the new policies, passed on October 14, 2016, will result in a penalty of negative 4 percentage! Those who work in the healthcare … [Read more...] about Answering your questions about MACRA
Should your practice invest in medical billing software?
By Aiden Spencer bio There has been considerable debate among physicians about whether or not it is beneficial to get an EHR (electronic health record). If your practice is having this debate, let's evaluate the benefits and problems associated with an EHR and see if one is right for you. [Full disclosure: I have abundant experience in the field because I am working for a … [Read more...] about Should your practice invest in medical billing software?