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
Billing & collections
Improving your revenue cycle efficiency
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
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
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
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
Deadline to submit a MIPS Targeted Review Request is this month
If you participated in the Merit-based Incentive Payment System (MIPS) in 2018, your performance feedback, which includes your MIPS final score and payment adjustment factor(s), are now available for review on the Quality Payment Program website. The MIPS payment adjustment you will receive in 2020 is based on your final score. A positive, negative, or neutral payment … [Read more...] about Deadline to submit a MIPS Targeted Review Request is this month
Why you need an office policy on collecting fees
Most medical practices take time once a year to create new office goals or a business plan and, hopefully, to upgrade their policy manuals. And consideration of collecting on co-pays and deductibles needs to be an integral part of that business plan, according to Michael Glass, a medical consultant with Transworld Systems Inc. (TSI). Why bother with an office policy? The … [Read more...] about Why you need an office policy on collecting fees
Missouri staff train each other on solving the day-to-day issues
The best staff training, says a Missouri medical office manager, is the training staff give one another. At the OB/GYN office, staff do just that. They hold training sessions for one another on a "when-needed, what's-needed, and who-needs-it" basis. The office has four physicians and 25 staff. There's no set routine. The manager simply schedules an in-service whenever she sees … [Read more...] about Missouri staff train each other on solving the day-to-day issues
Doctors pay $1.1 million to settle genetic test kickback claims
Kickbacks for genetic test referrals has become a focus of recent federal enforcement action. The most recent case involves three doctors and a cardiology practice that allegedly accepted bribes from a now-bankrupt genetic testing company in the Seattle area. The DOJ claims that Natural Molecular Testing Corporation (NMT) paid doctors as much as $10,000 per month in consulting … [Read more...] about Doctors pay $1.1 million to settle genetic test kickback claims
What you need to consider before getting started in telemedicine
By Nick Hernandez bio Many practices are hearing about telemedicine and becoming increasingly interested in how such a program could be implemented in their operations. Physicians want to start a telemedicine program quickly. Practice managers don't want to learn by trial and error. The biggest issue I see by far is that practices immediately focus on the technology. … [Read more...] about What you need to consider before getting started in telemedicine