Why you need this policy:
BILLING & COLLECTIONS
Model Policy: Patient Billings Collection and Financial Policy
March 13, 2023 by
CMS
Reminder: 2022 MIPS data submission period ends March 31
March 8, 2023 by
MIPS Eligible clinicians can submit their 2022 data through March 31. The Centers for Medicare & Medicaid Services (CMS) has opened the data submission period for Merit-based Incentive Payment System (MIPS) eligible clinicians who participated in the 2022 performance year of the Quality Payment Program (QPP). Data can be submitted and updated until 8 p.m. ET March 31. How to submit your 2022 MIPS data Clinicians will follow the steps outlined below to submit their data: Go to the Quality Payment Program sign in page. Sign in using your QPP access credentials (see below for directions). Submit your MIPS data for the 2022 performance year or review the data reported on your behalf by a third party. (You can’t correct errors with your data after the submission period, so it’s important to make sure the data submitted on… . . . read more.
INCREASING PROFITS
Track these 5 metrics for practice profitability
January 6, 2023 by
By Mike Rigert “It was the best of times, it was the worst of times … , ” wrote author Charles Dickens in his classic novel, “A Tale of Two Cities.” While it’s certainly not the worst of times for most healthcare practices (that honor likely went to 2020-2021), things could always be better, right? You’re likely still dealing with the impacts of rampant inflation and ongoing short staffing, among other things. Despite these setbacks, there’s clear opportunities to move your practice forward to improve both production and productivity to help you reach your financial goals. It all goes back to numbers—the key performance indicators (KPIs) that determine whether your practice sinks or swims. Some metrics are more important and vital to the success of your practice than others. We’ve outlined five… . . . read more.
COVID-19
Jan. 3 deadline for MIPS Extreme and Uncontrollable Circumstances application
December 15, 2022 by
The deadline to submit a MIPS EUC Exception application for the 2022 performance year is 8 p.m. ET on Jan. 3, 2023. If you believe you’ve been affected by an extreme and uncontrollable circumstance (such as the public health emergency triggered by the COVID-19 pandemic), you can apply whether reporting traditional MIPS or the APM Performance Pathway (APP). MIPS eligible clinicians, groups, and virtual groups may submit an application to reweight any or all MIPS performance categories if they’ve been affected by extreme and uncontrollable circumstances that impact these performance categories. Alternative Payment Model (APM) Entities may submit an application but are required to request reweighting for all performance categories. Beginning in the 2023 performance year, clinicians will also have the option to report via the MIPS Value Pathway (MVP)s framework instead of traditional MIPS. Learn more: CMS’s Current Emergencies Medicare IFC: Revisions in Response… . . . read more.
BILLING & CODING
Telehealth policy to change after the COVID-19 public health emergency
September 1, 2022 by
The COVID-19 public health emergency has been extended to Oct. 13. Of particular interest to medical practices is the continuation of telehealth flexibilities, which will expire at the end of the public health emergency. US Department of Health and Human Services Secretary Xavier Becerra officially renewed the declaration in mid-August. The emergency declaration has been in place since January 2020, and the latest renewal came as the Omicron offshoot BA.5, the most contagious variant yet, continues to stake its claim in the US. Daily case rates, though vastly undercounted, are the highest they’ve been in months, as are COVID-19 hospitalizations and deaths. Data published in August by the US Centers for Disease Control and Prevention shows that more than half of the country’s population lives in a county with a… . . . read more.
STAFFING
Is it a recession or not? The answer may surprise you
August 11, 2022 by
By Lynne Curry My in-box filled with questions after I posted a Recession Fears Loom blog. Readers asked how I made sense of the different views voiced by economists and politicians. As a medical office manager with responsibilities around staffing and profitability, you are probably watching to see which way the economy goes. Here’s the background, and my answer to “are we headed into a recession?”: Some say “yes.” Over 60 percent of the 750 CEOs surveyed by the business research firm Conference Board expect a recession in the next 12 to 18 months1. Another 15 percent of surveyed CEOs report their region is already in recession.1 The most recent gross domestic product report that tracks our overall economic health showed a second consecutive quarter of negative growth, the textbook… . . . read more.
BILLING & COLLECTIONS
Medicare covering OTC COVID-19 tests
April 4, 2022 by
Starting this week and through the end of the COVID-19 public health emergency (PHE), Medicare covers and pays for over-the-counter (OTC) COVID-19 tests at no cost to people with Medicare Part B, including those with Medicare Advantage (MA) plans. In addition to helping prevent the spread of COVID-19, the goal is to find out if Medicare payment for OTC COVID-19 tests will improve access to testing and result in Medicare savings or other program improvements. What’s covered Eligible providers or suppliers can distribute U.S. FDA-approved, authorized, or cleared OTC COVID-19 tests to patients enrolled in Part B, including those enrolled in MA plans. Patients who only have Medicare Part A can get free OTC COVID-19 tests through other government-led programs, like covidtests.gov, which operates through the United States Postal Service (USPS). Or,… . . . read more.
MOM WEBINAR
Learn about changes and updates to telehealth
March 25, 2022 by
There’s a lot you need to know about telehealth. That’s why Medical Office Manager is offering a webinar, Telehealth—What Managers Need to Know, on April 6. It’s free to Medical Office Manager members. Presenter Jen Bell of Karen Zupko and Associates will give you the tools and knowledge you need to comply with new telehealth regulations. Meanwhile here is Jen’s update on telehealth changes to early 2022. POS 10 Telehealth Provided in Patient’s Home Patient is located in their home (which is a location other than a hospital or other facility where the patient receives care in a private residence) when receiving health services or health related services through telecommunication technology. Home may be defined to include temporary lodging (hotels, homeless shelters) and patient travels of short distance from the exact… . . . read more.
BILLING
Newly proposed Medicare Part B Physician Fee Schedule contemplates Making COVID-19 telehealth changes permanent
July 22, 2021 by
On July 13, 2021, CMS published its proposed physician fee schedule rule for FY 2022. One of the key items is the proposal to make the temporary change allowing Medicare providers to deliver healthcare services via telehealth a permanent part of Medicare Part B. The Proposed Medicare Changes During the public health emergency (PHE), Congress added the home of the beneficiary as a permissible originating site for telehealth services for the purposes of diagnosis, evaluation or treatment of a mental health disorder. In addition to updating the fee schedule, the proposed CY2022 rule would allow certain services added to the Medicare telehealth list to remain on the list until the end of December 2023. This would allow CMS to continue to evaluate whether the temporary expansion of telehealth services adopted… . . . read more.
BILLING
New federal rule to protect consumers from surprise medical bills
July 13, 2021 by
The Biden-Harris Administration has announced a rule to protect consumers from surprise medical bills. The U.S. Departments of Health and Human Services (HHS), Labor, and Treasury, and the Office of Personnel Management, issued “Requirements Related to Surprise Billing; Part I,” an interim final rule that will restrict excessive out of pocket costs to consumers from surprise billing and balance billing. Surprise billing happens when people unknowingly get care from providers that are outside of their health plan’s network and can happen for both emergency and non-emergency care. Balance billing, when a provider charges a patient the remainder of what their insurance does not pay, is currently prohibited in both Medicare and Medicaid. This rule will extend similar protections to Americans insured through employer-sponsored and commercial health plans. “No patient should… . . . read more.
