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In This Issue:
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Medical Homes: What They Mean and How to Be PreparedBy Elizabeth W. Woodcock, MBA, FACMPE, CPC
Is a medical home in your future? Along with its endorsement by major primary care organizations, the medical home gained further traction with the passage of national health care reform legislation that embraces several of the concept’s guiding principles. In response, many primary care physicians are… Complimentary Webinar – Guarding Your Revenue: How to Prevent and Uncover Embezzlement
Thursday, November 10, 2011
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Case Study“I am paying 20 percent of what I had been paying before Kareo. Lower costs have improved our overall functioning as a business.”
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Case Study“Thank you, Kareo. I do not exaggerate when I say you helped me save my business!”
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Billing Tip of the Month
Avoiding CO-16 Denials for Missing Information
Bob Nichols, Medical Billing Services & Solutions
CMS requires that immunizations and injectible drugs include the 11 digit NDC code be submitted on the claim. The FDA website and the packaging label generally only list 10 digits... Read More
Top News and Ideas from Industry
CMS Revises Physician Pay Cut Down to 27.4%
The Advisory Board Company, Nov. 2, 2011
CMS issued final rules for hospital and physician payments in calendar year (CY) 2012, outlining a 27.4% cut in physician reimbursement and finalizing new quality metrics. Current law requires Medicare to reduce physician payments under the controversial sustainable growth rate (SGR) formula, and CMS originally proposed a 29.5% cut in physician reimbursement ... Read More
Decline in Doctor Office Visits Could Be Permanent
Emily Berry, Amednews, Oct. 31, 2011
The number of visits patients make to physicians in a given month -- a vital sign for the whole health care economy -- has been declining consistently, according to multiple tracking studies, companies and researchers. Studies suggest that recent declines reflect cost-conscious patients training themselves to avoid making an appointment unless they believe it's absolutely necessary… Read More
CMS Redesigns Medicare ACOs to Be More Appealing to Physicians
Charles Fiegl, Amednews, Oct. 31, 2011
The Obama administration's final rule on Medicare accountable care organizations removes several proposed conditions on participants in an effort to make the new shared savings payment model more enticing to physicians and other key players… Read More
Medicare Auditors Find $593 Million in Incorrect Payments
Charles Fiegl, Amednews, Oct. 20, 2011
More than half a billion dollars in improper payments has been uncovered by Medicare auditors during the first nine months of the 2011 fiscal year. The amount far exceeds what Medicare recovery audit contractors, or RACs, found in 2010… Read More
CMS Previews 2012 MPFS Final Rule, Moves Closer to Pay for Performance
AAPC News, Nov. 2, 2011
The Centers for Medicare & Medicaid Services (CMS) released a sneak peek at the final rule Nov. 1, with comment period that will update payment policies and rates for physicians and nonphysician practitioners (NPPs) for services paid under the Medicare Physician Fee Schedule (MPFS) in 2012… Read More
2012 HCPCS II Available With Over 430 Changes
AAPC News, Nov. 1, 2011
The Centers for Medicare & Medicaid Services (CMS) released the HCPCS Level II codes that go into effect Jan. 1, 2012, on Oct. 31. Changes include 285 code additions (and one new modifier), 48 revisions, and 75 deletions. Another 18 codes were added and eight deleted throughout 2011… Read More
Medicare Covers Additional Preventive Services
AAPC News, Oct. 28, 2011
The Centers for Medicare & Medicaid Services (CMS) announced, Oct. 14, in two national coverage determinations (NCDs) that it will add to the list of preventive services by covering alcohol misuse screening and behavioral counseling, as well as screening for depression… Read More
Report: Less Than 10% of Providers Are Halfway Completed in ICD-10 Transition
Bob Herman, Becker’s ASC Review, Nov. 3, 2011
Less than 10 percent of healthcare providers are more than halfway ready in terms of being fully prepared for ICD-10, according to a KLAS report. A patient accounting director in the report also said "meaningful use is a cakewalk compared to ICD-10"... Read More
Using GEMs: How to Navigate ICD-10 Crosswalks
ICD-10 Watch, Nov. 1, 2011
If you're just starting your ICD-10 implementation planning, the General Equivalency Mappings (GEMs) could look like a tempting shortcut. But GEMs are too limited to be a reliable coding tool, says Patrick McNeese, business solution manager and ICD-10 practice lead… Read More
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