Join The webinar

Be a part of this free webinar on Ob/Gyn Coding challenges and get your biggest questions answered.

Lisa Maciejewski-West
CMC, CMOM, CMIS, MCS-P

Register Now

Medical Billing Services | Medical Billing Company Checklist

The EMR Billing Specialists

  • Home
  • Services
  • Payments
  • Company
  • Contact

Are you worried about HIPAA audits? Tips to come out unscathed!

June 3, 2014 by Ango Mark Leave a Comment

Are you worried about HIPAA audits? Tips to come out unscathed!

Don’t let a HIPAA audit catch your practice off-guard!

HIPAA audits are painful and unwelcome. But failing an audit can be a disastrous and a huge blow to the reputation of medical practices. Despite guidelines being formulated every other day, there is, very little coordinated effort being taken by healthcare organizations to meet them. Failure to prepare is preparing to fail.

Put these ten tips into action to prevent your medical practice from penalized by auditors. It is a team effort so rope in employees and make a cohesive effort, to stay HIPAA compliant. There are lot of plates spinning and deadlines to meet. So it is important you chalk up a plan and tick things off a checklist to stay on track and move towards complete HIPAA compliance.

  • Run a thorough end to end risk analysis check across the entire organization. Check your documentation management and informational security policies.
  • Devise clear cut policies such as passwords for accessing information and that all images such as scans are securely encrypted.
  • Invest in workforce training. Conduct regular workshops for all your employees on operating procedures and security protocols.
  • Monitor closely if all the newly implemented procedures are working in the first place. Check and re-check the progress of each strategy created to meet HIPAA guidelines.
  • Keep clinical documentation updated and maintain a report of your security procedures and documentation. This will help when auditors ask for evidentiary documents.
  • Create a contingency plan. In a landscape that is constantly shifting things may not play out the way you plan. Having a plan B is important too.
  • Revised HIPAA guidelines place emphasis on business associates and subcontractors being HIPAA compliant. Discuss with your business associates about the security measures they have to follow and keep tabs on the physical and informational security they provide.
  •  The economic liability of data leaks has increased to over two million dollars which is $400,000 dollars more than in 2010. So pull up your socks and start working towards HIPAA compliance, now.
  •  Laptops and paper based records are the major reasons of data breaches. Almost 202 cases of data breaches due to stolen or lost laptops have been recorded according to a 2014 survey. Prohibit employees from bringing laptops or digital storage devices to office.
  • If you work with a business associate and need to share medical information insist that your partner has a secure VPN connection to transmit and receive medical data.

Filed Under: 2014, General, HIPAA Tagged With: hipaa audit checklist, HIPAA audits, HIPAA compliance, HIPAA compliance audits, hipaa guidelines

Is your medical practice ready for Meaningful Use audits?

April 9, 2014 by Ango Mark Leave a Comment

Tips To Face MU Audits

Prepare your medical practice for CMS audits

A recent statistic reveals that one in twenty practices that have attested for MU will face an audit. And that most practices are most likely to face pre-payment audits. The increased governmental scrutiny can catch practices off-guard. Several hospitals maintain a ‘Book of evidence’ in case auditors come knocking by.

Attesting for Meaningful Use is not enough! Medical practices should ensure they can face audits head-on and have the requisite medical documentation.

Tips to become audit ready!

  • Always be ready! The best to insulate your practice from audits and fines is to be prepared. Always save the electronic documentation that supports your attestation. Save the documentation that has the values you entered in the Attestation Module for Clinical Quality Measures. Also, ensure that your payment calculations are carefully documented.
  • Your primary documentation includes the time period of the report, the denominators and numerators for the CQMs and evidence that it was created for that particular EP, hospital or medical center. Additional documentation includes a clear review of medical records. And documents to prove and support each measure attested for.
  • Most providers make the mistake of hating CMS auditors with a vengeance! It is important to comply with audit requests promptly. Providers should have pertinent document in hand after they receive the initial request letter from the contractor. Providing sketchy documents and one line statements will do more harm than good. Detailed, precise and evidence based documentation is required.
  • Medical care providers should stop being backseat drivers. Relying on admin staff or practice managers too much can be a risky proposition. Physicians should stay in the loop, verify documentation, analyze medical care records and medication lists. It is mandatory for every physician to make sure their patient records are accurate. As the slant is on evidence based care there is no better person than physicians to verify the veracity of documents.
  • Is your EHR certified? Receive documentation from the vendor stating that they are CHERT certified. The Office of the National Coordinator maintains a list of certified EHR products. Monitor upgrades and verify that your system meets evolving guidelines and measures. Get a copy of the licensing agreement with your vendor to submit to the auditors.
  • Conduct a thorough security risk assessment of your medical practice. Check if your practice is compliant with the existing security regulations. Not conducting an extensive security risk assessment periodically, can trip you up when the auditors reach your practice.

Is all these tips helpful for you? Tell us how your prepared for Meaningful Use Audits?

Filed Under: 2014, Meaningful use Tagged With: CMS audit, Meaningful Use, meaningful use audit, medical documentation, Medical Practice, MU Audit, MU penalties

Medical Billing Strategies of 2014 – Sink-in to Amplify Your Funds

December 16, 2013 by Ango Mark Leave a Comment

Medical Billing Process

Decide Here – Whether to Dwell-in or Leave the Page!

This article is especially designed to meet the needs of the physician practices and other healthcare delivery organizations that are looking for the tactics to revamp their medical billing process so as to boost your cash inflow.

 Where the healthcare billing is travelling?

Though, physicians aren’t tethered to the aged technology and strategy, circumambient healthcare milieu may revoke your cerebral cortex due to diversified growth in healthcare information technology (HIT).

Do you have numerous “wh-questions” on your mind – pertinent to the funds management in your revenue cycle management (RCM) process? Then, this is the go-to technique to enliven your cash coffer.

MEDICAL BILLING STRATEGIES – 2014

Hoard your revenue in each phase of RCM!

Physician Credentialing and Contract Negotiation:

The federal payers have already fixed your reimbursement rates for the patient care services. Despite this, there is a dire need for the providers to negotiate with the payers to get lucrative reimbursements for the service rendered by you. Besides, abiding the payers’ rules during credentialing process brings you more savings.

Front-desk Collection:

Start collecting payments from the scratch – don’t let your staffs ignore the front-end tasks:

1. Point-of-service (POS) payments (Co-pays, deductibles, etc.).

2. Collection of dues well before patient encounter.

3. Thwarting denials through accurate eligibility verification.

4. Gathering insurance accurate data to avoid reimbursement disappointments.

Charge Capture:

HITECH Act, ACA’s “performance based payment” and other federal mandate are the driving forces that accentuate the ideal EHR implementation.

Charge capture must be done accurately for each encounter, procedure and surgery. Evolving ICD-10 guidelines call for the renovation of your super bills in sync with your clinical practice so that charge capture will be immaculate.

Claim Scrubbing:

          This is the vital phase in the medical billing process that aid abridged AR process. AAPC/AHIMA certified coders must be a part and parcel of the claim scrubbing process – so that revenue loss due to underpayment and overpayment issues could be avoided. Concentrating on this phase greatly mitigates the claim rework cost.

Electronic Transmission:

          Timed Clearinghouse transmission for fresh claims is one of the overlooked approaches in most practices. Large practices may need to file the scrubbed, “clean” claims daily.

          Delay in addressing the rejected/denied claims with the remedial action may also hamper your cash in-flow.

eRemittance:

          Interpretation of the remark codes and timely payment posting after the receipt of EOBs/ERAs is very essential for a successful RCM process. Besides, prompt cash inflow/ AR feed into the practice management system (PMS) or electronic medical/ health records (EMR/EHR) is mandatory to avert payment miss-outs and pointless follow-ups.

Denial Follow-up:

The denials must be addressed with an immediate effect to avoid delayed payments or re-denials. While working out on denials, the obligatory documents must be attached during re-submission or appeal. Though the cost involved in denial appeals or re-submissions is an additional burden, ignorance of denial management would be a serious pecuniary loss.

Patient Billing:

          Don’t load your dice against yourself! Precision in the patient billing is a crucial point in the bill settlement. Inaccurate and difficult-to-read billing statements ensue in patient discontent, consequently culminating in bulldozed physician – patient relationship. Above all, a clear statement supports timely payment.

Resource Utilization:

          Exploiting the resources like human resources, infrastructure, funds, technology, etc. to run a practice profitably is a master skill. Among that, leveraging the technology to satisfy patients and enhance practice profits is the challenging task. The following technology platforms ameliorate your patient experience, accelerate revenue cycle process and thus perk-up your business.

Practice Website:

  1.  Patient portal
  2.  Online forms and statements
  3.  Online EHR access
  4.  Online lab and imaging reports
  5.  e-Payment support
  6.  mHealth support (iPad, iPhone, Tablet, etc.)
  7.  Chat support
  8.  Healthcare News
  9.  FAQs
  10.  Social media (e.g. Facebook, twitter, etc.)
  11.  Patient Blogs & forums

Benchmarking:

                  Setting a yardstick and working towards its accomplishment must be the prime goal, if you are attempting to reach your vision and mission.

What functions of the billing process that must be set in the yardstick achievement program?

1. Follow-up and retrieval of underpayments.

2. Averting penalties due to the breach of laws and audit policies (RACs, HIPAA, HITECH Act, etc.).

3. Aggressive follow-up of accounts receivables/bad-debts.

4. Evaluating and making small balance write-offs.

Besides, regular evaluation of your practice, process and finance must be done through the following reports:

  1. Practice Analysis Report
  2. RCM Analysis Report
  3. AR Summary Report

“PERSISTENT REVENUE INFLOW IS THE SINGLE PARAMOUNT WANT OF THE MEDICAL BILLING PROCESS”

Stretch your achievement from good to excellent with these proven medical billing strategies. It will be the hot topic in 2014 as most practices are going out-of-kilter due to stringent policies and other industrial factors.

Filed Under: 2014, EHR, Medical Billing Tagged With: EHR, EMR, healthcare billing, medical billing process, medical billing strategy, patient billing

Infographics: Obamacare – A Precursor for Financially Sound Healthcare Practice

November 6, 2013 by Ango Mark Leave a Comment

Affordable Care Act(ACA)

How Obamacare Benefits Medical Practitioners?

As a medical practitioner, you will be glad to know that “Obamacare” has proved its mettle in reviving fortunes of the medical business fraternity. Obamacare¸ also known as the Affordable Care Act (ACA) was enacted as federal law by President Barack Obama on March 23, 2010. ACA, along with the Health Care and Education Reconciliation Act, has effectively overhauled the US healthcare system.

ACA, the new health care reform law in America, enhances the affordability, quality, and availability of insurance policies from public and private payers to about 44 million uninsured citizens. This will increase collection of insurance reimbursement collection of hospitals and clinics for providing healthcare services to patients. In addition, it also curtails the rise in healthcare spending.

Any Statistical Evidence That ACA Will Prove its Worth?

Sure – no doubt about that!

Healthcare establishments across the US stand to gain since public opinion favours ACA. Proof of the pudding lies in the fact that statistical survey reports justify the fact that ACA has started gaining momentum across the US. Due to competition in the insurance marketplace, premiums have started dipping below the projected levels. This will lead to estimated savings of roughly $190 in the federal budget during the next 10 years. This fact is a vital early indicator that the ACA is performing much better than anticipated to decrease federal budget deficits and national spending on healthcare.

Due to these savings, the healthcare deficit will be lowered to the tune of 174%. In terms of savings in healthcare suggested by the Simpson-Bowles commission (namely the National Commission on Fiscal Responsibility and Reform) -, this works out to be around 40%. In addition, reduction in premiums will further decrease the number of uninsured citizens by 700,000. Since insurance will be less expensive, more number of citizens will opt for insurance policies, resulting in additional reimbursement receipts for hospitals.

Statistical Surveys Reinforce Credibility of ACA

Recently, Washington-based Gallup conducted a daily tracking survey, with a random sample of 1,528 adults. These adults were bracketed in age groups of 18-29, 30-49, 50-64, and older than 64. Maximum support for the plan came from the 18-29 age group. The number of persons in the younger generation category who approved the Obamacare plan exceeded the numbers in the same category who disapproved the plan. This implies that more numbers of younger adults are likely to be uninsured in comparison to people in the upper age groups. In addition, there is a steady rise in the population of younger adults. Their willingness for opting for insurance policy is a crucial factor for success of Obamacare.

Do Medical Practitioners Gain by Entry of New Insurance Agencies in the Market? 

Of course! According to the McKinsey Center for U.S. Health System Reform, new insurance payers form about 26% of the number of insurance agencies in the US. Entry of these additional players has led to more intense competition in the insurance market. These agencies priced their premiums lower than existing ones in the market. Lower premiums will lead more people to go in for insurance policies. This will boost up insurance receipts of medical entities.

In addition, the Kaiser Family Foundation conducted a preliminary study of insurance plans offered in 18 areas. 15 out of these 18 areas experienced premiums that were less than premiums estimated by the national Congressional Budget Office (CBO).

Reduced premiums imply that more and more number of citizens will walk into the insurance coverage basket. It has been estimated that the number of citizens who are not insured will be reduced by 2.8% due to 16% drop in premiums. This, in turn, results in additional revenue collection for hospitals and clinics.  In addition, insurance coverage will be increased for 700,000 citizens by 2013 since CBO had projected a reduction in number of uninsured citizens by that time.

Any Plans Related to ACA Coverage?

You will be pleasantly surprised to know that insurance policies are already available which incorporate the need for minimum coverage. With effect from Jan 1 2014, the ACA mandates that most of the US citizens opt for minimum essential insurance coverage or pay a penalty. Following plans are available for US citizens:

  1. Medicare or Medicaid federal sponsored programs.
  2. Private insurers’ plan in the individual insurance market.
  3. Employer sponsored plans.
  4. Health plans available in States’ individual markets.
  5. Certain health plans that were operative before ACA.

Win-Win Scenario for Doctors and Patients!

Doctors and patients both stand to gain as Obamacare counters effectively insurers’ tendency to deny payment for pre-existing health conditions and impose limits on annual payment by insurance payers. Now pre-existing conditions will also be covered for insurance payment. Citizens will also avail plans that cover out-of-pocket expenses, for the first time in the country. Medicaid coverage is being expanded by many states, so that additional citizens are covered by 2014. The ACT will also cheer-up small business owners who form bulk of uninsured people. This means additional reimbursement receipts for medical units.

For further enquiries on Obamacare, rewards and incentives for wellness programs, tax credits, free EHR/EMR subscriptions, and so on, you are welcome to contact us any time convenient to you.

Filed Under: 2014, General, obamacare Tagged With: ACA, Affordable Care Act, health insurance agencies, Obamacare, US healthcare system

Infographics: Eradicating Impediments In Medical Claims Reimbursements

July 23, 2013 by Paul Martin Leave a Comment

Physician Reimbursement Facts For 2014

Existing turbulent healthcare industry scenario :

In the current turbulent economy-ridden environment healthcare providers and physicians are not able to precisely and correctly claim the actual reimbursements of expenses incurred for  diagnostic and treatment purposes from the insurance agencies, resulting in loss of revenue, profitability, incorrect claims, delayed claims, missing out on claims, the main reason being that they are not fully equipped to provide precise diagnostic and treatment documentation, backed by capturing the correct medical codes for medical billing. The physicians do not have the time to oversee capturing the correct medical codes and medical billing procedures as they have to focus on their core competency of diagnosis and treatment as first priority.

Vital issues compounding the problems :

Healthcare professionals are constantly under pressure due to increased patient/financial constraints and regulatory pressures, forecasting a doomsday for medical services.  This situation is worsened further due to federal regulations that advocate improved, affordable healthcare services without comprising on quality issues even under the present economic scenario where the inputs for provision of healthcare services are experiencing spirally increased costs. To further complicate the issue, in-house administrative personal are not inadequately trained, inexperienced and lack the requisite expertise in medical coding and billing, as well as thorough and accurate clinical documentation.

The physicians would like to spend most of their time and efforts by focusing on core issues of diagnosis and treatment, rather than diverting their resources and energies over the nuances of managing and monitoring their   to maximize revenue. Rather than have in-house medical coding and billing services, it pays to opt for outsourcing or right sourcing the billing services to established and experienced vendors. There is a dire need for in-house analysis of existing problems, solutions, future trends, and remedial measures.

The situation will further worsen in the near future since presently health care reforms are under way with focus on affordable health coverage and quality. 

Medical Reimbursement Problems faced by Health Providers :

  1. Insufficient knowledge or experience in medical coding and billing
  2. Lack of training in medical coding and billing
  3. Physicians using In-house medical coders and billers have to feel the consequences by struggling with inexperienced coders straight out of college
  4. These billers and coders fail to cope up with evolving coding and billing guidelines, for medical procedures, and stay abreast with the latest procedures
  5. Nightmares of lost revenue and unpaid bills 

Lost revenue opportunities :

  1. Physicians tend to miss opportunities to maximize medical reimbursements from the insurance companies.Lost revenue due to various factors includes:
  2. Undercoding level of treatment,
  3. Omitting modifiers,
  4. Submission of medical reimbursement claims without the requisite documentation required to support the reimbursements.
  5. Wastage of resources in determining and tracking reasons for claims rejected, besides finding out claims missed or under claimed.

The pathway to maximum reimbursement :

  1. Out sourcing or better known as “Right sourcing” the medical billing and coding, clinical documentation, claims processing, EMR services to professional one-stop third party vendors  results  faster, precise and complete reimbursement of medical claims, boosting up revenue and  profits.
  2. Besides assigning the right codes for medical services the outsourcing vendor provides specialty specific coding services using experienced and AAPC credentialed coders on board. 
  3. The vendor is conversant with the significance of coding for the technical and professional components of a medical service, place of service codes, e/m codes, revenue codes, and when claims need to be bundled or unbundled.Compliance with all medical coding systems such as ICD, CPT and HCPCS ensures that working with such vendor is a smart option.

Remedial Measures :

  1. Wise,prudent, and strategic to partner established third party vendors such as MedicalBillingStar who have long-standing expertise, experience in dealing with state-of-the-art coding and billing services to a wide range of categories in the US medicare industries.
  2. Healthcare and medical units, irrespective of whether they are small, medium, or large, stand to experience hassle-free boost-up of medical reimbursements, without the nightmares of returned claims, missed-out claims, and piling up of rejected claims, and efforts to resubmit claims.
  3. MedicalBillingStar closely follows the on-going trends in medical coding and billing and medical insurance claims processing methodologies.

Filed Under: 2014, EHR, EMR, Medical Billing, Medical Coding, Medicare, Revenue cycle management Tagged With: medical billing and coding, Medicare Physician Fee Schedule, physician reimbursement, reimbursement claims, Revenue cycle Management

A Few Survival Strategies For Healthcare CFO’s To Handle 2014

June 20, 2013 by Ango Mark Leave a Comment

Time for healthcare CFO’s to step up their plate !

2014 is going to be a year of change. Federal mandates, financial constraints and heavy penalties for non –compliance is going to make 2014 a challenging, tumultuous year. It is time to up the game to ensure medical practices don’t crumble under pressure. And as always it is the man at the helm who needs to up the game!

Focusing on wellness programs can help you save on taxes !CFO

The PPACA requires all healthcare organizations to review the wellness plans of all full time employees. Choosing a wellness plan that is highly deductible can be a major tax saver. CFOs will have to examine the current coverage plans.

And freeze in on a wellness plan that works both for their employees and also saves on taxes. This could well be the major priority of healthcare CFOs in 2014.

Systems to record the quality of care…

The healthcare landscape is undergoing a period of transition. From volume based payments. To a model that is based on the quality of care and patient outcomes. It is essential that CFO’s implement systems and upgrades to report and measure clinical variations. Maintaining, longitudinal health records that are detailed and contain data across the care continuum, is important.

Will your clinical documentation cut it ?

Do you maintain pristine clinical documentation ? If yes you are lucky. If, like a majority of health care providers your answer is, no, then it’s time you upped the ante. Review your revenue cycle that coordinate with coders and physicians to ensure more accurate and updated clinical documentation.

Analyze every phase of the RCM to see where you can reduce costs. Have your billing team give a detailed report of key financial metrics.

Outsourcing can be a huge cost saver !

Reducing the number of full time employees can help you cut back on costs. But this is a move that has to be taken after weighing in the pros and cons. 

Here’s a quick presentation for CFO’s to handle the practice.

Filed Under: 2014, CFO'S Corner, Revenue cycle management Tagged With: 2014, Clinical documentation, Healthcare CFO's, Medical Billing, Physicians, Revenue cycle Management

Forget The Incentive. Can Your Practice Escape MU Penalties?

June 10, 2013 by Ango Mark Leave a Comment

How do you avoid MU penalties ? There is just one way, demonstrate meaningful useMU. The primary worry of all healthcare providers is missing out on incentives. But taking steps to avoid the fast approaching penalties should be the top most priority right now. It is time for physicians to get in on the ground floor and work towards MU.

Working hand in hand with patients !

To, meet compliance deadlines, it isn’t enough, that you adopt an EHR, and optimize, your, workflow. Remember that it all boils down to just one thing, the quality of care you provide patients. Explore better ways of working with your EHR to avoid nasty payment cuts and penalties.

Eligible professionals, who are going to demonstrate meaningful use to avoid payment adjustments in 2015, must kick start their EHR reporting period by July 2014. You will have to work at breakneck speed to reach the finishing line on time.

Ramping up patient portal efforts…

Under stage two of Meaningful Use patients should be able to view their data, download it and be able to transmit it. Do you know that a functional patient portal can help you meet, 3 core objectives and 4 menu objectives? That it could be the easiest way of meeting the patient engagement criteria?

 Though a patient portal can be available in the provider’s website or function as a stand -alone online application. A patient portal that is integrated in to your EHR can improve functionality and ensure data security.

Patient engagement the big “gotcha” !

Laura Kreofsky the principal advisor for Impact Advisors predicts that patient engagement and public reporting are going to be the major stumbling blocks for physicians. Make sure you option for an EHR with a robust patient portal. If you are an EHR user insist that your vendor provides you with a fully functional patient portal.

The payment cuts for physicians who’ve missed the boat…mu-penalties

Source:Practice fusion

Filed Under: 2013, 2014, EHR, EMR, Meaningful use Tagged With: EHR, EMR, Healthcare, Meaningful use penalty, Medical Practice, MU Incentive, Patient engagement, Patient Portal, Physicians

Complicated Crosswalks, More Codes And Stricter Documentation Requirements. But ICD 10 Is Not The Loch Ness Monster !

May 15, 2013 by Ango Mark Leave a Comment

Are you ready to get cracking on ICD 10 ?

The deadline for adopting ICD 10 is inching a little closer every day ! It is time for the eternal question. Are you prepared? A study by the Health Revenue Assurance Associates says that 20% of medical practices are yet to start an education or training program on ICD 10.

About half of the medical practices surveyed were way behind timelines set by Medicare and Medicaid. The transition is going to be tough. No matter what mild mannered, reassuring experts say ! And that is why the sooner a practice makes the switch, the better.

Confounding crosswalks…

Medical practitioners who think cross-walking ICD 9 codes with the latest codes is just a matter of few mouse clicks, have a second think coming. The General Equivalence Mappings does offer a detailed crosswalk of both the coding systems.

But the fact that there are very few one to one matches between both coding sets is going to make the transition, tricky.

According to a study by researchers from the University of Michigan and Illinois, mappings for specialists are going to be, especially, complex. Emphasis has to be laid on understanding and managing, mapping categories and networks.

ICD-10-Crosswalk

A little bit of effort from everybody…

It isn’t the coding or billing team alone that is going to struggle with the new codes. It is going to take a bit of effort from all concerned.

As ICD 10 is all about greater specificity and granularity, physicians will have to focus more on the medical documentation they send to the billing team. More documentation could mean just one thing, more revenue !

Have you forgotten your insurer ?

Well, your insurer is a part of your team as well. Ask for a testing plan and send a few “test” claims to the insurer. Coordinate with your payers to make sure you are ready for the D day. Keep in mind that you cannot send ICD 10 claims till the compliance date. But don’t let that stop you, from sending out trial claims, to payers.

Why ICD 10 is not the Loch Ness monster, after all !

The entire hullabaloo surrounding ICD 10 makes the codes look like small, poisonous creatures, out to get physicians. In the long run ICD 10 can prove to be good for practices. It could mean more accurate payment for medical procedures. Fewer miscoded claims. And, a better idea of how much you’d be paid, prior, to a medical treatment.

Filed Under: 2013, 2014, ICD-10, Medical Coding Tagged With: Healthcare, ICD 10, ICD-10 Certified Coders, ICD-10 Crosswalk, ICD-9, Medical Coding, Physicians

Increased Reimbursement For Primary Care Physicians, A Closer Look !

April 23, 2013 by Ango Mark Leave a Comment

A welcome respite for primary care physicians !

Everybody knows that primary care physicians are struggling to stay in business. A mandate by the Affordable Care act has announced that Medicaid rates for certain primary care procedures will be paid on par with Medicare rates.

 To receive additional reimbursement physicians will have to fill out, a, state specific Medicaid self-attestation form.

Medicare

Who are covered ?

Family practices, pediatricians and general internal medicine physicians are eligible for increased reimbursement. So are several other sub-specialties and physicians who perform high levels of primary care services. The major criteria are that, physicians should be board certified and have a billing history that indicates that about 60% of their billing is for primary care codes.

The rate increase will be in effect till the end of 2014. Physicians, who’ve registered through MITS and are approved by the Office of Medical Assistance, can see more digits in their pay check from April 2013.

The code to more dollars !

Primary care physicians will be reimbursed in accordance to HCPCS codes related to primary care. Evaluation and management codes from 99201 through 99499 are eligible, as are certain vaccine administration codes.

The rough and tumble of practicing primary care…

Primary care physicians are working under heavy financial pressure. The sequestration cuts of 2013 have taken a heavy toll on medical practices. The sustainable growth rate formula has quickly turned in to a nightmare for physicians.

 Reimbursement cuts, operational pressures and complicated regulations scared the daylights out of physicians.

Quite arguably it was primary care practices that were the hardest hit. Primary care centers were soon shutting their doors as it became increasingly difficult to practice. Primary care practitioners were finding it almost unfeasible to take care of their elderly Medicare patients.

At a time when it was needed the most !

The increase in reimbursement has come at a time when physicians need it the most. The increased Medicaid reimbursement means physicians are offered a reprieve after all the financial pressures they’ve gone to.

Want a few tips to increase the revenue of primary care practices ?

Filed Under: 2013, 2014, ACO, Medicare Tagged With: ACA, Affordable Care Act, Healthcare, Medicare, primary care physicians, reimbursement

Is Your Medical Practice Ready To Attest For Meaningful use?

April 5, 2013 by Ango Mark Leave a Comment

Are You Ready To Attest For Meaningful Use ?

If you are an EP, receiving the MU incentive check is going to top your list of priorities. It is time for physicians to pull up their socks and start working towards meeting the eligibility criteria for MU 2. Before getting down to the brass tacks it is important that you phase out the attestation process.

Meaningful Use

Being Up To Speed On Data Transmission…

Data transmission is a tricky word. It means you need to share data without making compromises on data privacy. To, begin with exchange a clinical document with one of your peers who use a, different EHR. Send out “trial” documents to test the waters. Check whether you are able to transmit clinical data securely.

Shop for a HIE and team up with one, to be able to transmit medical data easily across the care continuum.

Time To Stop Fighting Over Turf  !

Physicians have always felt a little queasy about letting patients access their EHR. A secure patient portal that allows patients to view and download medical information is important to meet the patient engagement criteria.

It is essential that stringent authorization methods are followed to prevent data misuse. And that, patients, are sufficiently educated about data security.

Dial Your Vendor’s Number…

You’ve pulled out all stops to make sure your practice meets MU standards. But is it is of little or no use, if your vendor doesn’t match your pace. Check with your vendor whether your EHR is compliant with the Meaningful Use 2 guidelines. Communicate with your EHR vendor and emphasize that a specific timeline needs to be adhered to.

With data interoperability being one of the key considerations, to attest for MU, it is important that you join forces with your EHR vendor, to reach the finishing line on time.

Have you spoken to your business associates ?

It is important that your business associates are an integral part of your MU attestation efforts. Whip up a plan with your business associates to optimize your workflow and streamline your everyday work processes.

2 hours a day !

Spending as little as two hours a day to work towards achieving MU can put you on the fast track to receiving your check. The key is to coordinate. Make sure that everybody who is involved with your medical practice is on the same boat. And to, make the most important person in the equation, your patients, to get more actively involved.

Filed Under: 2014, EHR, EMR, Meaningful use Tagged With: Attest your practice with MU, Data transmission on EHR, EMR, Healthcare, Meaningful use stage 2 rule, Physicians

  • 1
  • 2
  • Next Page »

Get Updates

Leave your email address here & Receive our latest blogs and infographics to your inbox!

RESOURCE

Most Popular

  • Why do independent practices fail when outsourcing RCM and billing to EHR companies?
  • Hospitals outsource revenue cycle management to meet value based payment initiatives [infographics]
  • How to prepare for MIPS in 2018 [QPP Year 2]
  • 4 Thoughts on conducting a successful RCM Audits [Infographic]
  • Experts Reveal the Unknown Facts of MACRA & RCM Challenges [Infographic]

Categories

  • 2013
  • 2014
  • ACO
  • Anesthesiology
  • Business Intelligence tools
  • CFO'S Corner
  • Dictastar App
  • EHR
  • EMR
  • General
  • Healthcare IT Trends
  • HIPAA
  • ICD-10
  • MACRA
  • Meaningful use
  • Medical Billing
  • Medical Billing Company
  • Medical Billing Company Checklist
  • Medical Billing Company Reviews
  • Medical Coding
  • Medical Practice
  • Medicare
  • obamacare
  • payer contract negotiation
  • Physician Credentialing
  • physicians
  • Revenue cycle management

Tags

Affordable Care Act EHR EHR Billing Company EHR Implementation EHR vendor Electronic Medical Records Company EMR EMR billing Services EMR medical billing company Free Physician Credentialing Services Healthcare Healthcare Claims Processing Services healthcare physicians ICD-10 Medical Coding ICD-10 Medical Coding Services ICD 10 Meaningful Use Meaningful use of stage 2 final rule Medical Billing Medical Billing Companies Medical Billing Payments Medical Billing Reports Medical Billing Services Medical Coding Company Medical Coding Services Medical Practice Medical Practices Medicare Medicare Billing Company Medicare Billing Services Obamacare Patient engagement Patient Portal Physician Billing Services Physician Credentialing for New Practice Physician Practice Billing Company Physician Practice Billing Services Physicians Physicians billing Company Physicians billing EMR services Physicians billing services physicians EHR Revenue cycle Management Revenue Cycle Management Process Revenue Cycle Management Services

Join on twitter

Tweets by @medbillingstars

Copyright © MedicalBillingStar.com 2014 ·| Privacy Policy

11517, Belvedere Ct, Cerritos, California - 90703, United States