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CMS clarifies 60-day revalidation requirement ahead of 2013 deadline

08/22/2011

Don’t be lulled into complacency by the 2013 deadline for CMS’s latest revalidation initiative. You will have only 60 days to submit a complete revalidation to your Medicare Administrative Contractor (MAC), starting the day you receive a revalidation notice – regardless of the fact that March 23, 2013 is the ultimate deadline. Miss the 60-day deadline and your Medicare billing privileges could be suspended, according to CMS.

5 steps to ensure medically necessary office visits don’t become non-payable phone calls

08/22/2011

by: Grant Huang

You’ve got more and more patients calling for refills and referrals to avoid the cost of office visits. It’s a trend traceable to rising private payer premiums in a persistently down economy, but you must ensure patients come in for office visits not only to protect your revenues, but also to provide better care, experts say.

4 steps to meet list-based meaningful use measures

08/22/2011

by: Grant Huang

You will have an easier time meeting the list-based meaningful use measures, but there are still best-practice ways to meet these measures while taking clinical considerations into account, physician experts tell Part B News. Part of a continuing series: Review previous articles in this series to help you earn EHR incentive cash, one meaningful use measure at a time.

CMS will make major, time-saving improvements to online PECOS in 2012

08/22/2011

by: Grant Huang

You will have many more reasons to switch from paper enrollment forms to CMS’s web-based Provider Enrollment Chain Ownership System (PECOS) in 2012, Part B News has learned. Currently, online PECOS lets you enter most enrollment updates or new enrollment information electronically, but you must still sign and mail paper forms as part of the process.

3 tips to get paid for E/Ms billed with modifiers 24 and 25

08/22/2011

by: Lauren C. Williams

Your specialty practice has likely seen its share of modifier-related claims denials, but the risk is much higher with a total loss of nearly $600 million in denied claims with surgical modifiers 24 and 25, according to a Part B News analysis. Here’s the numbers on how you and your peers are faring, plus tips from coding pros on how to stop denials on the front end.

Pros and cons of using health information networks to collect

08/22/2011

by: Lauren C. Williams

You must know whether your private payer patients are in network, owe a deductible and how much they have left on it before they walk in your practice – not knowing slows down collections and threatens cash flow. While you can always devote staff time to calling payers and having specific patients looked up, using a health information network (HIN) can greatly reduce that time and streamline the whole collections process, practices say.

Benchmark of the Week: What impacts imaging denials, 2007 vs. 2009

08/22/2011

by: Grant Huang

Does greater volume of utilization impact denial rates for imaging services, or does the actual value of the Medicare payment have a greater effect? These charts sort 10 imaging services by their 2011 fee schedule charge, from lowest to highest value, and show the denial and utilization rates in 2007 and 2009.

Ask a Part B News Expert: Face-to-face rule explained

08/22/2011

I would like clarification on certification rules for Medicare coverage clarified by CMS. For the third hospice benefit period, a face-to-face visit must be documented in the certification form. It states that a hospice physician or nurse must do the certification. At the end of the article you then state “remember, the certification may also be done by the hospice medical director when the patient does not have an attending physician.” Does that mean the attending physician may do the initial, subsequent and third certification for hospice benefit? I was under the impression that the attending could do certifications.

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