You are running out of time to prepare for CMS’ new three-day billing rule, which will slash physician payments and complicate billing for hospital-affiliated practices starting July 1. But before you change anything, determine whether your practice’s hospital relationship legally binds you to this new rule. The varied and often very complex hospital-practice ownership structures make it hard to determine whether it applies to you, experts tell Part B News.

Develop a standard policy for drug sample distribution with a consistent set of guidelines for when you would deviate from that. Otherwise, you might wind up running out of samples or allowing patients to abuse your generosity. Due to a slumping economy and high unemployment rates, there’s likely an increase in certain parts of the country of patients asking physicians for more samples, experts say.

You and your peers lost over $93 million in 2010 on wound care code denials with an overall denial rate of 13%, according to the latest CMS claims data available. Since these denials are largely due to lack of documentation, it’s vital your providers correctly document wound care services and follow CPT policy changes in order to avoid even deeper revenue losses, experts say.

Example 1: A mechanic was admitted to hospital with burns on both arms and hands, after his gasoline-saturated clothing was ignited from a spark.

Hospital-practice relationships are very complex and come in many different forms. Use this chart featuring six business arrangements and policy explanations to help your practice decipher whether it will be subject to CMS' three-day payment window (see related story).

This chart presents the total annual professional charges per practice, broken down by a diverse array of specialties. The charges exclude technical component and amounts collected from work by non-physician practitioners or NPPs.

Our obstetrics/gynecology practice sees Medicare patients for their pap smears and breast exam. How do we bill these services and explain to our patients what our doctors recommend and what Medicare covers?