Payers may soon be required to use identifiers, just like your national provider identifiers (NPIs), to make it easier for providers to identify them and save the government time and money. But the change may prove inconsequential depending on how CMS utilizes the new IDs. Payers currently use numerous identifiers for their health plans, which often lead to misrouted or rejected claims and payment delays. 

Regardless of what stage of ICD-10 implementation you achieved before CMS proposed a one-year delay this month, use the extra time to convince your physicians that ICD-10 training is essential. The necessity to take advantage of the additional year rather than perceive it as a chance to blow off preparation was a message reinforced in several sessions of the American Health Information Management Association (AHIMA) ICD-10 Summit in Baltimore last week.

Don’t be quick to overlook Medicare’s new annual depression screenings because of the low RVU (0.51, $17.36). The preventive service is intended to take only 15 minutes and can be incorporated into your existing workflow with little effort.

“[CMS] is willing to throw a couple extra bucks to physicians and saying, ‘Not that you’re not already doing this, but we’re going to give you a little extra money if you do it in a formal way,’” says Joan Gilhooly, CPC, president of Medical Business Resources in Lorain, Ohio.

Save your practice potentially thousands of dollars of recouped funds by using regular audits to find coding and documentation errors before your payers do.

“You don’t want your practice to lose money earned because you failed to find an error; you want to protect yourself,” says Tori Kreher, compliance officer for the Orthopedic Center of Southern Illinois in Mt. Vernon, who performs annual audits for her practice. “If you correct it, it won’t cause you as much [of a] problem in the long run.”

This chart presents the ratio of paid level 3 E/M visits to paid level 4 E/M visits – both for initial and established patients – at 10 Medicare-heavy specialties. Based on a Part B News analysis of 2010 Medicare claims, the data points for initial visits were determined by taking the total number of paid visits billed as 99203 for each specialty – subtracting all denied visits – and dividing this figure by the total paid 99204 visits. This process was repeated for established patient visits using codes 99213 and 99214.

Your small practice may have to pay tens of thousands of dollars if you fail to keep up with HIPAA safeguards. HHS will collect $100,000 from a five-doctor cardiology practice in Arizona after it unintentionally made public patient appointments from its internal Web-based calendar, HHS says in an April 17 news release.

Does CMS prohibit taking an X-ray on a new patient before the patient is seen?