Be ready to spend time collecting and calculating payroll information to share with your accountant if you want to take advantage of the Affordable Care Act’s small business health care tax credit, which could save you thousands of dollars.

The tax credit is meant for small companies to offset the cost of providing employee health insurance, according to www.healthcare.gov.

A brief explanation of the surgeon’s need for an assistant could secure reimbursement and dodge denials for assistant surgery, which are on the rise. Modifier 80 (Assistant surgeon) was the top denied modifier in 2010, based on a Part B News analysis of Medicare claims (PBN 5/7/12). The denial rates rose to 20.9% in 2010 from 18.9% in 2009.

Expect minor pay increases and decreases overall this quarter for your most frequently billed drug codes with an average 2% raise. CMS leveled out its adjustments for 2012’s third quarter average sales price (ASP) list, effective July 1, by giving pay bumps to about 40% the listed drug codes.

Be prepared to bill patients directly for an even greater share of your claims. Patients who will pay for their care because they haven’t hit the deductibles of high-deductible health plans (HDHPs) are shifting how practices go after collections. Practices used to “pound on” insurance companies for payments. “Now it’s the patient. You need more savvy staff at the front desk,” explains Doral Davis-Jacobsen, manager of health care consulting, Dixon Hughes Goodman, Asheville, N.C.

These charts present payer performance based on two key determinants – amount of time it takes to send first payment and the percentage of claim lines paid $0 for any reason. Payer timeliness is broken down by time ranges of zero to 15 days, 16 to 30 days and 31 to 45 days. For the second chart, the claim lines were paid $0 for such reasons as denials, claim edits and patient responsibility.

Can you add modifier 59 (Distinct procedural service) to a physical therapy re-evaluation (97002) to unbundle it from another treatment given the same day, such as 97110?