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CMS introduces easy way to start PQRS reporting, avoid 2015 payment cuts

12/03/2012

Want CMS to do all of the work to satisfy physician quality reporting system (PQRS) requirements for you – helping you avoid a 1.5% cut to your Medicare payments? Sign up for the administrative claims-based reporting option in 2013, the only year it’s available. CMS will pull the data from your claims, and you’ll avoid the 1.5% payment adjustment in 2015.

5 tips from a thriving multispecialty ACO to achieve physician buy-in

12/03/2012

by: Ben Penn

Help overcome the biggest challenge of forming an accountable care organization (ACO) – persuading your physicians to abandon fee-for-service Medicare and receive reimbursements based on patient outcomes and efficiency – with guidance from two doctors who have won over their peers.

Take preliminary HIE precautions now that HHS has released proposed rule

12/03/2012

by: Ben Penn

Prepare your practice to treat patients covered in a vastly different private insurance structure in 2014, now that HHS has defined the list of essential health benefits and other provisions of health insurance exchanges (HIEs) in a proposed rule.

Map out next year’s Medicare revenue in 2013 with or without SGR cut

12/03/2012

by: Lauren C. Williams

To help determine how much revenue your practice will collect for certain codes in 2013, the following chart contains current and projected payments for 20 misvalued codes that will see a drop in relative value units (RVUs) – and pay – next year.

Take note of OIG 2013 Work Plan repeat targets

12/03/2012

by: Julia Kyles

Repeat targets on the HHS Office of Inspector General’s (OIG’s) 2013 Work Plan indicate that OIG is warning you that auditors are less likely to be understanding if they find these errors in your claims. That could leave your practice owing CMS thousands of dollars for botched claims.

Benchmark of the Week: Top 10 high-growth, high-denial codes, 2010-2011

12/03/2012

by: Ben Penn

A variety of procedures top the list of high-denial codes that also saw a big jump in utilization from 2010 to 2011, the latest year for which CMS claims data is available. Note: Lab codes and supply codes were excluded from analysis, as were codes with low utilization, low denial rates and/or low utilization growth over the one-year period.

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