Part B News | Part B News

Sequester deadline set to pass as of press time; 2% cut in effect April 1

02/28/2013

By the time you read this, Congress’ sequestration deadline will have passed, and without congressional action, a mandatory 2% cut will be imposed on your practice’s Medicare reimbursement. This is an unprecedented event, and experts with whom Part B News spoke were hesitant to predict what will happen next – though they expect some sort of deal to be worked out.

Medicare payment error may mean money owed to your physician practice

02/28/2013

by: Karen Long

Keep a close eye on payments you’re receiving from Medicare because at least one recovery auditor (RAC) has spotted underpayments being made under the wrong fee schedules, Part B News has learned.

Remittance advice change may make it easier to analyze, respond to unpaid claims

02/28/2013

by: Scott Kraft

Efforts to standardize the way payers communicate remittance advice remark codes (RARCs) and claim adjustment reason codes (CARCs) could eliminate some of the confusion providers now face when figuring out why claims are going unpaid, experts tell Part B News.

CMS to recoup AWV overpayments when physicians, facilities both bill

02/28/2013

by: Karen Long

You may have to pay back money from annual wellness visits (AWVs) that were billed first by a facility because CMS erroneously paid both claims for one service dating back to April 4, 2011.

Providers lag on HIPAA, audits show, and other findings from the HIPAA Summit

02/28/2013

by: Roy Edroso

Last week, we shared OIG concerns from the recent HIPAA Summit in Washington, D.C., about encryption issues and human error causing violations (PBN 2/25/13). But busy practice managers need to also focus on other areas to ensure HIPAA compliance, according to presenters at the Feb. 19-21 Summit.

Provider denial trends when using modifier 52 by specialty, 2007-2011

02/28/2013

by: Lauren C. Williams

In 2011, claims with modifier 52 appended were denied 45% of the time (PBN 1/7/13). But a closer look at those claims show that nearly a third of the codes billed, which amassed at least 1,000 claims, saw 100% denial rates.

2 tips for proper modifier 52 use

02/28/2013

by: Lauren C. Williams

Don’t let the overall high denial rates keep you from getting paid for incomplete services. Keep these tips in mind when billing modifier 52.

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