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Practice efforts to link provider pay to quality face uphill battle

03/19/2013

It won’t be easy to convince your physicians that their paychecks should be a direct reflection of patient quality care, as required in certain CMS and private payer pay-for-performance initiatives. But once you do, or even if you don’t, your next challenge will be structuring payments to reflect a wide variety of shared savings and patient-centered initiatives, experts tell Part B News.

State self-attestation forms popping up for increased Medicaid payments

03/18/2013

by: Karen Long

The time is now in many states for pediatricians, internists and family medicine physicians to sign up for increased Medicaid payments. Many states have notified those providers of how to participate in the two-year program.

Be careful when using new G-codes for negative pressure wound therapy

03/18/2013

by: Roy Edroso

Check coverage carefully on the new G-codes for negative pressure wound therapy (NPWT). The coverage may extend to more than one kind of device, and you will have to document its use carefully. This year, CMS added two G-codes — G0456 and G0457 — for the use of disposable NPWT devices.

CMS updates 2013 PQRS requirements, start reporting now to avoid 2015 penalty

03/18/2013

by: Lauren C. Williams and Laura Evans

Start reporting measures this year for CMS’ Physician Quality Reporting System (PQRS) program or you won’t be able to avoid a 1.5% pay cut starting in 2015.CMS made several updates in February to the PQRS program reporting requirements, including adding and deleting measures and measure groups, pursuant to the 2013 final physician fee schedule.

Navigate negative patient response to doctor-pharmaceutical relationships

03/18/2013

by: Lauren C. Williams and Marla Durben Hirsch

More need-to-know facts about how the Sunshine rule affects your practice

03/18/2013

by: Marla Durben Hirsch

While non-payer payments from manufacturers and vendors are not inherently illegal or inappropriate, you must tread carefully. Here are four ways the rule will affect your practice:

Providers struggle with high denials for wound care services, 2010–2011

03/18/2013

by: Lauren C. Williams

The following graphs represent how successful providers billed wound care services such as surgical debridement (11042–11047, 97597–97598) and negative pressure wound therapy or wound vacs (97605–97606) in 2010 and 2011.

Pinpoint how, when you notify payers of patient visits to comply with HIPAA

03/18/2013

by: Karen Long

Identify in your practice’s workflow the times when you communicate to insurance companies specific information about a scheduled patient encounter — such as at scheduling or pre-authorization — so you can ensure you comply with a patient’s request to withhold information about a visit or treatment from a payer.

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