Part B News | Part B News

Waiting for details, practices see benefits, obstacles in PECOS surrogate program

08/19/2013

Third parties that want to enroll providers can use the Provider Enrollment, Chain and Ownership System (PECOS) instead of paper under the new surrogate program.

8 trouble spots on claims you can check to avoid denials, save money

08/19/2013

by: Roy Edroso

Stay out of contractors’ crosshairs and avoid denials with regular and spot audits of certain areas. Contractors are increasingly targeting E/M services, but E/Ms aren’t the only thing you should be monitoring.

Assess real damage from claims denials by looking at dollar loss value

08/19/2013

by: Scott Kraft

When you think about how to address a denials problem at your physician practice, one of the easiest ways to start is to look at the codes that have the highest denial rates as a percentage of overall claims filings. As good of a marker as that is for plugging financial leaks, it opens you up to a different type of risk — services with a relatively small rate of denial but high utilization will slip through the cracks, opening your practice up to persistent financial drips that wreak havoc with your bottom line.

ACA loophole allows for unpaid care for some health exchange patients

08/19/2013

by: Marla Durben Hirsch

Your practice may treat patients in new health insurance exchanges (HIE) but not get paid and be left to chase payments if those patients don’t pay their premiums.

Weigh clearinghouse price of 4010 conversions to avoid added ICD-10 costs

08/19/2013

by: Jennifer Clampet

You could actually save money in the long run by switching your systems to the 5010 HIPAA standard rather than relying on your clearinghouse to convert from 4010 to 5010. Some 20% of practices that use clearinghouses aligned with the Cooperative Exchange (CE) still rely on them for the switch, according to data from the industry group, which represents 19 clearinghouses.

Complete dollar loss value data

08/19/2013

Part B News had room for only the top five dollar loss value codes per specialty in this week’s issue. This is critical data for your practice, so here is the entire list for each specialty.

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