Part B News | Part B News

Tighten patient scheduling gaps to avoid both no-shows and floods of visits

11/18/2013

Is poor scheduling costing you patients and income? A couple of basic investigations should help you plug the gaps. Everyone knows that scheduling snafus make for an unhappy waiting room. But they can also cost you a surprisingly large amount of money -- thousands of dollars at a typical practice, experts estimate.

Recruiting: how to hire the right physician for your practice

11/18/2013

by: Roy Edroso

You can recruit physicians to your practice with minimal outside help — but be careful of legal issues, and make sure your new doc is a good fit.

As we mentioned in our study of non-clinical hiring for practices, it’s a seller’s market for medical talent these days, with or without an MD. That makes things tough for practices that lack a human resources budget.

Arthritis drugs move to self-administered list; watch for denial increase

11/18/2013

by: Scott Kraft

If you’re seeing denials for three commonly used injectable drugs to treat arthritis, a little-noticed policy change from your Medicare Administrative Contractor (MAC) may be to blame. An increasing number of MACs have moved the drugs to the list of those usually self-administered by the patient, making them ineligible for reimbursements under Part B.

CMS clarifies: employee with permission can act as surrogate within PECOS system

11/18/2013

by: Scott Kraft

You’re not restricted to using certain individuals within your practice to act as surrogates for your providers under the Provider Chain Ownership Enrollment System (PECOS) system surrogate program that went live Oct. 7. Any individual granted permission by an authorized or delegated official of a group practice can access any individual provider record within that group, a CMS official confirmed.

eRx “informal review” period begins, but notifications not seen

11/18/2013

by: Roy Edroso

You can start contesting CMS’ ruling that you didn’t qualify as an eRx provider now — though you probably won’t, since CMS appears not to have sent notifications to people who will need to. This year’s e-prescribing deadline was June 30, and it is expected that some providers will have failed to meet the qualifying criteria or exemptions, which would subject them to a 2% cut in 2014.

PECOS ordering/referring edits begin Jan. 6, 2014

11/18/2013

by: Roy Edroso

If your lab, imaging, and DMEPOS partners aren’t all enrolled via PECOS, tell them about this: Starting January 6, 2014, contractors will implement edits to catch a variety of claims submitted without proper provider credentials — including Part B claims on ordered tests from clinical laboratories and on ordered imaging procedures from imaging centers.

Benchmark: Use of observation E/M codes skyrockets

11/18/2013

by: Scott Kraft

At least one segment of E/M billing utilization is booming — use of new patient observation codes 99218–99220 and subsequent codes 99224–99226, according to a Part B News analysis of Medicare billing data from 2010–2012, the most recent years available. The jump in use of observation services is not a complete surprise, however.

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