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As health workers gain whip hand, consider alternatives to raises or prepare to pay

06/03/2019

A hot health care job market means staff asking for raises. If that’s too rich for your blood, offer them other, less expensive perks, such as bonuses and esprit de corps.

Conscience rule finalized; providers, staff can refuse service within limits

06/03/2019

by: Roy Edroso

The Trump administration has finalized its conscience protection rule that empowers providers to refuse to provide services and even medical information that runs contrary to their personal morality.

Quarterly fees under CPC+ add more than $50K per provider to practices

06/03/2019

by: Richard Scott

Practices that opt to partake in the Primary Care First delivery model that’s launching in 2020 will greet a hybrid payment model that combines two revenue sources: per-encounter fees and quarterly, population-based payments (see story, p. 1).

Go for accuracy, consistency as OIG audit pinpoints diagnosis coding errors

05/20/2019

by: Richard Scott

Exert extra attention on your diagnosis coding, particularly under Medicare Advantage (MA) models, or you may be at risk of a CMS regulations – and your payers’ beneficence. A May 2 report from the OIG found that some physician practices were at the root of basic coding errors that were causing federal overpayments.

Go for accuracy, consistency as OIG audit pinpoints diagnosis coding errors

05/20/2019

by: Richard Scott

Exert extra attention on your diagnosis coding, particularly under Medicare Advantage (MA) models, or you may be at risk of running afoul of CMS regulations — and your payers’ good will. A May 2 report from the OIG found that some physician practices were at the root of basic coding errors that were causing federal overpayments.

Make reporting easy, discreet to guard staff against bad boss behavior

05/20/2019

by: Roy Edroso

A big boss-from-hell lawsuit at a major health system shows that workplace discrimination can be hard to address when the perpetrator has power over victims. To keep things from getting out of hand, practices should give their staff a chance to be heard safely in such instances.

Keep track of your CCM work — your own and your vendor’s — to avoid trouble

05/20/2019

by: Roy Edroso

A recent DOJ settlement over misuse of chronic care management (CCM) services acts as a reminder that, even if you’re using a CCM vendor to help, the care of the patient and the documentation of the service to CMS remains your responsibility.

Puncture your allergy-testing denials with correct units, ICD-10 codes

05/20/2019

by: Richard Scott

Overcome the bad reactions that may afflict you when a wind of high denials hits for core allergy testing code 95004 (Percutaneous tests [scratch, puncture, prick] with allergenic extracts, immediate type reaction, including test interpretation and report, specify number of tests).

Most-used codes by POS show Albuterol a hit at home

05/20/2019

by: Roy Edroso

You may be surprised to learn that the place of service (POS) with the most-claimed code under Medicare would be 12 (home) rather than 11 (office) or 21 (inpatient hospital). But that’s where the lion’s share of Medicare’s biggest code is billed. And the number of services claimed for home overall stretches into 10 figures.

Review Open Payments data for accuracy, fee analysis before deadline hits

05/13/2019

by: Richard Scott

Mark your calendar to review the payments that health care suppliers and manufacturers made to you — or say they did. You’ll have until May 15 to initiate a review of the federal Open Payments program data and dispute any errors.

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