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Health records access increases — but poorer, less educated patients lag

06/10/2019

As mentioned in our patient records story, there’s been a slow, steady climb in U.S. patients’ willingness to access their medical records. But the climb has been slower for some groups than others.

Consider the jump to value-based care as Primary Care First comes into focus

06/03/2019

by: Richard Scott

You may find a lot to like about the Primary Care First model options that CMS unveiled in April as the federal agency continues to accelerate the shift to value-based care. However, while CMS envisions that the primary care-focused model will cover 25% of Medicare-eligible patients in the near term, you’ll have to assess whether it’s the right fit for your practice.

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

06/03/2019

by: Roy Edroso

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).

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