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How to improve patient collection strategies when facing ACA, high-cost plans

04/10/2017

Shorten your revenue cycle and keep cash flowing by taking a close look at how you’re collecting out-of-pocket fees from patients as cost-sharing continues to shift away from insurers.

Mind your risk-adjustment, diagnosis coding as whistleblower suits target MA claims

04/10/2017

by: Roy Edroso

Practices that do risk-adjustment coding for Medicare Advantage plans should watch their step as the government pursues two big fraud cases that hinge on risk-adjustment issues. So far, only insurers are in the line of fire — but that may not last.

New ACA repeal plans emerge in GOP talks; Part C, D plans get slight raise

04/10/2017

by: Roy Edroso

Hints in Congress of a new anti-Obamacare plan, big rules submitted to the Office of Management and Budget (OMB) and payment changes for Part C and Part D plans are among the big health care news items from Washington.

Pair claims-based quality measures with CPIAs to reduce MIPS workload

04/10/2017

by: Julia Kyles

Make selecting and performing clinical practice improvement activities (CPIA) easier for your practice by matching the activities with a provider’s quality performance efforts under the merit-based incentive payment system (MIPS).

Obesity counseling denials could be caused by billing by wrong type of provider

04/10/2017

by: Roy Edroso

Question: We’re getting denied on obesity counseling and can’t understand why. What could the reason be?

Practices see revenue gains for obesity-counseling code G0447

04/10/2017

by: Richard Scott

Payments for obesity-counseling code G0447 (Face-to-face behavioral counseling for obesity, 15 minutes) continue to climb as the service gains traction among medical practices.

MAC covering 10 states gets tougher on E/M exam requirements

04/03/2017

by: Richard Scott

Practices will find it more challenging to reach a higher-level E/M because of one Medicare administrative contractor’s (MAC’s) changes to documentation requirements for detailed exams.

Obamacare replacement plan fizzles; momentum stalls on comprehensive change

04/03/2017

by: Richard Scott

You can continue to conduct business as usual with patients on health exchanges after the American Health Care Act (AHCA) went down without a vote. Facing opposition from both moderate Republicans and the more conservative House Freedom Caucus, the bill that would have repealed the Affordable Care Act...

Save time by letting patients set pre-visit agenda through EHR, patient portals

04/03/2017

by: Richard Scott

Give your patients the opportunity to set an agenda ahead of their office visits and you may witness improved patient engagement and clinical outcomes — while also saving yourself a significant amount of administrative time.

Change to claims-processing manual expands ACP copay advantage to OPPS

04/03/2017

by: Roy Edroso

CMS has made performing advance care planning (ACP) and getting paid for it easier in more situations by expanding a key benefit to the hospital outpatient prospective payment system (OPPS).

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