Part B News | Part B News

03/16/2015

New model offers "higher levels of financial risk and reward than are available under the current Pioneer Model and Shared Savings Program (MSSP)."

CMS invites your PQRS measure suggestions.

03/16/2015

by: Roy Edroso

Want to add a measure of your own making to PQRS?

Medical identity theft up almost 22%

03/16/2015

There were 500,000 more victims of medical fraud in 2014 than in 2013, this report finds.

Use well-trained staff to up collections from self-pay, high-deductible patients

03/09/2015

by: Scott Kraft

Ensuring patients pay out-of-pocket costs promptly — or be discharged from the practice if they’re unwilling to pay — takes resources and staff education from the time the appointment is made until the patient is seen.

Tools to use when patients can’t or won’t pay your practice

03/09/2015

by: Scott Kraft

Denying established patients access to your practice based on payment ability could get you in trouble for patient abandonment, according to William Maruca, attorney with Fox Rothschild in Pittsburgh.

Use 52 for discretion, 53 for necessity — and neither if the patient walks

03/09/2015

by: Roy Edroso

The reason your provider doesn’t perform an entire intended service or procedure will determine whether you’ll use modifier 52 (Reduced services) or 53 (Discontinued procedure) — or, if it’s the patient’s decision, no modifier at all.

CMS adds lung cancer screening, counseling to preventive services bucket

03/09/2015

by: Richard Scott

You can now provide lung cancer screening and counseling to patients covered under Medicare Part B and get paid for it, following the release of a new CMS national coverage determination.

Court expands definition of ‘referral,’ upholds conviction of gatekeeper doc

03/09/2015

by: Marla Durben Hirsch

The stakes for payment arrangements or other deals with providers that also treat your patients just got higher. The U.S. Court of Appeals for the Seventh Circuit has upheld the conviction of a doctor for certifying patients for home care services — even though he didn’t direct the patients to the agency that was paying him.

Put extra guidance in care plan to give NPPs incident-to leeway

03/09/2015

by: Roy Edroso

Question: A patient who is being followed by a physician for diabetes comes to the office and is seen by a mid-level/non-physician practitioner (NPP) at the practice.

Follow these 6 guidelines when making an addendum to the medical record

03/09/2015

by: Richard Scott

Question: I’m unclear about creating an addendum to an operative report. Here’s my situation: The physician conducted multiple procedures, all of which are included in the title of the note.

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