You can bill Medicare for alcohol and substance abuse intervention services when patients demonstrate symptoms of related illness or injury and your providers do a thorough job documenting the encounters. A July 6 educational article from CMS reminds you about these services, which are technically termed "structured assessment and brief intervention" (SBIRT). They allow your physicians and most non-physician practitioners (NPPs) to bill for face-to-face time spent with patients suffering illness or injury due to alcohol or non-tobacco substance abuse.

When you're having payment problems with a Blues plan, you may have an additional weapon in your arsenal to challenge the plan. Most Blues plans signed on to a national agreement to settle class action litigation regarding their activities. If their current activity violates those agreements, you have the right to file a complaint with a third party to help you out.

Watch for letters questioning your enrollment status from your carrier. A medical association reports multiple physicians have received notices that their enrollment isn't valid, despite these physicians appearing on CMS's ordering/referring master list (PBN 7/12/10).

Two-thirds of your peers believe they've positioned their practices to earn electronic health record (EHR) program incentives within the next two years, according to a Part B News reader survey. However, the incentive amount - up to $44,000 per physician from the Medicare program - won't cover implementation costs incurred by the practice, readers say. Just 22% of respondents believe the bonus payments will fully compensate the physicians for participation in the program (PBN 7/12/10).

The release of the Electronic Health Record (EHR) Incentive Program final rule provides much needed relief for you and your peers, health information technology experts tell Part B News. Earning up to $44,000 in Medicare incentives is now within reach for practices.

You'll face financial consequences beginning in 2012 if you fail to electronically prescribe drugs for your patients in 2011. Your Medicare reimbursements will decrease by 1% in 2012 and by 1.5% in 2013 for not adopting e-prescribing technology next year, CMS states in the proposed 2011 Medicare Physician Fee Schedule.

Eye doctors would be the biggest winners in 2011 when it comes to Medicare payment, a Part B News analysis of the proposed physician fee schedule (PFS) shows. While primary care practices are poised to see the biggest pay boosts of all thanks to health reform (PBN 7/5/10), ophthalmologists and optometrists would get a 4% raise in 2011 that would double to 8% in 2013, if the proposed PFS is finalized.

Watch out for prefered provider organizations (PPOs) you deal with that are affiliated with "wraparound networks." These networks are not illegal, but they create problems for physicians when they don't know they're in one and end up billing patients incorrectly.

Download the July Tool of the Month from the Part B News online Hot Documents library at www.partbnews.com today. The tool is a checklist to help you track that your electronic health record (EHR) system meets meaningful use requirements and you will qualify for EHR Incentive Program bonuses.

Your chances of defeating an overpayment demand from one of CMS's Recovery Audit Contractors (RACs) is very high when you can show the claim should be paid, according to the latest data on appeals filed against RACs during the program's three-year demonstration.