Download the June Tool of the Month from the Part B News online Hot Documents library. The tool is a form letter to help you challenge underpayments when a discount has been wrongly applied to your reimbursement (see story). This letter is based on one developed by attorney Robin Fisk, of Ashland, N.H.

This chart assigns a per-provider denial amount, in dollars, by assessing how often each specialty has denied claims and how many providers belong to the specialty.

Medicare providers in North Carolina, South Carolina, Virginia and West Virginia won't have to worry about the chances of a disruptive Medicare Administrative Contractor (MAC) transition anytime soon. A protest has been filed against the award to Palmetto for the MAC contract to oversee those states in Jurisdiction 11 (PBN 6/7/10).

In one month, a Medicare carrier denied a quarter million claims just because billers left off critical referring information to reimburse services. The offense: Your peers neglected to attach the referring provider's name and/or National Provider Identifier (NPI).

You'll know you're not in CMS's Provider Enrollment, Chain and Ownership System (PECOS) when you receive a letter from your carrier this month. Two-page letters appearing on your carrier's letterhead are being mailed in standard-size envelopes to the practices and providers who aren't in PECOS.

Be on the lookout for silent preferred provider organizations (PPOs) - private insurance companies that underpay you without your permission. You'll lose out on thousands of dollars - maybe without your knowledge - if you're not careful.

You know you need to buy and implement an electronic health records (EHR) system soon to take advantage of federal incentives worth up to $44,000 per provider starting in 2011. The payout goes down the longer you wait (PBN 3/8/10). But what do you know about EHR systems right now - can you visualize what you'll get?

You're looking at yet another temporary Medicare payment fix - this one with a 2.2% payment increase at least - after Senate negotiators failed to gain enough support for a longer term 19-month pay fix bill. The 2.2% increase, which still has not passed Congress as Part B News went to press, would be retroactive to June 1 but would expire Nov. 30.

CMS will give Congress three extra days to pass a payment fix before processing claims with a 21.3% cut, an agency official announced. Your contractors will now hold claims submitted for the month of June through Thursday, June 17. CMS will lift the hold on June 18. Claims with a date of service before June 1 will continue to be processed without the cut.

You now have a clear road to payment for every hour of pulmonary rehabilitation performed, a change long sought by specialists and previously covered only by some Medicare contractors under varying local coverage determinations (LCDs). But pulmonary rehabilitation (PR), like its sister services cardiac and intensive cardiac rehabilitation (CR and ICR), isn't just a free new billing opportunity, experts say.