You and your peers are billing more high-level established patient office visits than ever before, a shift upward from low and mid-level E/M codes, an exclusive Part B News analysis shows (see chart). The facts: 99214 (office/outpatient visit, est., $92.33) made up 30.9% of all claims submitted with codes in the 99211-99215 series in 2008 - dramatically up from 20.7% in 2000. 99214's increased share represents a numerical increase of 34.2 million claims submitted over the eight year window.

You'll need to start using two new enrollment forms by Nov. 30 or risk your application being denied by your carrier. CMS made mostly minor edits to the forms, but make sure you download and use the correct forms before you begin the time-consuming enrollment process. The changes apply to CMS-855I (for physicians and non-physicians) and CMS-855B (for medical groups and clinics).

You increase your revenue and keep your billing team sharp by resubmitting denied claims, but most practices don't think about five important factors, experts say. Take these into account to maximize your chances of getting every last dollar you're owed.

Eliminate the guesswork in determining the place of service (POS) when your physician provides a consult service (99241-99245) in a hospital emergency room by looking at the patient's status, experts say. The correct POS is not going to be the same POS every time.

You'll need to attach one of three new modifiers when filing claims for a "never event" surgery. You still won't get paid for never event claims because of medical necessity (PBN 6/22/09). But the modifier you use sends a signal to your carrier to place the patient and the date of service for the surgical error on a list, CMS says.

Get paid in full more often by accepting credit cards and encouraging patients to use them, experts say. The main reasons for not accepting credit cards are the transaction fees, or when your records show most of your patients pay with cash or checks.

Almost one out of every five practices doesn't take credit cards (PBN 7/6/09). "The reason we decided not to do it ... is because most of our patients are elderly and don't use credit cards," says Desiree Baylin, practice manager at Associates in Adult Medicine, an internal medicine practice in York, Pa.

Recovery Audit Contractors (RACs) have come a long way. Since August, every RAC has released targets (PBN 8/10/09). Diversified Collection Services (DCS) - the RAC for Region A - became the last RAC to release target issues on Sept 21.

Your practice could see lowered prices on everything from medical equipment and practice management software to drugs and basic supplies by joining a health care group purchasing organization (GPO).

Use these five strategies to see if a group purchasing organization (GPO) is worth it for your practice and, if so, how to get the best deal on a membership (see story).