As a follow up to my recent post “Avoiding Payment Denials for Cloned Notes,” the Centers for Medicare & Medicaid Services (CMS) has issued new instructions to Medicare Administrative Contractors (MAC’s), Recovery Audit Contractors (RAC’s), and Zone Program Integrity Contractors (ZPIC’s) to look for claims generated from Electronic Health Records (EHR’s) that do not contain adequate information.
Medicare Administrative Contractors (MACs) warn that individualized patient notes are required for each patient visit, and that use of “cloned notes” may cause a provider to overlook new information, resulting in treatment, safety, and quality issues.
It is said that “a bird in the hand is worth two in the bush,” and that is especially true when you’re talking about collecting payments from patients at the time of service. According to the AMA, the average cost to physicians for collecting monies owed and processing claims is 10 – 14 percent of gross revenue, butthere are ways to be more efficient, reduce these costs, and collect payments faster. The AMA website offers a Point-of-Care Pricing Toolkit to help you collect payment from patients before they walk out the door.
Providers should start preparing now for the implementation of ICD-10, which is scheduled to begin October 1, 2014. Basically let’s talk about getting your practice's infrastructure in order.
The Centers for Medicare & Medicaid Services (CMS) on November 1, 2012 issued its 1,362-page final rule of fee schedules for 57 physician and other specialty provider groups for calendar year 2013.
Recovery Audit Contractors (RAC’s) are now reviewing high level evaluation and management (E&M) codes used in billing office visits in private practice. E&M services are based on the providers understanding of the patient’s medical history, review of patient’s medications, a physical examination, and of course a medical decision. According to Charles Fidel of AMedNews.com, Medicare paid $33.5 billion for E&M services in 2010. Of the 442,000 physicians that billed for E&M services, only 1,669 providers consistently billed high-level E&M codes such as 99215. A claim for a low-level visit by an established patient only paid about $20 in 2010, while a high-level new patient paid around $190.
Chances are that you like all the members of your staff, and that you appreciate their integrity, loyalty and hard work; so the thought that one of them could be stealing from you is probably not at the top of your list of things to worry about today. But if you’re leaving everything to your staff while you focus on patient care, you might very well be tempting them with an irresistible carrot.
Most medical offices have procedures in place that attempt to address the inevitable cases of last-minute cancellations and patient no shows. There are a number of tricks to handling them effectively to minimize their frequency and the damage they can do to the practice’s revenue in general. After all, a medical practice is a business, and the best business solutions are those that yield the greatest positive effect with the lowest overall cost financially and with the least effort. In the case of patient no shows, it is important to realize why and when they occur in order to devise the best combination of ways to respond to them and mitigate their effect on the schedule—and your revenue—over all.
Following on the heels of our recent article, “Billing and Coding for the Medicare Annual Wellness Visits,” we got this comment from a reader:
In a recently published article by Ricardo Alonso Zaldivar, reporting for the Associate Press, our healthcare system wastes $750 billion a year. Almost 30 cents of every dollar is spent on unneeded care, paperwork, and fraud, according to the Institute of Medicine.
