tag:blogger.com,1999:blog-33220762783332614032012-01-03T05:19:23.267-08:00The Cape Medical Billing BlogCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.comBlogger621100tag:blogger.com,1999:blog-3322076278333261403.post-38645577517891873212012-01-03T05:13:00.000-08:002012-01-03T05:19:23.295-08:00January 2012OFFICE CLIENTSJust a reminder to our office clients that it is important to send a list of patients seen each day so we can verify all patient charges have been received. Ideally it would be the first page after the Batch Cover Sheet. ATLANTICARE INSURANCE CHANGESAtlantiCare notified all employees and area providers on December 13th that their insurance will be changing effective January 1, 2012 Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-80669221256946875462011-12-02T18:11:00.000-08:002011-12-02T18:13:50.060-08:00December 2011Medicare Provider Revalidation“All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to submit their enrollment information so they can be revalidated under new risk screening criteria required by the Affordable Care Act (section 6401a). Providers/suppliers who enrolled on or after Friday, March 25, 2011 have already been subject to Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-19221541375902137142011-12-02T18:09:00.000-08:002011-12-02T18:11:40.990-08:00November 2011Medicare Provider Revalidation“All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to submit their enrollment information so they can be revalidated under new risk screening criteria required by the Affordable Care Act (section 6401a). Providers/suppliers who enrolled on or after Friday, March 25, 2011 have already been subject to Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-11158218019301358482011-12-02T18:00:00.000-08:002011-12-02T18:09:28.706-08:00October 2011ELECTRONIC CLAIMS AND PAYMENTS – 5010 FORMATOn January 1, 2012 the medical billing industry must begin submitting claims and applying payments using the 5010 version. CPB and our vendor are testing and do not anticipate any problem meeting this deadline. Medicare EHR PaymentsFrom CMS:“To qualify as certified EHR technology for the EHR Incentive Programs, an EHR needs to be tested by one of the Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-35019201320152544942011-09-01T17:42:00.000-07:002011-09-01T17:46:21.644-07:00September 2011WorkWell
WorkWell is a Pennsylvania Workman’s Comp Carrier which is expanding into NJ. Their rates look reasonable. They are looking for the following specialties:
Family Practice
Internal Medicine
If you are interested, let me know and I’ll forward additional information to you.
Medicare NEW Patients definition
Effective August 15, 2011, WPS Medicare Part B will turn on an edit that will Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-15368940640545398462011-08-10T14:44:00.000-07:002011-08-10T14:46:13.788-07:00August 2011Medicare Annual wellness visits and ekg’s
Medicare does not have a separate CPT code to bill an EKG on the same day as a Medicare Annual Wellness Visit (G0438 & G0439) like they do for an IPPE (G0402). Thus, to bill an EKG with either a G0438 or G0439 you will need one of the “normal” diagnosis indications.
GOOD OFFICE FINANCIAL POLICIES
By 2010, more than 54 percent of large employers Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-77889788090793062732011-08-10T14:41:00.000-07:002011-08-10T14:44:30.560-07:00July 2011Medicare routine services
Routine services such as a TB test are not covered by Medicare. In such cases, an Advanced Beneficiary Notice (ABN) is NOT required and payment can be collected on the date of service.
Medicare eRx & EHR Vendor Codes
Just a reminder, the eRx & EHR vendor codes for Medicare is required to be billed on the same claim as the E&M code it goes with. It cannot be billed Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-12265231517667924912011-06-20T16:43:00.000-07:002011-06-20T16:45:24.123-07:00June 2011Medicare advantageWe have added a new Financial Class – Medicare Advantage – to your reports to help track this segment of patients. Financial Class is always based upon the primary insurance. If you have any questions, please call Rich. CRedit card paymentsAs a follow-up to a question about credit cards, the credit card payment is deposited directly into your bank account by the credit card Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-30480406133827612432011-05-09T15:22:00.000-07:002011-05-09T15:26:40.921-07:00May 2011Credit card paymentsWith more insurance policies than ever having high patient and family deductibles (we have seen them as high as $5,000 per year!), you may want to consider offering credit cards as one of your payment options.We have researched this and it appears that an average cost per month for 75-80 patients to charge $2,500 (an average of about $32 each) is less than $100. Vendors now Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-84289721787984747302011-05-09T15:19:00.001-07:002011-05-09T15:22:53.148-07:00April 2011Medicare EMR PAYMENTSRecently we were asked what is required to qualify for the Medicare EMR funds for qualified providers:Be using one of the 200+ ONC 2011 Certified EHR applications,Use the product in a “meaningful way” for 90 days starting anytime after 01/01/2011, andGo on-line to register with CMS.CMS has asked that we remind eligible professionals that they must register in order to Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-67088161250759514622011-03-21T17:41:00.000-07:002011-03-21T17:46:12.242-07:00FOR IMMEDIATE RELEASENEWS RELEASE AssistMed Highlights Cost- and Time-Savings to Physicians and Billing Service Companies with Its Duet™ Digital Pen and Custom Forms Product --Technology Eliminates Manual Processes; Improves Efficiency in Patient Care-- LOS ANGELES, CA – AssistMed, Inc. announced the results of an informal survey demonstrating improved time- and cost-savings to physicians and billing services Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-21203183724342731182011-03-21T17:36:00.000-07:002011-03-21T17:38:52.153-07:00March 2011New Medicare wellness visitsMedicare has redefined the G0402 (Initial Preventive Physical Exam). It is now valid for 12 months (it was 6 months) after the patient becomes eligible for Medicare (not the previous 6 months). For new Medicare patients joining your practice, you will want to verify whether they received a previous well visit (G0402 now, or G0438/G0439 next year) with a previous Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-29784398170739675012011-03-21T17:30:00.000-07:002011-03-21T17:36:14.198-07:00February 2011Medicare – New opportunities to treat patientsAs you know, each year Medicare patients must meet their annual deductible which results in a significant cash flow slow down for many providers.An interesting way to let them meet the deductible elsewhere is for you to use the new Medicare Wellness codes. Medicare implemented a new Annual Wellness Visit (AWV) service which does NOT require a Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-6006897503190877832011-01-18T15:21:00.000-08:002011-01-18T15:23:03.756-08:00January 2011HAPPY HOLIDAYS, Medicare fee schedule, and Red Flags ruleWe hope you enjoyed the holidays! Congress & President Obama did provide 2 nice “gifts” for the new year: 1) Medicare Fee Schedule changes that were to end on 11/30 have been extended thru 12/31/11, and2) Physicians and other healthcare providers (including ambulance) were exempted from the Red Flags Rule. As you know, Medicare payment Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-4076155005535201362011-01-18T15:18:00.000-08:002011-01-18T15:21:05.532-08:00December 2010CPB Holiday scheduleCPB will be closed on Christmas Eve (Friday, December 24th), and New Years Day Eve, Friday, December 31st. We hope you enjoy the holidays! PECOS – cms just “blinked”CMS announced on November 24th that the automated edits will not be turned on effective January 3, 2011. They are working diligently to resolve enrollment backlogs and other system issues and will provide ample Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-79940291404699607842010-11-05T18:51:00.000-07:002010-11-19T18:54:50.595-08:00November 2010Medicare MLN Matters Article #MM7133 - Counseling to Stop Tobacco Use The Medicare Learning Network® (MLN) has released MLN Matters Article #MM7133 to inform providers that the Centers for Medicare & Medicaid Services (CMS) will cover counseling services to prevent tobacco use for outpatient and hospitalized beneficiaries. Effective for claims with dates of service on and after August 25, 2010, Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-12045286563225096172010-10-04T18:44:00.000-07:002010-11-19T18:50:37.496-08:00October 2010HUMANA CHANGES On August 6th Humana announced they will be making a number of changes in billing and payment policies and procedures effective November 6, 2010. The most notable that we saw pertains to our PCP’s: Humana will include E&M services with the removal of impacted cerumen (69210). It is not clear from their letter whether they will allow modifiers to show when the 69210 was separate Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-62861819018514570022010-09-04T04:12:00.000-07:002010-09-04T04:25:28.861-07:00September 2010 CMB APPOINTMENT SYSTEMSeveral office-based clients are now using our appointment system and enjoying the numerous benefits it offers. And it is free! Setup takes only a few minutes (which we do) and simply requires a computer and high-speed internet.The system also offers an add-on auto-dialer option that works off the appointment system to remind your patients they have an appointment – thus Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-62504062778116914202010-08-06T19:22:00.000-07:002010-08-06T19:34:13.032-07:00August 2010MEDICARE - PECOSMedicare is reminding all physicians regarding the PECOS requirements for providers who have not re-enrolled or updated their enrollment within the past 6 years. Providers will need an approved enrollment record in PECOS to continue to order or refer items or services for Medicare beneficiaries and to receive incentive payments made by Medicare and Medicaid. If you, or a Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-55324209114113606822010-07-10T17:10:00.000-07:002010-07-10T17:17:58.268-07:00July 2010Electronic Medical Records (EMR’s)Lots of discussion is occurring about EMR’s. One of the key considerations is, aside from working well for you, is that it must meet “meaningful use” criteria. If it does not meet it before or after you buy it – it will result in no Medicare bonus payment to you! One of those criteria is certification which many EMR programs do not have and are being sold Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-639976289000195262010-06-11T17:44:00.000-07:002010-06-11T17:46:59.377-07:00June 2010HealthNet of the NortheastUnited Healthcare has acquired the licensed subsidiaries of HealthNet of the Northeast effective May 1, 2010. As a result, it will no longer be able to provide managed care services for its NJ Family Care/Medicaid members. Patients will be able to select a different HMO or will be assigned to AmeriChoice if they do not select another by April 9th. If you see Medicaid Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-91014701853316479252010-05-05T19:52:00.000-07:002010-05-05T19:53:51.321-07:00May 2010Medicare Timely Filing CHANGE On March 23, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (PPACA), which amended the time period for filing Medicare fee-for-service (FFS) claims as one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program. Under the new law: · Claims for services furnished on or after January 1, 2010, Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-70863346060398674782010-04-22T20:24:00.000-07:002010-04-22T20:25:23.366-07:00April 2010AETNAOn March 16th Aetna announced via email (forwarded to all clients that have provided us with email addresses) that beginning June 14, 2010 they will no longer send paper EOB’s. CPB is already set up for most clients and will work with whomever necessary to ensure a smooth transition. However, please note that if you still wish to have paper EOB’s that you can complete an “Exclusion form”. Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-15135904669917006832010-03-04T19:52:00.000-08:002010-03-04T19:53:34.626-08:00March 2010RED FLAGS PROGRAMThe Red Flags statute is scheduled to go into effect on June 1, 2010. On Tuesday, March 23 at 8:00 am (prior to office hours) CPB is sponsoring a program at our office in conjunction with MSNJ on implementing the Red Flags program. The program includes handouts that will put you about 90% of the way to compliance. If you are interested in attending, please RSVP no later than Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-47047130695145467602010-03-04T19:49:00.000-08:002010-03-04T19:52:19.849-08:00February 2010PROVIDER MEDICAL RECORD SIGNATURES - UPDATEHighmark Medicare has now agreed that “Electronically Signed” signatures are now acceptable.Medicare 2010 eRx ProgramThe 2010 program has some small changes from the 2009 program making it easier to participate.· Only 1 code is now used: G8553: “At least 1 Rx created during the encounter was generated and transmitted electronically using the eRxCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-90052149275683855892010-01-22T21:27:00.000-08:002010-02-25T14:07:47.993-08:00January 2010PROVIDER MEDICAL RECORD SIGNATURESCMS and other insurers are VERY active with pro-payment and post-payment audits (CERT & RAC) and are carefully reviewing medical record documentation. One of the critical requirements that is checked on EVERY medical record is the presence of an acceptable provider signature. This type of denial is easy to avoid. In the December Highmark Medicare Report, page 3 (Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-90333129980216271172010-01-14T13:56:00.001-08:002010-01-22T21:29:35.632-08:00December 2009HOLIDAY SCHEDULECPB will be closed at 1:00 on Christmas Eve, Christmas Day and New Years Day. We hope you enjoy the holidays! We will also close at noon on Wednesday, December 2nd for our Annual Employee Appreciation Day.AUDITS – PRE-PAYMENT, CERT OR RACIf you receive an audit request, whether prepayment, CERT, or RAC, we suggest that you notify CPB immediately before responding and let us look Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-69953136713901547572010-01-14T13:54:00.000-08:002010-01-14T13:56:04.143-08:00November 2009THANKSGIVING HOLIDAY + ANNUAL CPB EMPLOYEE APPRECIATION DAYCPB will be closed Thanksgiving Day and the Friday after Thanksgiving to provide our staff a long weekend. We hope you enjoy the holiday also!We will also close at noon on Wednesday, December 2nd for our annual Employee Appreciation Day. Medicare AUDITSCPB has seen the first of pre-payment audits that are being conducted by Highmark Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-58292986058313714402010-01-14T13:53:00.000-08:002010-01-14T13:54:49.834-08:00October 2009Patient’S WITH INJURIESPlease be pro-active - we are starting to see more delayed claims due to diagnoses that indicate the patient was injured. Diagnoses such as laceration, fracture, etc. often cause insurers to delay payment until the patient is sent a Coordination of Benefits (COB) letter and returns it – which often is not done very timely. To avoid this, please ask patients to tell you Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-482970190976297992010-01-14T13:52:00.000-08:002010-01-14T13:53:49.544-08:00September 2009Labor Day HolidayCPB will be closed on Monday, September 7th to celebrate the holiday. We hope you and your staff enjoy it as well.NEW clientsCPB is always looking for new clients and appreciates referrals from our existing clients. If you know a colleague who is experiencing slow cash flow, poor insurance collections, or any of the many non-payment issues – please refer them to CPB. In today’Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-23267327663298987652010-01-14T13:44:00.000-08:002010-01-14T13:52:32.475-08:00August 2009Labor Day HolidayCPB will be closed on Monday, September 7th to celebrate the holiday. RED FLAG RULES DELAYED AGAINThe FTC announced on July 29th that the Red Flag Rules will be delayed again with a new date of November 1, 2009. Per the FTC announcement, their staff will “redouble its efforts to educate them (small businesses) about compliance with the "Red Flags" Rule and ease compliance by Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-91364284184238478912010-01-14T13:41:00.000-08:002010-01-14T13:44:09.821-08:00July 2009July 4th HolidaySince July 4th falls on a Saturday, CPB will be closed on Friday, July 3rd to celebrate the holiday. CIGNAAfter hours care. CIGNA will allow separate reimbursement for after-hours CPT codes 99050 and 99058. CPT descriptions:· 99050 is "services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (e.g., Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-20049485184841181352010-01-14T13:40:00.000-08:002010-01-14T13:41:49.830-08:00June 2009July 4th HolidaySince July 4th falls on a Saturday, CPB will be closed on Friday, July 3rd to celebrate the holiday. Days IN ACCOUNTS RECEIVABLE (DAR)Days in Accounts Receivable (DAR) is a standard measure of how fast money that is owed to you is collected. It is usually calculated over the previous 3 months by dividing your actual accounts receivable (AR) (minus bad debt and other long term Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-54534305812578390962010-01-14T13:34:00.000-08:002010-01-14T13:39:58.770-08:00May 2009Medicare DeductiblesAmazingly this year, we are STILL seeing patients meeting their Medicare deductibles as recent as today, May 1, 2009. This is by far the latest in the calendar year we have seen in our 19 years of business.HOSPITAL OBSERVATION STATUSRecently some physician clients have been experiencing occasional issues with differentiating hospital observation vs. inpatient status. Because Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-54291971978056552502010-01-14T13:33:00.000-08:002010-01-14T13:34:35.204-08:00April 2009Medicare DeductiblesAmazingly this year, we are STILL seeing patients meeting their Medicare deductibles as recent as today, April 1, 2009 (not an April Fool’s joke!). This is by far the latest in the calendar year we have seen in our 19 years of business. OIG WOrk Plan 2009Each year the OIG publishes its Work Plan for the coming year & CPB reproduces the relevant targets for our clients. The Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-44503003254773281822010-01-14T13:28:00.000-08:002010-01-14T13:33:51.666-08:00March 2009OFFICE FINANCIAL POLICIESAs everyone knows, there are two parts to getting ahead with money – making it and saving it! This article will discuss some ways to consider how to watch the money you do collect. · For office payments – patient co-pays, deductibles, and coinsurance – require that 2 people be involved in reconciling at the end of the day. The collector (front desk usually) of Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-47904784133386991282010-01-14T13:27:00.000-08:002010-01-14T13:28:45.226-08:00February 2009ePRESCRIBING (eRx)Just a reminder that providers that can qualify for the 2% Medicare bonus must send 1 of 3 special codes to Medicare when billing each office visit or consult code. They cannot be sent at a later time. There are other requirements that make it important for you to begin sending these codes ASAP. We can add these codes to your Charge form – just let us know - and we will Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-45038616530234180112010-01-14T13:26:00.000-08:002010-01-14T13:27:37.260-08:00January 20092008 RECAPThe year 2008 was a very good year for CPB clients with collection rates among the highest in the industry (high is good!) and Days in Accounts Receivable among the lowest (low is good – measures the number of days, on average, it takes to collect your reimbursement). However, with the tough economy, 2009 is likely to be a challenging year due to layoffs, bankruptcies, business Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-63825791540953586412010-01-14T13:25:00.001-08:002010-01-14T13:25:59.317-08:00December 2008CPB HOLIDAY CLOSURE DATESJust a reminder that CPB will be closed on Thursday, December 25th, Friday December 26th, & January 1st for the Christmas & New Years holidays. Wednesday, December 24th we will be open from 9:00 AM – 5:00 PM. We hope each of you enjoy your own special holidays.Medicare CARRIER TRANSITION ON NOVEMBER 14This seems to have occurred without any significant issues. ECONOMY –Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-15246386679232525592010-01-14T13:24:00.000-08:002010-01-14T13:25:14.428-08:00November 2008Medicare CARRIER TRANSITION ON NOVEMBER 14Most clients have now sent CPB a copy of the Medicare letter indicating their new EFT has been processed. That letter is the only way you know that your EFT has been properly set up so that your Medicare payments will continue after the transition to the new Medicare carrier on November 14. If you have not already done so, please be certain to send us aCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-23804889235913624542010-01-14T13:23:00.000-08:002010-01-14T13:24:12.143-08:00October 2008Medicare CARRIER TRANSITION ON NOVEMBER 14Most clients have now sent CPB a copy of the Medicare letter indicating their new EFT has been processed. That letter is the only way you know that your EFT has been properly set up so that your Medicare payments will continue after the transition to the new Medicare carrier on November 14. If you have not already done so, please be certain to send us aCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-36046337223592323902010-01-14T13:22:00.001-08:002010-01-14T13:22:59.511-08:00September 2008MEDICARE FEE SCHEDULEOn July 15th, 2008 Congress passed the Medicare Improvements for Patients and Providers Act of 2008. This legislation cancelled the scheduled 10.6% fee reduction mandated by the SGR and replaced the reduction with a .5% increase which is the same amount paid by Medicare from January 1st, 2008 through June 30th, 2008. CPB had a strategy to delay sending claims until after theCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-27280442431419871222010-01-14T13:18:00.000-08:002010-01-14T13:21:56.083-08:00August 2008MEDICARE FEE SCHEDULE & THERAPY CAP STATUSOn July 15th, 2008 Congress passed the Medicare Improvements for Patients and Providers Act of 2008. This legislation cancelled the scheduled 10.6% fee reduction mandated by the SGR and replaced the reduction with a .5% increase which is the same amount paid by Medicare from January 1st, 2008 through June 30th, 2008. Medicare expected to begin making Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-39217209798444062192010-01-14T13:17:00.000-08:002010-01-14T13:18:46.377-08:00July 2008NPI # Information From MedicarePayments are flowing properly!MORE NPI # INFORMATION - OTHER THAN MEDICAREAs you know, the NPI # became mandatory for all insurers on May 23rd. As of 6/27/08 we have not received any rejected claims and are sending NPI #’s only (as required by law). We will continue to watch and address any issues as needed. MEDICARE FEE SCHEDULE & THERAPY CAP STATUSIn order to Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-35468862653229763232010-01-14T13:15:00.000-08:002010-01-14T13:17:07.716-08:00June 2008NPI # Information From MedicareThis is no longer an issue. Payments are flowing properly!MORE NPI # - OTHER THAN MEDICAREThe NPI # became mandatory for all insurers on May 23rd. As of 6/2/08 we have not received any rejected claims and are sending NPI #’s only (as required by law). We will continue to watch and address any issues as needed. CPB’S NEW PHONE #CPB now has a new main phone #: Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-74332347708974013642010-01-14T13:14:00.000-08:002010-01-14T13:15:38.777-08:00May 2008NPI # Information From MedicareWe are pleased to report that CPB has been sending only the NPI # to Medicare for several weeks without any problems getting paid. At least for Medicare patients, it appears we are in good shape for May 23rd. MORE POTENTIAL CASH FLOW ISSUESThere is still potential for cash flow interruption when the NPI # becomes mandatory for all insurers on May 23rd. Our Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-87413255228308291042010-01-14T13:13:00.000-08:002010-01-14T13:14:30.635-08:00April 2008NPI # Information From MedicareWe are pleased to report that CPB has been sending only the NPI # to Medicare for several weeks without any problems getting paid. At least for Medicare patients, it appears we are in good shape for May 23rd. MORE POTENTIAL CASH FLOW ISSUESOnce we get past the annual deductibles in March, there is still potential for cash flow interruption when the NPI # becomes Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-15380667997226428652010-01-14T13:05:00.000-08:002010-01-14T13:09:24.311-08:00March 2008MEDICARE DEDUCTIBLES = DECREASE CASH FLOWThe 2008 Medicare Part B deductible increased to $135 further slowing cash flow over the previous year. Cash flow will be down as usual in January & February since Medicare deductibles hit - until secondary insurance & patient payments are received in February & March. Just a reminder that historically for all providers it takes until the end of March Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-25691199295164664612010-01-14T13:04:00.000-08:002010-01-14T13:05:23.171-08:00February 2008MEDICARE DEDUCTIBLES = DECREASE CASH FLOWThe 2008 Medicare Part B deductible increased to $135 further slowing cash flow over the previous year. Cash flow will be down as usual in January & February since Medicare deductibles hit - until secondary insurance & patient payments are received in February & March. Just a reminder that historically for all providers it takes until the end of March Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-67021129585016586192010-01-14T10:43:00.000-08:002010-01-14T13:03:32.681-08:00January 20082008 PART B DEDUCTIBLEThe Centers for Medicare & Medicaid Services (CMS) announced the Part B annual deductible for 2008 is $135.00 (up from $131 for 2007). If the patient has no secondary insurance, we strongly recommend collecting the deductible and co-insurance on the day of service. Be sure to ask if the patient has paid all or part of their deductible to any other providers, of course. TheCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-75005292449475218652007-12-03T15:48:00.000-08:002007-12-03T15:49:10.280-08:00December 2007CPB HOLIDAY CLOSURE DATESJust a reminder that CPB will be closed on Tuesday, December 25th & January 1st for the Christmas & New Years holidays. Monday, December 24th we will be open from 9:00 – 1:00. We hope each of you enjoy your own special holidays.Hospital Consult vs. Patient VisitThe question is whether there was a request for consultation for the management of a problem that another Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-76536853150286703622007-12-03T15:44:00.000-08:002007-12-03T15:47:40.388-08:00November 2007NPI #’sCMS finally released the NPI number registry on September 5, 2007 & we are working on loading all referring physician NPI #’s in our database. CPB, as has nearly every other practice and billing service, continues to deal with various related minor insurance company NPI # issues. This is because CMS gave every insurance company in the USA (over 2,000 of them!) the latitude to decide whenCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-72860673740718749422007-10-08T08:24:00.000-07:002007-10-08T08:25:50.347-07:00October 2007NPI #’sCMS finally released the NPI number registry on September 5, 2007 & we have almost finished loading all referring physician NPI #’s in our database. CPB, as has nearly every other practice and billing service, continues to deal with various related minor insurance company NPI # issues. This is because CMS gave every insurance company in the USA (over 2,000 of them!) the latitude to Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-80344671003702128662007-10-08T08:23:00.000-07:002007-10-08T08:24:39.057-07:00September 2007NPI #’sCMS delayed the release of the NPI number registry now until September 5, 2007. We will begin loading NPI #’s as soon as they are available. QualCareEffective August 1, 2007 QualCare is the exclusive medical network for Humana commercial health plan members in NJ. QualCare participating providers are now able to serve members from both Humana's local and national accounts. All Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-37887662586079724892007-08-03T20:00:00.000-07:002007-08-03T20:09:22.342-07:00August 2007CPB STAFF OUTINGOn Friday, August 17th CPB will be closed for the day to enable our staff to enjoy our annual office Employee Appreciation outing. NPI #’sCMS is supposed to make the full NPI # list available online for download as a file on August 1st. We have printed the entire list of referring physicians in the CPB database and will begin loading NPI #’s as soon as they are available. Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-22279304836930554902007-08-03T19:58:00.000-07:002007-08-03T20:00:11.614-07:00July 2007NPI #’sThe data dissemination notice (for NPI #’s) was put on display on May 23rd at 4:00 for CMS officials to review. CMS is supposed to make it available for download as a file in 30 days with NPIs office addresses, practitioner name, and license number (no SSN). Approximately 98% of the estimated 2.3 million covered health care providers now have NPIs. The NPPES Data Dissemination Notice (CMSCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-23638378270374484422007-08-03T19:56:00.000-07:002007-08-03T19:58:51.662-07:00June 2007NPI #’s – A CASH FLOW ISSUE IN JUNE ?The Centers for Medicare & Medicaid Services (CMS) announced that it is implementing a contingency plan for covered entities (other than small health plans) who will not meet the May 23, 2007, deadline for compliance with the National Provider Identifier (NPI) regulations under HIPAA. CMS will not enforce the deadline as long as the entity is making progress Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-71256383516932317802007-08-03T19:54:00.000-07:002007-08-03T19:55:41.094-07:00May 2007Medicare’s Physician Quality Reporting Initiative (PQRI) ProgramDetailed program instructions, educational materials, and supportive tools are posted as they become available on the CMS PQRI Web site at: http://cms.hhs.gov/PQRI . Here are a few key aspects of the program that begins July 1, 2007 and ends December 31, 2007. Eligible Professionals1. Medicare physician, as defined in Social SecurityCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-21446062636235245472007-08-03T19:51:00.000-07:002007-08-03T19:53:15.130-07:00April 2007NPI #’s – A CASH FLOW ISSUE IN JUNE ?Just as we are getting past the cash flow slow-down due to the annual deductibles another looms on May 23rd. As you probably know by now, NPI #’s are required for payment on and after May 23rd. CPB strongly encourages you to be very frugal with your cash until we see how this conversion progresses thru the end of June. We have also filed the #s with various Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-66983348213843018892007-08-03T19:50:00.000-07:002007-08-03T19:51:37.072-07:00March 2007NPI #’s – A FUTURE CASH FLOW ISSUE ?Just as we are about to get past the cash flow slow-down due to the annual deductibles another looms on May 23rd. As you probably know by now, NPI #’s are required for payment on and after May 23rd. Providers with NPI #’s that have not been properly linked by insurers will likely be part of the financial crisis for providers across the nation. Current Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-50911153886643357972007-08-03T19:48:00.000-07:002007-08-03T19:49:53.002-07:00February 2007HMO, PPO & OTHER MANAGED CARE AGREEMENTSWe occasionally hear providers express concern that they are not being paid well enough by a particular insurance company (OK – usually “companies”!). Practicing medicine is one profession, doing the business of medicine is another.One of the most economically challenging business arrangements is the solo practice who negotiates on their own. Often Cape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0tag:blogger.com,1999:blog-3322076278333261403.post-5341731758766961512007-08-03T17:23:00.000-07:002007-08-03T19:47:27.271-07:00January 2007A FEW REMINDERS· The new Medicaid ID cards have a CCN # listed. This is not the Medicaid ID# needed to bill with. To ensure the patient is covered Medicaid requires you to follow their procedure to contact them and obtain their Medicaid #.· Make sure when a patient is filling out the Patient Information form that they indicate whether the charges are related to an auto accident orCape Medical Billinghttp://www.blogger.com/profile/11774134115075484350noreply@blogger.com0