Slow Medicare Payments
Just a reminder that that Medicare patients must meet their annual
deductible in January which causes a slowdown in cash flow. But due to Congress’ delay in approving the
Conversion factor until January 2nd, it is even slower paying than
usual. The reason is that all of the
Medicare contractors (MAC’s) could not process any claims until the fee
schedules were updated. CMS gave the
MAC’s until January 23rd to get that done. Novitas released their fee schedule on
1/22. So, instead of being able to
process a charge to deductible and releasing it to the 2’ early in the month,
all of those charges were delayed nearly 3 weeks. Cash flow should start to pick up by
mid-February and improve from then on.
FREE Eligibility Checking for CPB Appointment System Users!
Patient eligibility is now offered to all clients using the
CPB Scheduler. If you are interested in
using it, please call Rich. At least for
the next few months, CPB will cover the cost.
EHR’s – CHOOSE WISELY THE FIRST TIME
According to
Medscape.com (August 13, 2012 edition) half of EHRs sold are replacements! “Use of electronic health records
(EHRs) is snowballing, and so is the number of unhappy users. Half of EHR
systems sold to physician practices are now replacements, up from 30% last
year, according to a recent study by research firm KLAS. The leading reason for switching systems, cited by 44% of practices, is
product issues. Service issues (15%) and group consolidation (14%) - such
as when a hospital converts newly hired physicians to a new EHR - are a distant
second and third.
Morale of the Story:
Choose carefully and thoroughly evaluate your choice before
purchasing. It is disruptive enough to
move from paper to electronic. Switching
to another EHR is a 2nd major impact to your practice.
TherAPy Cap 2013 update
CMS announced that the Therapy Cap
will be $1,900 for 2013. Once the total
gets to $3,700, then Medicare is required to perform a mandatory review the
same as late in 2012.
The other new items are the new
“G” codes, Proper Modifier Reporting, and Multiple Procedure Payment Reduction
(MPPR) process.
ICd-10
ICD-10 is still about 20 months
away, but after attending an ICD-10 coding class earlier this month, thought
you might enjoy some statistics. Someone
took the time to count the # of ICD-9 codes commonly used by several
specialties and compare them to the same ICD-10 codes.
Specialty
|
ICD-9
|
ICD-10
|
Increase
|
Cardiology
|
178
|
430
|
2.4
|
Family Practice
|
229
|
829
|
3.6
|
OB/GYN
|
220
|
777
|
3.5
|
Pediatrics
|
165
|
836
|
5.1
|
Orthopedics
|
143
|
5843
|
40.9
|
Aetna Medicare
Advantage (MA) plans
Per Aetna, “Aetna Medicare
Advantage (MA) plans now cover an annual
wellness visit; no longer cover annual physicals. Effective January 1, 2013, Aetna MA
plans include coverage for an annual wellness visit. The CPT codes for a
wellness visit are G0438 and G0439.
Aetna MA plans no longer cover annual physical exams. The CPT codes for the annual physical exam are 99381-99397, 99401-99404, 99201-99205 and 99211-99215 with primary diagnosis of preventive. The preventive diagnosis codes that are not covered are: V03.0-V03.9, V04.0-V04.89, V05.0-V05.9, V06.0-V06.9, V20.0-V20.2, V70.0, V70.3, & V70.5.
This change was made as a result of a change in coverage made by the Centers for Medicare and Medicaid Services (CMS).”
Aetna MA plans no longer cover annual physical exams. The CPT codes for the annual physical exam are 99381-99397, 99401-99404, 99201-99205 and 99211-99215 with primary diagnosis of preventive. The preventive diagnosis codes that are not covered are: V03.0-V03.9, V04.0-V04.89, V05.0-V05.9, V06.0-V06.9, V20.0-V20.2, V70.0, V70.3, & V70.5.
This change was made as a result of a change in coverage made by the Centers for Medicare and Medicaid Services (CMS).”
PATIENT BALANCES
According to a recent article in
MGMA Connexion, $1 of every $4 owed
is now paid by the patient. That is 25%
of the average practice’s revenue.
Ways to collect these balances:
- Verify patient
eligibility when the appointment is made.
At the latest, verify it a day before the appointment so you can
have the appropriate discussion on the date of service.
- Be sure
patients know when the appointment is made that payment is due on the date
of service.
- Collect all
co-pays before the patient is seen.
- Accept credit
& debit cards
Current state-of-the-art software provides features to
establish and create payment plans using credit & debit cards, automatic scheduling
of those payments (with patient / guarantor approval, of course), store the
credit card data in a fully compliant PCI format, etc. CPB has access to such programs. If you are interested, please contact Rich.
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