At the top of any practice’s mind is that of reimbursement. Gone are the simple days having a doctor write out a referral and hand it over to the patient. AAPC member Sharon Blank, CPC recently discussed this issue in the June edition of Radiology Today magazine.
“[M]any referring physicians now use EMRs to convey orders for their patients, and every year new CPT and ICD-9 diagnosis codes are introduced to the healthcare arena,” she wrote. “Add to that the growing concern among all healthcare professionals about when ICD-10 will finally become a reality, and it becomes clear that radiology professionals could benefit from a refresher course in the hows, whats, and whys of basic radiology coding in an effort to gain maximum reimbursement for their work.”
Read the full article here.
June 30th, 2012
Working on the business side of medicine features a lot of skills that most of the general public will ever know. One feature is that of requesting fee schedules from payers. AAPC Chapter Association (AAPCCA) member Melissa Corral, CPC wrote on this issue in the latest Coding Corner column for Advance for Health Information Professionals.
“Many payers are selective in releasing a complete physician fee schedule, even if you request on behalf of a multi-specialty practice,” she wrote. “[F]irst look at narrowing down which CPT codes are the most important to your practice in order to request for reimbursement from payers. Depending on your practice and size, it may be 20 codes or 200.”
Read the full article here.
June 29th, 2012
Medicare Payment Advisory Commission’s (MedPAC) June 2012 ”Report to the Congress: Medicare and the Health Care Delivery System” has been released. The six-chapter report evaluates Medicare payment issues and makes recommendations to Congress regarding access to care, quality of care, and other issues affecting Medicare. (more…)
As a result of an Office of Inspector General (OIG) June 2012 report, providers and suppliers can expect increased scrutiny of high utilization claims for test strips and lancets. In response to the report, which estimates contractors overpaid as much as $271 million for these types of claims in 2007, contractors stated they have taken, or plan to take, corrective action.
When submitting requested medical documentation to payers, time is of the essence. In the age of electronic submission of medical documentation (esMD), “It’s in the mail” is an antiquated and ineffective excuse. Missing a deadline could mean lost revenue for your medical practice.
The Centers for Medicare & Medicaid Services (CMS) instructs review contractors in Transmittal 426 on the process for handling late esMD.
When a provider has failed to submit a response to an Additional Documentation Request (ADR) letter by the deadline, CMS says, Medicare administrative contractors (MACs) should use the esMD content transport services (CTS) receipt date as the date the documentation was received. If the CTS receipt date is outside of the contractor’s normal business hours, the following business day may be used as the receipt date.
The moral of this story: If you have 30 days to respond to an ADR letter, don’t wait until day 29.