Signs that You Need an Associate Doctor By Jonathan Ford Hughes| August 7, 2018 If you’re like most doctors in private practice who find themselves in the back half of their careers, you might be thinking that it’s time to bring on an associate doctor and retire comfortably. But can you, your patients, and your...
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FREE WEBINAR: Impact of the Proposed 2019 E&M Changes The plethora of recent papers and articles concerning the new proposed Medicare 2019 E&M code changes have focused solely on the coding and documentation components. What seems to have been ignored, is both the financial impact as well as the impact on physician compensation packages tied to...
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CMS 2019 fee schedule takes modifier 25 cuts, runs with them Grant Huang, CPC, CPMA Director of Content With so much focus on the potential E&M reimbursement reductions that could result from the CMS proposed rule changes in its 2019 Physician Fee Schedule (PFS), there’s another crucial E&M provision that’s gotten precious little attention – but could significantly...
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Getting the Right Eligibility Information for Payment - Your Rights and Health Plan's Requirement Stanley Nachimson Principal, Nachimson Advisors, LLC This auditing and compliance "Tip of the Week" was originally published by the National Alliance for Medical Auditing Specialists (NAMAS), a division of DoctorsManagement. We need timely and accurate patient information to bill health plans...
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Are incident-to services worth the risk? Incident-to services allow non-physician practitioners (NPPs) such as nurse practitioners and physician assistants to bill under a supervising physician if they perform services that are incidental to a physician-created plan of care. Incident-to billing offers two key benefits: First, the physician is reimbursed at 100% of the contracted rate...
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CMS proposes a leaner MIPS for in 2019 Next year, CMS wants the Merit-based Incentive Payment System (MIPS) to be more streamlined, with fewer measures to report, expanded eligibility for non-physician providers to participate, and various tweaks to the four MIPS performance categories. The provisions appear in the Quality Payment Program (QPP) proposed rule, which...
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How to access your 2017 MIPS feedback report Your providers’ report cards for the 2017 reporting year of Medicare’s Merit-based Incentive Payment System (MIPS) are finally out, released by CMS via their Quality Payment Program website. So long as an eligible provider (MD, DO, nurse practitioners and physician assistants) submitted any MIPS data during 2017,...
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MIPS results for 2017 are in, but bonus payments are low The first year of performance monitoring under Medicare’s Merit-based Incentive Payment System (MIPS) is in the books and CMS has finally released MIPS report cards – which include Part B payment adjustments for 2019 – to all providers that submitted data. Unfortunately, the sheer...
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CMS proposal simplifies E/M coding but complicates payments CMS wants to simplify outpatient E/M coding by letting providers choose an office visit code level based on the most important component, medical decision making (MDM), or face time spent with the patient – without the existing requirement that the visit be counseling-dominated. This bombshell provision, appearing...
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Health Net, insurer in three states, cancels modifier 25 cut One more private payer has decided to rescind its planned policy of applying a 50% reduction to E/M codes with modifier 25 appended. Health Net, which offers a variety of insurance plans in Arizona, California, and Oregon announced that it will cancel the policy before...
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