Opting Out of Medicare

Whenever Medicare changes its rules, providers express interest in opting out of Medicare. Indeed, many clinicians are wondering about, and opting out of third party payment systems for a variety of reasons (low payment, no payment, and hassle factors), which we will explore in another article. However, with the Medicare Access and CHIP Reauthorization Act …

Medicare to hold claims

The 2014 Medicare Physician Fee Schedule (MPFS) final rule stipulated a negative update to the MPFS that was to be effective January 1, 2014. That reduction was averted for three months with the passage of the Pathway for SGR Reform Act of 2013, which provided for a 0.5 percent update for services paid under the …

Clinicians Business Tip: Medicare, Medicaid or Not

Recently I’ve received several questions from nurse practitioners and other clinicians about Medicare and Medicaid. Specifically they are questioning if they should accept patients into their practices with these insurances and if they already do, should they consider opting out? Not surprisingly, there is a lot of emotion behind these questions. Most NPs I’ve spoken …

EHR: NPs, CNMs, PAs

From the Centers of Medicare and Medicaid Services, here is an important announcement on electronic health records (EHR). As of Tue Jan 31, more than $3.2 billion in Medicare and Medicaid electronic health record (EHR) incentive payments have been made; more than 191,000 eligible professionals, eligible hospitals, and critical access hospitals are actively registered. Learn …

Medicare Update for Clinicians

There are three updates that Medicare has recently posted that Nurse Practitioners, Physician Assistants and other clinicians (and their billing staff) will want to be aware of. 1. Summary of Policies in the CY 2011 Medicare Physician Fee Schedule (MPFS) and the Telehealth Originating Site Facility Fee Payment Amount – http://www.cms.gov/MLNMattersArticles/downloads/MM7264.pdf 2. Emergency Update to …

ICD10 Codes

Nurse Practitioners and other clinicians should be aware of the changes  that are taking place when it comes to diagnostic coding. On October 1, 2013, medical coding in U.S. health care settings will change from ICD-9-CM to ICD-10. The transition will require business and systems changes throughout the health care industry. Everyone who is covered …