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 …

Create a Disaster Plan for ICD-10 and Your Cash Flow

It’s less than one year away. On October 1, 2014, ICD-10 will take effect. It’s a major change that is likely to cause any number of snafus, ultimately resulting in major delays in reimbursement to providers.  It’s critical that first and foremost, you do everything you can in your practice to ensure that you are …

Incident To: Proceed with Caution

Billing incident to is a question I frequently find in my inbox, on listserves, social media groups and at conferences. I’ve even seen this discussed, often erroneously on medical billing and coding discussion groups and listserves. In most situations, this applies to  Medicare, but it is possible that your state Medicaid payer, as well as …

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 …