Meaningful use reporting deadline pushed back two weeks to March 13 The Centers for Medicare & Medicaid Services (CMS) on Monday announced that physicians would have two additional weeks to register and attest to meaningful use for 2016 and avoid the 2018 penalty. Physicians now have until Monday, March 13, to attest for the 2016 reporting year. Two weeks ago, hospitals also received a similar reprieve. Physicians should note that CMS is only extending the attestation period, not the reporting period, so physicians must have concluded their reporting by December 31, 2016. Although the Medicare meaningful use program is being phased out ... March 2, 2017 Medicare Meaningful Use, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
2017 Medicare EHR payment adjustment reconsideration forms due February 28 Eligible physicians who have been identified as being subject to Medicare electronic health record (EHR) payment penalties in 2017 (based on the 2015 reporting period), and believe that determination to be in error, have until February 28, 2017, to submit a reconsideration form to the Centers for Medicare and Medicaid Services (CMS). The reconsideration form can be downloaded from the CMS website. For reconsideration instructions, click here. If you have questions about the reconsideration process, please email pareconsideration@provider-resources.com. For more information on payment adjustments and hardship applications, or for information ... February 23, 2017 Medicare CMS, EHR, Electronic Health Record, Medicare, Centers for Medicare and Medicaid Services 0 0 Comment Read More »
CMS erroneously warns some physicians of 2017 meaningful use penalties Providers who attested to meaningful use with the Medi-Cal Electronic Health Record (EHR) Incentive Program for program year 2015 are exempt from Medicare payment adjustments in 2017. Because the California Department of Health Services pushed back the deadline to submit meaningful use applications for the 2015 program year to December 13, 2016, the agency was not able to send information to the Centers for Medicare and Medicaid Services (CMS) regarding 2015 Medi-Cal meaningful use attestations until late in December 2016. For this reason, some Medi-Cal providers are now erroneously ... February 13, 2017 Medi-Cal, Medicare Department of Health Care Services, EHR, Meaningful Use, Medi-Cal, Medicare, CMS 0 0 Comment Read More »
Time to verify your patients' eligibility and benefits for 2017 The beginning of a new year brings with it changes to your patients’ eligibility and benefits. Physicians are urged to be diligent in verifying each patient’s eligibility and benefits to ensure they will be paid for services rendered. The beginning of a new year also means that both calendar year deductibles and visit frequency limitations reset. And, with open enrollment, patients may even be covered by a new payor. Don’t get stuck with unnecessary denials or an upset patient. Do your homework before the patient arrives by obtaining updated ... December 21, 2016 General, Managed Care, Medi-Cal, Medicare Running a Practice, Eligibility 0 0 Comment Read More »
Tip: Don't lose revenue by not working denials It’s no secret that claim rejections and denials can result in a significant amount of lost revenue. Consider this – a practice submitting 80 claims a day at an average reimbursement rate of $100 per claim should expect to receive $8,000 in daily revenue. If 10 percent of those claims were rejected or denied (eight claims per day at $100 per claim equals $800 per day), and the practice only appealed one out of every 10 rejections or denials ($720 per day loss), the practice could expect to lose ... December 13, 2016 General, Managed Care, Medi-Cal, Medicare Denials, Reimbursement, Tip of the Month 0 0 Comment Read More »
Deadline extended to dispute 2015 PQRS and QRUR findings The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. Today, CMS announced that physicians who have concerns about the findings in their report(s) have until December 7 to file for an informal review of their data. The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully ... December 6, 2016 General, Medicare Medicare, PQRS, Value-Based Payment Modifier 0 0 Comment Read More »
2017 Medicare fee schedule includes $140 million in additional funding for primay care The Centers for Medicare and Medicaid Services (CMS) on Wednesday released the final 2017 Medicare physician fee schedule. The fee schedule transforms how Medicare pays for primary care through a new focus on care management and behavioral health, which is expected to result in an additional $140 million in payments next year for physicians providing these services. The 2017 physician fee schedule focuses on improving Medicare payments for services provided by primary care physicians for patients with multiple chronic conditions, mental and behavioral health issues, and cognitive impairment or mobility-related ... November 14, 2016 Medicare Fee Schedule, Geographic Practice Cost Index, GPCI, MACRA, Medicare 0 0 Comment Read More »
Don't forget: Last day to change your Medicare participation status for 2017 is December 31 Once again, it’s time for physicians to decide if they want to make changes to their Medicare participation status. Physicians have until December 31, 2016, to make changes for 2017. Although Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) penalties will not kick in until 2019, there are two more years of penalties that will be applied based on 2015 performance—tied to the meaningful use, Physician Quality Reporting System and Value-Based Modifier reporting programs. This will also decrease the limiting charge amounts that nonparticipating physicians can bill to ... November 14, 2016 Medicare Medicare 0 0 Comment Read More »
Physicians have until November 30 to dispute 2015 PQRS and QRUR findings The Centers for Medicare and Medicaid Services (CMS) recently released data that indicates which physicians will be subject to the 2017 payment penalties associated with the Physician Quality Reporting System (PQRS) and Value-Based Payment Modifier (VM) programs. Physicians who have concerns about the findings in their report(s) have until November 30 to file for an informal review of their data. The penalties in question stem from policies in effect prior to the enactment of the Medicare Access and CHIP Reauthorization Act (MACRA). Failure to successfully complete required PQRS reporting ... November 14, 2016 Managed Care, Medi-Cal, Medicare Quality Reporting, Medicare, Physician Quality Reporting System, PQRS 0 0 Comment Read More »
California GPCI fix implementation to begin in January Last week, the Centers for Medicare and Medicaid Services (CMS) released the final Medicare physician fee schedule for 2017, which begins implementation of the long overdue overhaul of California’s outdated geographic payment localities. The California Geographic Practice Cost Index (GPCI) fix will update California’s Medicare physician payment regions and raise payment levels for 14 urban California counties misclassified as rural, while holding the remaining rural counties permanently harmless (starting in 2018) from cuts. All California payment localities will transition to Metropolitan Statistical Areas. The transition to the new localities starts next ... November 8, 2016 Medicare Geographic Practice Cost Index, GPCI, Medicare 0 0 Comment Read More »
