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A Mid-Year Review of the Sample Impact Analysis for the 88342 / G0461 and Changes

 Mick Raich, Vachette Pathology Earlier this year I wrote a brief article on the changes with 88342 and the new G codes G0461 and G0462.  This article proved very insightful to me and many others.  It helped me understand how I was looking at things incorrectly, and it helped our client practices understand their revenue shortfalls. It has been six months since that piece; let’s take a quick look back at the revenue losses we predicted, compared …

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Sequestration Frustration in Minnesota Impacts Pathology Revenue

It appears Blue Cross and Blue Shield of Minnesota (BCBSMN) has made a significant error in Medicare reimbursements and has just recently realized it.

In May 2014, BCBSMN notified providers they will begin withholding a 2% Medicare payment reduction mandated by sequestration to all claims processed after June 6, 2014 — even though sequestration began April 1, 2013.

Plus, BCBSMN will be recovering the 2% reduction on Medicare claims with dates of service October 1, 2013, and later. However, they will only be targeting claims with a net payment of $100 or greater.

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What is a Virtual Credit Card Payment?

Our clients are asking about a new phenomenon — insurance companies who send an explanation of benefits (EOB) with “virtual” payment. The EOB will state, “payment for this remittance is being made via virtual credit card; please process this payment as you would any credit card.”

This brings up several areas of concern. First, what if you don’t take credit cards? Some practices have not progressed this far, and they do not have the ability to accept these virtual payments.

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