|
Written by Mick Raich
|
|
Tuesday, 17 August 2010 09:32 |
|
A recent news story about pathology reports being found in a dump made me smile. See The
Boston Globe 8/13/2010. The first thought that came to my mind was that some pathology group cancelled their contract with their biller and now the biller was cleaning out the cabinets.
Obviously this was a distinct violation of HIPAA and not very professional. The whole thing made me think about what happens when you terminate your billing service. How are they supposed to treat you? How do you move through this process in a professional way?
In my position, we are often brought in to work with groups that are moving through this process. They are unhappy with their current billing service. Often the reasons for this dissatisfaction are the same. The billing service keeps changing service representatives and there is no longer a personal relationship, the billing service was sold to another company and all the players have changed, or the biller is not providing quality service, i.e. the cash flow is declining. It doesn’t matter the reason. The bottom line is that this is a business divorce and like many divorces it can get messy.
|
|
Read more...
|
|
|
Written by KMA Legislative Alert
|
|
Tuesday, 25 May 2010 12:13 |
|
With 21% cuts in Medicare physician payment looming for June 1, the US House of Representatives is expected to consider legislation that would provide for modest increases and/or freezes in physician payments for the next four years. The proposal is being incorporated into H.R. 4213, The American Jobs and Closing Tax Loopholes Act of 2010, and might be considered by the US House as early as Tuesday, May 25. Specifically, the language included in H.R. 4213 would provide for:
- a 1.3% update in Medicare physician reimbursement for 2010;
- a 1% increase in 2011; and
- updates in 2012-13 updates based on target expenditures, which, at worst, would freeze payments for the two years.
In 2014, Medicare physician payment would, once again, be subject to the Sustainable Growth Rate (SGR) formula. Some projections have indicated that Medicare physician payment might be cut by 32%, at that time.
|
|
Read more...
|
|
|
Written by Mick Raich
|
|
Thursday, 04 February 2010 08:05 |
|
Recently the 2010 National Physician Fee Schedule Relative
Value File was released. This file shows
us the Relative Value Unit (RVU) for each CPT code that is billed. The RVU is multiplied by a Conversion Factor
(CF) to get the payment for that CPT code. This is how Medicare (CMS) determines what you
get paid.
For example the RVU for an 88305-26 in 2008 was 1.04. This was
multiplied by the 2008 conversion factor of $38.08 ($38.08 x 1.04) to come up
with the payment of $39.60. In 2008, $39.60
was the national payment for this CPT code.
|
|
Read more...
|
|
|
|
|
