Beginning January 1st, 2016 RHCs and FQHCs may receive payment for Chronic Care Management Services (CCM) furnished to Medicare beneficiaries having multiple chronic conditions that are expected to last more than 12 months or death of the patient.The payment rate for CCM services in RHCs and FQHCs will be $40.82, and could be billed in addition to the RHC visit as long as the required 20 minutes of qualified CCM services is met.
Cash and Point-of-Service Collection Risks:
Although more Americans have health insurance coverage, 25% do not have money or liquid assets to cover their deductible, according to an article in U.S. Money on March 3, 2015. Even if your state has expanded Medicaid, according to the IRS regulation for 2016, HDHP individual policies have out-of-pocket maximums as high as $6,550 and family policies as high as $13,100. HDHP are also required to have deductibles not less than $1,300 for an individual or $2,600 for a family.
Incident to vs. Split/Shared
There tends to be a lot of confusion surrounding services performed by mid-level providers, such as nurse practitioners and physician assistants….Read More
Congratulations Laura on earning your CPCO – Certified Professional Compliance Officer Credential!
Contributions by Laura Lovett CPC, CPCO, CPMA, CPC-I, CANPC, CEMC. Laura can be reached directly at email@example.com or 810-853-6173
MACRA Participation is Voluntary…Sort of
MACRA (Medicare Access and CHIP Reauthorization Act) is the legislation that was introduced to replace the not sustainable SGR (Medicare Sustainable Growth Rate). It is said to be simpler than the current PQRS (Physician Quality Reporting System) but this remains to be seen and clearly shows the relativity of the word “simpler.” Read More
Mid‐level Provider Services
Coding and billing for mid‐level providers, NP/PAs, can seem like a daunting task. The reality is it is not
difficult if you take time to understand the guidelines and develop practices to utilize these providers
appropriately. Read More
What it means to be a medical coder…….
You have to stop and think when someone asks you a question like “how old are you?” but can rattle off the codes for things like DM, HTN, COPD, GERD, etc. without batting an eye.
You find humor in the strangest things “this gentleman presents today after having accidentally introduced a foreign body into his left knee”. (FYI, he shot himself with a nail gun) Read More
Industry Trend: Probe Audits and Data Mining
Nobody wants to be audited. Nobody has time to be audited. Unfortunately that is the reality that
healthcare providers face; external audits can be initiated at any time. Read More