Tag: payment
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How to Tell If There Is a Problem with Your Accounts Receivable and How to Fix It
You can’t correct a problem if you don’t know it exists. Physicians usually spend the day focused on patients and patient care so it can be difficult to spot A/R inefficiencies unless key performance goals are in place. Specific reports should be generated each month to analyze the practice collection performance. Warning Signs of a…
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Evaluating and Managing the E/M Codes for 2019 and Beyond
Editor’s Note: This article is the first in a series of articles about notable changes in the 2019 Physician Fee Schedule Final Rule. In the 2019 Physician Fee Schedule (“PFS”) Proposed Rule, the Centers for Medicare and Medicaid Services (“CMS”) proposed some major changes to the PFS, including changes to the way Evaluation and Management…
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CMS Releases Physician Payment Rule
This week CMS released the final physician payment rule for CY 2019. In addition to the changes to the physician fee schedule (slightly higher than the CY 2018 rate), the rule expands payment for telehealth and aligns physician interoperability requirements with hospital requirements and allows more flexibility in the physician quality reporting program. The rule…
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Big Changes Proposed for Evaluation and Management Services
It’s been more than 20 years since the 1997 revisions to Evaluation and Management guidelines, which focus mainly on physical examination. The 2019 proposed changes provide practitioners a choice in the basis of documenting E/M visits; alleviating the burdens and focusing attention on alternatives that better reflect the current practice of medicine. The implementation of…
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CMS Releases Proposed Rule for 2019 Medicare Quality Payment Program
On July 12, the Centers for Medicare & Medicaid Services released its proposed policies for Year 3 (2019) of the Quality Payment Program via the Medicare Physician Fee Schedule Notice of Proposed Rulemaking. The provisions included in the NPRM are reflective of the feedback we received from many stakeholders, and continue to provide additional flexibilities to reduce burden…
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Four Dangerous Words Physicians Regularly Say
One trend evident in all medical practices is the shift in payment responsibility from insurance payers to the insured patients. As employers modify coverage to contain their premium costs, health care providers are treating patients who have $2,500, $5,000 and even $10,000 deductibles. Physicians who have practiced for many years have instructed their collections staff…
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CMS Announces New Funding Opportunity for Quality Payment Program (MACRA)
The Centers for Medicare and Medicaid Services recently announced a new funding opportunity for development, improvement and expansion of quality measures for the Quality Payment Program. According to CMS, the program over three years will provide up to $30 million in funding and technical assistance to clinicians, patients and others working on QPP measures. These…
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MACRA: Rolled Out and Still Rolling
Most physicians have, by this point, gained some familiarity with the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The name of this law has appeared frequently in commentary over the past several years, and the changes it imposes are well on their way. However, many of the details concerning MACRA’s implementation—how it affects…
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CMS Updates Open Payments Data
On January 17, CMS updated the Open Payments dataset to reflect changes to the data that took place since the last publication on June 30, 2017. CMS updates the Open Payments data at least once annually to include updates from disputes and other data corrections made since the initial publication of the data. The refreshed…
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Now Available: CMS Data Submission System for Clinicians in the Quality Payment Program
CMS Launches New Data Submission System for Clinicians in the Quality Payment Program On Tuesday, Jan. 2, the Centers for Medicare & Medicaid Services launched a new data submission system for clinicians participating in the Quality Payment Program. Clinicians can now submit all of their 2017 Merit-based Incentive Payment System data through one platform on…