2018: A Year in Review

Donna White

Donna White

By Donna White, Principal Consultant and Owner of Legacy Consulting Services and Legacy Billing Solutions in Montgomery, Alabama.

We’re not exactly sure how, but 2018 has truly seemed to be an incredibly long year. That could be because of so many top news items in healthcare over the year. We thought we’d take this time as the year winds down to highlight some of the top items from our blog over the last year.

Early in the year we discussed your charge master and how critical it was to do an annual review of your charge master vs. your fee schedules to ensure you are maximizing your reimbursement potential. As the year comes to a close, make sure to do a charge master review and implement any changes before January 1.

In February of this year, the College of Healthcare Information Management Executives (CHIME) composed a letter to the Senate Committee on Finance based on their request for feedback on policy recommendations on how to help fight the Opioid epidemic. Their answer included a lot of changes to EHRs and their interoperability.

In May we discussed the importance of clinical documentation and how it can lead to better outcomes in your practice. Multiple templates, timely sign off on your notes and making certain your note is concise for ease of coding and billing. The faster your claims are coded and billed, the faster your reimbursement.

One of Amazon’s latest healthcare efforts occurred in June, with the company’s acquisition of online pharmacy startup PillPack for about $1 billion. July saw the release of an open letter to providers from the Center for Medicare and Medicaid Services (CMS) proposing wide-sweeping changes to the way providers document their patient visits and how they are reimbursed. It was proposed to move from 5 levels of office visit codes down to two. And to reduce the documentation requirements as well.

August saw an additional proposal to change the reimbursement. Currently, for surgical procedures, the 2nd and additional procedures are reimbursed at 50%. However, CMS was now proposing this be the standard for E&M visits with same day procedures.

In November we saw several big mergers and CMS’ final rule. CVS Health completed its acquisition of Aetna and Vertas Capital and Evergreen Coast Capital buy Athena Health for $5.7 billion. Also in November, the CMS final rule was released to provide a final word on all of the proposed changes that had come up over the summer. The reduction to E&M codes office visit levels was reduced, however, it was decided that Level 5 visits would still be reimbursed separately. Documentation requirements, however, would be reduced in 2019. However, many of these changes will not go into effect until 2021.

It has been a roller coaster of a year regarding healthcare news, and 2019 is shaping up to be just as busy. We will continue to keep you up-to-date on changes as they occur.

From Legacy Consulting, Happy New Year!

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