Last week saw a push from hospitals to lobby lawmakers about CMS’s proposal for site neutral payments. The site neutral payment proposal would be to pay the same rate for services delivered at off-campus hospital outpatient departments and independent doctor’s offices. According to CMS, they could save $610 million and patients could save $150 million […]
Insufficient documentation is the root cause for most of CMS’s improper payments. For example, according to the Medicare-Fee-For-Service 2016 Improper Payments Report, CMS paid $36.3 billion in improper payments, 64.1% of which were attributed to insufficient documentation. The guiding rule is if it didn’t happen in the documentation, then it didn’t happen at all. The
We have talked a lot over the last month or so about the proposed changes to E&M Coding and reimbursement. There are additional proposed changes we want to make sure you are aware of as well. Advancing Virtual Care CMS is building a stronger focus on remote or virtual care. Proposed changes would add reimbursement
Last week there were some noteworthy cases that came through regarding compliance. This emphasizes the importance of compliance controls in every practice and what each practice needs to do to protect itself. Unlawful Waiving of Co-Pays It often seems like a helpful thing to do for your patients. But did you know that waiving a
In the recent weeks, we have seen dramatic proposals from CMS regarding policy changes regarding reimbursement. If you missed the previous articles on E&M Coding and Reimbursement Changes, click here and here. On July 27th, a new proposal has been made for 2019. We have heard some client complaints that UHC has begun reducing reimbursement
We have had CMS on the mind a lot the last few blog posts, and we have one more we want to share. If you are not familiar with it, CMS launched a Targeted Probe and Educate Program over the last few years and have been stepping it up incrementally each year. What is Targeted
Last week we blogged about a proposed change to E&M Coding that would replace E&M levels 2-5 with a single code at a single reimbursable rate. As promised, we want to keep you up to date on the latest regarding this proposed change. At that time we did not have details about what the new
On July 16th 2018, anyone subscribed to the CMS Quality Payment Program received an e-mail containing a letter to doctors from Seem Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS). There are some widespread changes proposed in this letter of which you need to be aware. “Electronic Health Records were supposed to
It is the most important piece of any new EHR conversion: training. Training is typically led by a Subject Matter Expert (SME) in their respective field, financials or clinical. On the financials side, it may be a revenue cycle manager or someone with experience in billing and claims management. However, often on the clinical side,
One of the lesser-known offerings of Legacy is working with EHR and PM Systems. Of course, we can help implement new systems and have worked with dozens of systems. We can, however, also assist in an analysis of your current system and help with any potential issues that may be bogging your system down. Insurances
