Medicare Compliance & Reimbursement
Check Your 2018 MIPS Status with New Tool
Are you confused about whether or not you should be sending quality data to CMS this year? Well, you're not alone, and the agency wants to help with a new MIPS Participation Lookup Tool. Why: For 2017, the inaugural year of the Quality Payment Program (QPP), eligible clinicians reporting measures under the Merit-Based Incentive Payment System (MIPS) had to bill over $30,000 in allowable charges under Medicare Part B as well as provide services to at least 100 Part B beneficiaries annually. 2018: However, CMS scaled back requirements this year, and that's leading many Part B providers to wonder if they should report MIPS measures in 2018. Due to stakeholder feedback, the agency increased its low-volume threshold. Eligible clinicians in 2018 must have at least $90,000 allowed charges or see 200 Medicare Part B beneficiaries a year to participate in MIPS. To access the 2018 MIPS information and discover your status, you need only enter your National Provider Identifier (NPI) at https://qpp.cms.gov/participation-lookup/.
Medicare Compliance & Reimbursement
- E/M Coding:
Incorrect Codes, Poor Notes, and Setting Debacles Add to E/M Fails
CMS sees uptick in E/M claims problems. Evaluation and management (E/M) services are the bread [...] - Reimbursement:
Manage MSP Issues with Stronger Claims' Policies
Tip: Accurate patient information helps determine primary payer. Don't assume your patient's care falls entirely [...] - Determine Medicare or Private Payer with This Handy Chart
Tip: Check for dual-eligibility. There are a plethora of patient circumstances that impact whether Medicare [...] - Telehealth:
Know These Bipartisan Budget Act Changes Impacting Telehealth
The feds continue to promote telemedicine by lessening restrictions. With new codes outlined last fall [...] - Reader Question:
Anthem Opts Not to Change Modifier 25 Policy
Question: Last year, we heard Anthem would start cutting its modifier 25 payment by 50 [...] - Industry Note:
OIG Offers New Gadgets for Compliance Inquiry
Accessing federal guidance, researching advice, and investigating the nitty gritty of healthcare compliance can be [...] - Industry Note:
CMS Market Saturation Tool Helps Determine Provider Density
If your town is overrun by specialists in your field, you may find the latest [...] - Industry Note:
Check Your 2018 MIPS Status with New Tool
Are you confused about whether or not you should be sending quality data to CMS [...] - Industry Note:
Food for Thought: Meal Planning Reduces Hospital Readmissions, Research Suggests
If you want to cut down on hospital readmissions, meal planning might be the ticket, [...] - Industry Note:
OIG Adds Statistical Sampling To Work Plan
If you thought claims reviews were getting tougher, you were right. Medicare auditors with the [...]
