Medicare Compliance & Reimbursement

Physician offices still defrosting from 9-day Medicare freeze. The worst nine days of the year are over, and you have survived.

Medicare put a hold on physician payments for the last nine days of September, until the beginning of the new fiscal year on Oct. 1. Even though providers had advance notice of the hold, it still made their lives difficult.

"Everybody was pretty unhappy, as you can well imagine," says Linda Guerrera with Beth Israeal Deaconess Physician Organization in Boston.

"I'm still not sure we survived," jokes Pat Boudreaux with Tyler Neurosurgical Associates in Tyler, TX. More than 50 percent of her office's business comes from Medicare. To make matters worse, Part B carrier TrailBlazer had put a five-day hold on Texas physicians' payments just over a month earlier, due to a computer system transition.

Even a few days after the end of the freeze, physician offices hadn't yet started receiving checks from Medicare.

How did offices survive? Sources mentioned a few strategies:

· Daily billing. Tyler Neurosurgical transmits bills daily instead of weekly. The office makes a point of billing every claim as quickly as possible even under normal conditions, says Boudreaux. "We don't have a lot of lag." On the eve of the nine-day freeze, Tyler Neurosurgical made sure to post everything its coders coded.

· Looking ahead. Not only did Papillon, NE-based Oncology Hematology West get claims out the door as quickly as possible in advance of the freeze, but the office also looked ahead to see what bills were coming up. Where possible, the office tried to speed them along, says reimbursement coordinator Carolyn Davis Hutt. 

· Appealing early. Oncology Hematology West also made sure to send out appeals as quickly as possible before the freeze.

"We were in hopes that we would just be limited as far as what our charges were that were sitting there," says Hutt.

· Keep expenses down. Hutt tried to prepare for a couple of weeks with less money coming in the door. Wherever possible, she delayed expenditures and reduced expenses during that period.