Part B Insider (Multispecialty) Coding Alert
Medicare Will Start Drug Coverage Within A Year
The final edition of Medicare's rule for the 2005 prescription drug benefit went on display in the Federal Register Jan. 21., stating Medicare drug coverage is less than a year away.
The rule includes a process for plan sponsors to negotiate with the Centers for Medicare and Medicaid Services on their program bids. It also provides a streamlined appeals process for beneficiaries who need to get drugs that aren't on their plan's formulary and "any willing pharmacy" standards for long-term care pharmacies.
The rule spells out that beneficiaries with both Medicare and Medicaid will automatically gain membership in a drug plan by September or early October. The law allows for "facilitated enrollment" of low-income beneficiaries. CMS will start "intensive outreach" to find these beneficiaries and, where possible, fill out enrollment applications for them. The rule also includes:
Part B Insider (Multispecialty) Coding Alert
- Reimbursement:
Multiple Reductions, One Cast: How Many Codes Can You Bill?
Provide justification if you bill more than one code
This little piggy has a stress fracture, [...] - Joint Ventures:
'Under Arrangement' Deals Offer Better Payment, Fewer Fraud Risks
But don't pay docs more than their share of what the business is worth
Warning: Don't [...] - Reimbursement:
Brace Yourself For A New Layer Of Audits
New contractors will have you in their crosshairs
In case you didn't think you were bearing [...] - Congress Won't Have Time To Fix Physician Payment Mess
To avoid a looming 5 percent cut to physicians' payments, Congress will have to pass [...] - Incident-To Billing:
Can You Prove Where Your Doc Was Two Year Ago Today?
Some carriers require physician signature on incident-to claims
If your doctor is supposed to be supervising [...] - Drug Coverage:
Medicare Will Start Drug Coverage Within A Year
The final edition of Medicare's rule for the 2005 prescription drug benefit went on display [...] - Joint Ventures:
Don't Go Into Business With An Ignorant Partner
Watch out for these physician-hospital joint venture pitfalls
In recent years physicians have formed ventures with [...] - 3 Tips Will Pump Out Stress-Free Stress Test Coding
Know your component codes by heart to code correctly
Don't stress over trying to figure out [...] - Clip & Save:
Keep Stress Tests Modifier-Free
Let definitions guide you when choosing the right code If your carriers are stopping your [...] - Physician Notes:
Doc Faces 30 Years In Prison For Alleged Double Billings, False Claims
And "pay for performance" quality care incentives are in the pike
Pleasanton, [...]
