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Practice Management Alert

CPT 2007 UPDATE ~ Go With the Flow to Determine New vs. Established Patient Status
Even if the patient has been to your office before, he might be new Proper billing for va... Read more
YOU BE THE BILLING EXPERT ~ Ensure You're Following Compliant Record-Keeping Practices
Just how long is long enough for keeping inactive patient records? Question: We have so m... Read more
BREAKING NEWS ~ Watch Out for Steep Cuts in January if CMS Has Its Way
Good news: Expect a boost in E/M reimbursement despite blanket cuts Your reimbursement f... Read more
CLIP & SAVE ~ Here's the Quick Way to Find Out if the Patient Is Really New
Answer the new-vs.-established question correctly every time with this toolTake the AMA's ... Read more
December's Recipe for Billing Success
Follow These Filing Tips to Overcome Time Challenges If you don't file claims within the ... Read more
READER QUESTIN ~ Strengthen Your Denial Management Efforts
Question: Are there any tips you can offer on how to handle denials? It seems to take a lo... Read more
READER QUESTION ~ Give Payers an ABN Heads-Up
Question: When our physicians perform a surgery that we-re fairly sure Medicare won't pay ... Read more
READER QUESTION ~ Avoid Repeat Denials With Modifier 76
Question: How should I report a service that the physician performs more than once in a da... Read more
Eliminate Your No-Show Headaches With These Strategies
Tip: Make sure your carriers don't frown on payment penalties Every office has them ... Read more
YOU BE THE BILLING EXPERT:
Don't Mistake 99221-99223 for Admission Codes
Follow this expert advice for properly billing office visits and hospital admissions Que... Read more
CLIP & SAVE:
Let Patients Know Your No-Show Policy Up Front With These Tools
Use a series of letters to explain the consequences of missed appointments Make all of yo... Read more
Combat Critical Care Code Errors With This Chart
Learn when to report critical care codes multiple times Before billing critical care serv... Read more
NOVEMBER RECIPE FOR BILLING SUCCESS:
NCCI 12.3 Targets Radiology Codes
The latest version of the National Correct Coding Initiative edits (12.3) went into effect... Read more
DID YOU KNOW?
Each quarter, you face the often-daunting task of incorporating new bundling edits from th... Read more
READER QUESTION:
Bone Up on Your Incident-to Guidelines
Question: We bill for a nurse practitioner who does initial consultations in our office on... Read more
READER QUESTION:
Forget Address With POS 12
Question: Our doctor made a house call, so our claim will go with code 99347 and POS 12. I... Read more
READER QUESTION:
Meet the 4 R's Before Billing Consults
Question: My physician is being referred patients for -consults- by hospital physicians. W... Read more
News You Can Use ~ Brace Yourself for a 5.1 Percent Pay Cut Next Year
Watch for decreases in imaging reimbursement, tooUpcoming cuts in the proposed fee schedul... Read more
You Be the Billing Expert ~ Switching to EHR? Weigh These Pros and Cons
Caution: You may not be able to track who makes changes Question: With new technology em... Read more
Carrier Spotlight ~ Cash In on Empire's Changes to Mammography Payments
The contractor instructs you to start using modifier 52 in some cases One carrier has cla... Read more
Look Beyond CMS Web Site For NPI Applications
CMS removed NPI PDF from its Web site, but you have other options Getting a National Prov... Read more
October's Recipe For Billing Sucess
Modify Your Flu, PPV Coding After Oct. 1 Effective Oct. 1, you-ll be able to use diagnosi... Read more
Reader Question ~ Base Infusion Code on Method, Route
Question: Our physician administered three drug substances via one infusion. With all the ... Read more
Reader Question ~ Give Collection Agencies All the Details
Question: We-ve decided to turn over some of our outstanding accounts to a collection agen... Read more
Reader Question ~ Consider a Financial-Hardship Policy
Question: Is it OK for our practice to not collect a copay or deductible from a patient wh... Read more
Winning Strategies Help You Make The Transition to New CMS-1500
Is your software ready to handle the changes?Now's the time to update your billing system ... Read more
You Be the Billing Expert:
Avoid Writing Off Every Physician Phone Call
Add phone time onto next E/M service to get paidQuestion: Almost every physician has to ca... Read more
Learn How Easy It Is to Get an NPI Number
To save yourself time and effort, gather your info before you startEven though the deadlin... Read more
Get Up to Speed on the CMS-1500 Changes
Review the final version of the form onlineThe current CMS-1500 form will not be compatibl... Read more
September's Recipe for Billing Success
9 Lean Days May End Up Being 12 DaysYou-re already bracing for the nine days without Medic... Read more
READER QUESTIONS:
Consider Geographic Differences in Payments
Question: How can I figure out what a procedure code pays in dollars when I-m only given t... Read more
READER QUESTIONS:
Conduct Self-Audits Regularly
Question: Is it important for our office to perform self-audits regularly, or is it OK jus... Read more
READER QUESTIONS:
Planning, Extent Distinquish 58 and 78
Question: When should we use modifier 78 instead of modifier 58?Tennessee Subscriber Answ... Read more
Avoid Costly Mistakes:
Verify Insurance for Every Patient
Billers that take advantage of technology make their jobs easierVerifying each patient's i... Read more
You Be the Billing Expert:
Remember These Pointers for Sound Critical Care Billing
Does the physician's documentation identify a life-threatening condition?When you receive ... Read more
News You Can Use:
Review the Test Version of the New CMS 1500 Form
Your old forms won't work with new NPIsJust when you think you-re prepared for the convers... Read more
News You Can Use:
Focus on Biggest Bills in Self-Pay Backing
You can't chase every delinquent account, experts sayWhen a self-pay patient is behind on ... Read more
August Recipe for Billing Success
Payers Say Xolair Shots Are Not Chemotherapy Be on the lookout for some official guidance... Read more
READER QUESTIONS:
Avoid Underpayment From SNFs With a Contract
Question: We consistently have trouble collecting for services our physicians provide to p... Read more
READER QUESTIONS:
Weigh Efficiency vs. Compliance With Signature Alernatives
Question: I-ve heard that some offices use physician signature stamps. Is this legal?Washi... Read more
READER QUESTIONS:
Do Office Billers Need Liability Insurance?
Question: I know that some of my colleagues have biller/coder insurance. What I don't know... Read more
Cash Flow Management:
Here's How to Prepare for 9 Lean Medicare Days
5 strategies keep your cash flowing during September payment droughtIf your practice inclu... Read more
You Be the Billing Expert:
Prove Separate HEM, and You'll Code Properly for Modifier 25 E/M
File an E/M without all 3 components, and expect a denialWhen a patient reports to your me... Read more
News You Can Use:
Get Ready For Hundreds Of New Dx Codes
2007 list of diagnosis codes not finalYou-ll have to get used to a lot of new diagnosis co... Read more
Internal or External Audit? Use These Criteria to Decide
Having a staffer perform the audit will cost an office about $2,000Before your next round ... Read more
Clip and Save:
These Guidelines Govern Subsequent Care Billing
...but check with your insurer before settling on an E/M levelBillers that are reporting s... Read more
July's Recipe for Billing Success
Help Keep Aetna Honest By Filing Dispute FormsIf your medical office was part of the Manag... Read more
READER QUESTIONS:
Be Aware of Bundled Services With Critical Care Claims
Question: Our physician performed 64 minutes of critical care on a patient. During the enc... Read more
READER QUESTIONS:
Don't Count On After-Hours Care Reimbursement
Question: Our medical office is open from 8 a.m. to 6 p.m. Monday through Friday, and from... Read more
READER QUESTIONS:
If Doctor Cheats, Can Billers Be Charged?
Question: If a physician asked me to do something I knew was unethical or illegal--such as... Read more
Audit Strategies:
Find Hidden Revenue in Your Most-Used Code Claims
Experts: Insurers are paying added attention to modifier 25, 59 claimsIf you-re not c... Read more
You Be the Billing Expert:
Are You Coding Subsequent Hospital Care at the Proper E/M Level?
Why you'll report these codes a little differently than other E/MsWhen your physician prov... Read more
Perform Baseline Audit, Then Decide on Frequency
First audit will show you which practitioners need more educationMedical offices that are ... Read more
Here's How to Know When To Hold Off on ABNs
Medicare does not want to receive ABNs in some situationsMedical office billers are aware ... Read more
June's Recipe for Billing Success:
Master the New Documentation Rules for Modifier 25 Claims
Medical office billers who frequently report modifier 25 (Significant, separately identifi... Read more
READER QUESTIONS:
Do You Need Operating-Room Return for Modifier 79?
Question: What's the difference between situations in which I-d use modifier 78 and ones i... Read more
READER QUESTIONS:
Check Probate Status for Clues on Collecting From Deceased
Question: About a week ago, a patient who owes our practice $10,000 died. Do you have any ... Read more
READER QUESTIONS:
Will Workers' Comp Cover MVA Treatment?
Question: We are having trouble with a claim for a motor vehicle accident (MVA) patient. T... Read more
How Chart Audits Can Help You Capture Missed Charges
Prospective audits may be best if the office provides multiple servicesMedical offices tha... Read more
You Be the Billing Expert:
Prolonged Services Billing Tips That Mean Money for Your Practice
Know when not to use modifier 21Is your practice walking away from reimbursement it's enti... Read more
3 Steps to Avoid Internal Audit Hassles
Get your physicians on board for smoother sailingMedical offices that are striving for the... Read more
May's Recipe for Billing Success
ICD-9 Changes You Need To Know About For Hypertensive Conditions Heads up, billers: The ... Read more
Reader Questions:
PPOs Offer Members Greater Freedom Than HMOs
Question: What are the main differences between a preferred provider organization (PPO) an... Read more
Reader Questions:
ABNs Can Protect the Practice With Private Payers, Too
Question: Are there any waivers for use when the physician provides an experimental a... Read more
Reader Questions:
Move Patient Payment Discussions Away From Front Window
Question: A patient with a $60 past-due balance reports to the office for his annual check... Read more
Reader Questions:
State Guidelines Rule Most Workers' Comp Claims
Question: I am unsure about a workers- compensation claim. The patient, a traveling busine... Read more
Compliance:
Field-Tested Training Tips Help You Collect Deserved Cash
Role-play your way to improved collections and a healthier bottom lineYou could be getting... Read more
You Be the Billing Expert:
Can You Report a Hydration With Infusion Codes?
Watch out:  CPT has revamped its injection, infusion sectionsMedical offices that rep... Read more
You Can Get Separate E/M Pay on Injections, Infusions
The doctor usually performs a level-3 or -4 service during these sessionsWhen a physician ... Read more
April's Recipe for Billing Success
Capture Deserved Pay For CKD With New ICD-9 CodesWhile medical offices are trying to ... Read more
Training Tip:
Use These Simple Scenarios to Gauge A Collector's Readiness
Sample scripts help staff gain expertise--and more money for your medical practiceYou know... Read more
READER QUESTIONS:
When a New Problem Arises, Is Incident-To Still Possible?
Question: One of our nonphysician practitioners (NPPs) performed an evaluation and managem... Read more
READER QUESTIONS:
Research Will Show if Third-Party Biller Is Best for You
Question: What are some of the pros and cons of a medical office outsourcing its billing o... Read more
READER QUESTIONS:
Check Both Surgeons' Notes on Modifier 62 Claims
Question: Our gastroenterologist recently performed a PEG tube placement with the help of ... Read more
Compliance:
Look Past Minimum Requirement On Records Retention
Why observing the 6-year federal requirement may not be adequateBefore you toss those reco... Read more
You Be the Billing Expert:
Is Physician Presence Vital To Incident-To Billing?
Medicare is the only payer that consistently recognizes incident-toIf you don't know all o... Read more
Use This Consult Coding Checklist for 2006 Claims
Don't let new rules catch you off guardGiving insurers what they want on consult claims is... Read more
March's Recipe for Billing Success
Ratchet Up Your Diabetes Diagnosis Coding SavvyBillers who have not mastered the new ICD-9... Read more
Collections Tip:
How Training Staff on Direct Debits Builds Confidence
Make sure all your staff know how to ask for money and use equipmentIf your medical office... Read more
READER QUESTIONS:
Make Sure Dress Code Is More 'Business' Than 'Casual'
Question: We do not want to make employees wear uniforms, but we want a dress code that wi... Read more
READER QUESTIONS:
Should Non-Participating Providers Still Collect Co-Pays?
Question: Do we have any obligation to try to collect co-pays or deductibles when we are n... Read more
READER QUESTIONS:
Critical Care Billing Is Possible During Post-Op Period
Question: If the physician provides critical care services during the global postoperative... Read more
E/M Coding:
Your E/M Claims Could Make You A Billing Outlier
Here's how to tell if your 'bell curve' is out of shapeYou could be next in line for an -o... Read more
You Be the Billing Expert:
Are You Up to Speed on Medicare's Consult Documentation Rules?
Find out why both physicians should note consult request in recordsWhen your physician req... Read more
ICD-10--When?
Feds say new codes will come out after 2007Healthcare professionals have been hearing abou... Read more
Get SMART On Private-Payer Audits
No. 1 rule:  Sheath that sharp tongueWhen your medical office is responding to a priv... Read more
Sample Document, Part II:
Use This Confidentiality Agreement To Reduce HIPAA Hot Spots
Staff must know what is expected of them before handling patient infoMedical practices int... Read more
February's Recipe for Billing Success
Here's the Latest on New LTC CodesGood news for long-term care billers: New 2006 codes in ... Read more
READER QUESTIONS:
Prepare for More Detailed CPO Billing
Question: Sometimes, my physician will conduct care plan oversight (CPO) in an assisted li... Read more
READER QUESTIONS:
Solve the Consult-Versus-Referral Riddle
Question: What is the difference between a consultation and a referral, and how can I tell... Read more
READER QUESTIONS:
Educate Staff Before E-Mailing Patients
Question: Our physician wants the office to begin using e-mail to contact our patients. Ca... Read more
CPT 2006:
E/M Billing Update--CMS Clears Up New Patient Parameters
After 3 years, familiar faces are new againIf you want to get off on the right foot in 200... Read more
You Be the Billing Expert:
Locum Tenens Physicians Can Only Fill In for 60 Days
Don't forget to append modifier Q6When one of your physicians takes a vacation or a leave ... Read more
Tips Help You Avoid Locum Tenes Modifier Mix-Ups
Remember:  Q5 is a reciprocal-billing modifierTake care that you don't confuse  ... Read more
Security:
Defend Patients' PHI With Shredders
Put shredder where it will be used mostIf an identity thief nabs some of a patient's prote... Read more
Collections:
No-Show Charge Is a No-No Without Patient Notification
Most offices give patients 1 'free' no-showWhen a patient does not show up for a scheduled... Read more
January's Recipe for Billing Success
Look for Changes in Same-Day E/M RulesBillers who work in larger medical practices that em... Read more
Sample Document, Part 1:
Confidentiality Agreement Stops Leaks
Staff must know what's considered 'sensitive info'Did you know that logging in to the offi... Read more
READER QUESTIONS:
Are You Required to Report Both Wrongful and Incidental Disclosures?
Question: What is the difference between a wrongful and an incidental disclosure of protec... Read more
READER QUESTIONS:
Do You Need a Shredder Strong Enough for CDs?
Question: Our medical office is researching document shredders before purchasing one. What... Read more
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