Archive for the Week of September 8, 2006
Archive for the Week of September 8, 2006
Welcome to the medical billing blog archive for the week of September 8, 2006.
Here you will find links to every article added to the Outsource Management Group web site during the week of September 8, 2006.
You can browse this week's archives by clicking the "More" button from any of the excerpts below.
Well-Woman Exam Claims Squeaky-Clean
To code a well-woman exam correctly, you’ve got to know two key concepts: how Medicare and private-payer guidelines differ, and when you should separately code breast/pelvic exams and Pap smears. Best bet: Use these two quick tips for accurate well-woman coding. 1. Break Out Services for Medicare:If the family physician provides a complete well-woman exam for a Medicare patient, you should report G0101 (Cervical or vaginal cancer screening; pelvic and clinical breast examination) for the breast and pelvic exams. When the physician also obtains a Pap smear, use Q0091 (Screening Papanicolaou smear; obtaining, preparing and conveyance of cervical or vaginal smear to laboratory), says Carol Pohlig, BSN, RN, CPC, senior …
Medical Billing Is Not Just Data Entry
Many physicians are reluctant to outsource their medical billing because they are under the misconception they are simply paying someone else to do what can be done within their offices and there are also concerns they won’t have control over reimbursements if the process leaves their premises. They couldn’t be more incorrect. Your medical billing partner not only enters the claims for submission to the various carriers and insurances, they also handle payment posting to patient accounts so they will no longer be outstanding and those monies come from several sources, insurance companies, patient, Medicare, etc. This requires knowledge of insurances, adjustments and knowing how to properly apply money to …
Rates For Home Health Agencies Going Up In 2007
Good news coming in 2007 for home health agencies, your rates of reimbursement are going to increase and there is further coming additions for cases that are a mix of high therapy and adjustment. Earlier this year, the CMS proposed a 3.1 increase, which applies to the base rate for each 60-day episode and reflects the estimated home health market basket inflationary rate. The currently proposed base episode rate by CMS for 2007 is at $2,334 (before case-mix adjustment occurs). Also, a “high-therapy case-mix adjustment” of approximately $2,500 will occur if a patient receives at least 10 therapy visits within a 60 day episode. The rates of various services are …
Changes to DME Products
The CMS eases quality standards for small DME suppliers. Originally released earlier this year, the new standards were difficult to understand and even more difficult to comply to. Numerous complaints and comments were made regarding the changes and the CMS responded by releasing a “greatly simplified” version of quality standards for suppliers of durable medical equipment, prosthetics, orthotics and supplies (DMEPOS). Some of the items that were rewritten to be easier to comply with include: * Bringing the standards to meet from 104 pages to 14; * Focusing the standards more specifically on the issues affecting quality service for Medicare beneficiaries; * Clarifying the requirements for performance management to allow …
January 2007 Will Bring Cuts in Reimbursements
This January will bring something even larger than the reported 4.7%; now it has been reported to be 5.1 percent. As you know the maximum Medicare can cut your payments in one year is 5.1 percent and normally those cuts are done in a number of cuts over each year for certain types of payments, this year it will happen all at once in January. The cut comes from the costs to reimburse certain programs are sky rocketing and Congress keeps canceling the annual cuts without considering the following year’s growth rate for funds that will be needed. In order to level off the amount of claims versus payments, Medicare …
