Medical Billing Software Update: News and Ideas from Industry

Kathy McCoy, MBA April 29th, 2011

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In each issue of our monthly newsletter, you’ll find a section of news and ideas from the medical billing industry. Since these news items are often extremely popular with our readers, we’ve decided to bring them to you on a more frequent basis so that you can stay up to date on the latest in medical billing and medical billing software. We hope you find these items useful. Subscribe now to receive our monthly newsletter filled with tips on improving your medical billing results.

CMS Report Highlights RAC Overpayments, Underpayments

AAPC News, April 29, 2011

Since October 2009, when Medicare’s fee-for-service Recovery Audit Contractor (RAC) Program went nationwide, health care providers have returned $313.2 million in alleged Medicare overpayments and received $52.6 million in Medicare underpayments, according to a new report from the Centers for Medicare & Medicaid Services (CMS). The report also identifies the top overpayment issues in each of the four RAC regions nationwide…Read More

Not E-Claim Compliant? Expect No Pay in 2012

Emily Berry, Amednews, April 25, 2011

On Jan. 1, 2012, if physicians’ practice management systems are not up to new standards, they will risk not getting electronic payments from private insurers and Medicare. Physicians still have time to change from the HIPAA 4010 standards for electronic claims submissions to the 5010 set… Read More

Survey Says Physicians Aren’t 5010-Ready

AAPC News, April 29, 2011

The transition to the Health Insurance Portability and Accountability Act (HIPAA) Version 5010 standards is just over six months away. Physician practices who fail to make the impending deadline are at greater risk of not getting electronic payments from private insurers and Medicare. And yet, more than half of physician practices haven’t even scheduled testing, reports Medical Group Management Association (MGMA)…Read More

Obama Deficit Plan Includes Strengthened Medicare Pay Board

Doug Trapp, Amednews, April 25, 2011

President Obama on April 13 rebutted a House Republican plan to trim $4 trillion worth of federal deficits over a decade with his own proposal that he said would protect guaranteed benefits in Medicare and Medicaid. Meanwhile, a 2011 spending agreement signed by the president includes billions in health care cuts and slashes three health reform law programs. Obama also proposed that…Read More

CMS To Host Attestation Information Calls Next Week

HIMSS News, April 29, 2011

CMS is holding conference calls next week for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare Electronic Health Record (EHR) Incentive Program to provide information on the attestation process…Read More

Complexity of EMRs Discourages New Users, Doctors Tell HHS Panel

Charles Fiegl, Amednews, April 29, 2011

Physicians say they want electronic medical records to be fast, accurate and easily customized, but they are reporting that usability of EMRs doesn’t appear to be the focus of the federal government when establishing meaningful use standards and certifying products…Read More

PQRS and eRX Programs Pay Off for Participating Providers

AAPC News, April 29, 2011

A report released by the Centers for Medicare & Medicaid Services (CMS) April 19 shows a growing trend toward physicians and other eligible professionals (EPs) participating in the Physician Quality Reporting System (PQRS) and the Electronic Prescribing (eRx) Incentive Program. Both programs reward physicians and other EPs for successfully reporting quality measures…Read More

HHS Considers Mystery Patients to Evaluate PCPs

AAPC News, April 29, 2011

The office of the Assistant Secretary for Planning and Evaluation (ASPE) is proposing to use a mystery shopper approach to collect data from physician offices to accurately gauge availability of primary care physicians (PCPs) accepting new patients, assess the timeliness of services from PCPs, and assess the reasons that PCP availability is lacking…Read More

ONC Extended Deadline for Receipt of Public Comments

HIMSS News, April 22, 2011

ONC has extended its deadline for receipt of Public Comments on the Federal Health IT Strategic Plan that were due by this Friday, April 22, to noon on May 6, 2011. ONC’s Federal Health Information Technology Strategic Plan for 2011 – 2015 may be found at…Read More

CMS Details Upcoming ICD-10 Call

Tom Sullivan, ICD-10 Watch, April 27, 2011

CMS (The Centers for Medicare and Medicaid Services) has posted information about its next ICD-10-related national provider teleconference. Dubbed, “CMS ICD-10 Conversion Activities,” the material is targeted at medical coders, physician office staff, provider billing staff, health records staff, vendors, educators, system maintainers, and all Medicare FFS (fee-for-service providers)…Read More

AHIMA’s Top 10 ICD-10 Documentation Problems

Tom Sullivan, ICD-10 Watch, April 26, 2011

The new code sets promise challenges across the spectrum of uses and users, coding documentation being no exception. “Some documentation issues will require physicians to capture new information; others involve updated, modified, and otherwise expanded documentation needs,” AHIMA explains…Read More

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