Medical Office Manager

Billing & collections

Impact of 2021 evaluation and management coding changes to WRVU based physician compensation

By John McDaniel bio As you may know, all physician contracts which include any form of WRVU based compensation will need to be reviewed and probably amended due to the increase in WRVUs (work relative value units) associated with E&M CPT codes effective Jan. 1, 2021. We recently conducted an assessment for one of our hospital clients which showed the ʺunintended … [Read more...] about Impact of 2021 evaluation and management coding changes to WRVU based physician compensation

Retaining patients as insurance landscape shifts

By Kerri Lenderman bio Walmart’s July announcement that they plan to start selling Medicare insurance should have resonated with America’s physicians as more than an interesting headline to interrupt a summer of coronavirus news.  Indeed, it should be a wakeup call and a reminder that unsettling and unconventional forces with deep pockets and consumer brand loyalty are forming … [Read more...] about Retaining patients as insurance landscape shifts

Deadline Oct. 5 to ask for MIPS targeted review

If you participated in the Merit-based Incentive Payment System (MIPS) in 2019, your performance feedback, including your MIPS final score and payment adjustment factor(s), is now available for review on the Quality Payment Program website. This final score determines the payment adjustment you will receive in 2021, with a positive, negative, or neutral payment adjustment … [Read more...] about Deadline Oct. 5 to ask for MIPS targeted review

Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing

CMS and the Centers for Disease Control and Prevention (CDC) have announced that payment is available to physicians and health care providers to counsel patients at the time of COVID-19 testing about the importance of self-isolation after they are tested and prior to the onset of symptoms. The transmission of COVID-19 occurs from both symptomatic, pre-symptomatic, and … [Read more...] about Your office will be paid for counselling patients to self-isolate at time of COVID-19 testing

Protecting your medical practice during uncertain times

By John W. McDaniel bio Given the recent disruption and decreased demand for physician office services, coupled with the foreboding predictions associated with the COVID-19 pandemic, both hospital- affiliated and private medical practices are having to adjust their operations in order to provide billable patient care services while salvaging the cash flow/liquidity of the … [Read more...] about Protecting your medical practice during uncertain times

CMS to launch new MIPS Participation Framework in 2021 Performance Period

CMS is implementing a new participation framework for the Merit-based Incentive Payment System (MIPS), called the MIPS Value Pathways (MVPs), starting with the 2021 performance period. The goal of this new framework is to move away from siloed performance category measures and activities, and move toward an aligned set of measures and activities that are more meaningful to … [Read more...] about CMS to launch new MIPS Participation Framework in 2021 Performance Period

MIPS 2020 payment adjustments in effect based on 2018 performance

In July 2019, each Merit-based Incentive Payment System (MIPS) eligible clinician received a 2018 MIPS Final Score and associated payment adjustment factor(s) as part of their 2018 MIPS performance feedback, available on the Quality Payment Program website. 2020 MIPS payment adjustments, based on each MIPS eligible clinician’s 2018 MIPS final score, will now be applied to … [Read more...] about MIPS 2020 payment adjustments in effect based on 2018 performance

5 ways to break down bureaucracies to get payer contracts

By Steve Selbst bio It is important to remember that payers are large companies, with protocols, policies and business practices. As with any large company, there are bureaucracies, and they are necessary to maintain the order and success of these organizations. Therefore, the first tip is to understand that to get contracted you need to identify the right department and … [Read more...] about 5 ways to break down bureaucracies to get payer contracts

Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme

You know that a branch of lab testing has gone from fad to mainstream when it becomes the subject of a major federal enforcement takedown. Accordingly, the newly announced breakup of a $2.1 billion genetic billing fraud scam, one of the largest Medicare frauds ever undertaken, signifies that genetic testing has officially arrived. Operation Double Helix Known as Operation … [Read more...] about Feds Take Down $2.1 Billion Medicare Genetic Test Fraud Scheme