February 2015 Client Newsletter
February 1, 2015
This month most of the articles below discuss ways to enhance your revenue.
MEDICARE ICD-10 END-TO-END TESTING
We are pleased to announce that CPB was accepted by Novitas to participate in ICD-10 end-to-end testing at the end of January. This allows us to fully test ICD-10 claims for not only acceptance into the ICD-10 processing system, but also to confirm payment (the most important part!). Only 100 practices and billing services were accepted into the testing in Novitas’ entire five (5) state region.
Tuesday, January 27th we were notified by Novitas EDI Dept. that our file was accepted and passed their front end edits. AS of this writing (Friday, January 20th) we are still waiting to receive the ERA to post.
MORE ICD-10 – CASH RESERVE?
While it is probably less of a concern now than it was a year ago, there are still some prognosticators who are recommending that providers maintain cash reserves in the event ICD-10 implementation does not go well in October 2015. We are confident that CPB software & staff are ready since we participated in ICD-10 testing last year with Medicare (the only insurer who offered it at that time) – and all files were accepted without errors.
We have tested with other insurers and that also has been successful. But, it may be prudent to set some money aside each month – just in case.
99050, 99051, 99058
We have been told that Medicare & many other carriers pay 99050 (Services provided in the office at times other than regularly scheduled office hours, or days when the office is normally closed (e.g., holidays, Saturday or Sunday, in addition to the basic service). 99050 would be billed in addition to the 99201-99215. Let Rich know if you want to set this code up and/or add it to your Charge Form.
99051 (Service(s) provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service) & 99058 (Services provided on an emergency basis in the office, which disrupts other scheduled office services, in addition to basic service.)
For 99051 & 99058:
- Horizon does not cover either code.
- Aetna covers if billed with the office visit (99201-99215) by a participating provider.
- AmeriHealth covers - for PCP’s patient has a $50 copay. For specialists (including Podiatry) patients have a $75 copay.
PATIENT APPOINTMENTS - REMINDER CALLS
For our clients who use the Healthpac Scheduler / Appointment system, it does offer the option to automate calls to patients 2-3 days in advance to remind them of their appointment.
As a cost reference, for a provider with 250 pt. visits per month, the cost would be about $.22-23 per call ($50 per month) – less than the revenue of 1 patient visit. If no shows are an issue, perhaps worth considering.
If you are interested, please contact Rich for details.