October 2012 Client Newsletter
HORIZON NJ HEALTH – NOW REQUIRING CO-PAY’S
As you may know, Horizon NJ Health
is now requiring a co-pay. We strongly
recommend that it be collected on the date of service.
Refunds
- We reviewed the cause of refunds for the past few months – well over half are due to collecting co-pays for Well visits (99381-99397) when that was the only reason the pt was seen. It is not necessary to collect the co-pay when the pt was only seen for a Well Visit.
If the pt had
both a Well visit and a “sick†visit, then the co-pay should
be collected for the sick
visit.
- Another smaller but significant # of refunds are for patients only seen and billed for a procedure (echo, surgery, injection, etc.) – no office visit was billed. No co-pay is usually necessary then either.
Both of the above are separate from a patient’s deductible – which, if not met, still
needs to be collected.
Of course, please do not pay any refund request from
an insurer that has not been reviewed and confirmed by CPB as an
overpayment. For Medicare and other insurers who will do offsets, we will
notify the insurer (if we agree) to do that offset. If you send a check,
they often still take the $ back and then also have your check.
CHECKING PATIENT ELIGIBILITY & STATUS OF
CO-PAY & DEDUCTIBLES
For clients using the Appointment
Scheduler, we will have the ability to check patient eligibility and status of
co-payments & deductibles in the near future. If you are interested in this service, please
let Rich know.
BENEFITS of patient
portals
For office-based specialties,
physician and non-physician, the current “best practices†emphasizes collecting
the known patient balances on the date of service. Web-based programs now offer convenience to
both the offices and patients that were not available in the past. The following is an example of the benefits:
“Boca Raton
Regional Medical Center has significantly boosted collections from its patients
by placing a payment portal on the hospital's website.
The 400-bed
facility in Southeast Florida added the payment portal to its website in the
spring of 2011 with the intent of increasing cash flow and reducing its
accounts receivable days, Veronica Small, Boca Raton's patient finance services
director, said at the Healthcare Finance Management Association's annual
national institute in Las Vegas on Monday.
Although
web-based portals for paying bills have proven immensely popular for consumers,
healthcare has been slow to adapt such methods. Less than 10 percent of patient
payments were made online in 2010, reported American Medical News. However, some software companies are moving toward that arena, even
offering smart phone apps to process patient payments, according to Tech Crunch.
Boca Raton had
performed a little more than 77,000 patient payment transactions between April
2010 and March 2011, the one-year period just prior to installing the payment
portal. After its installation in April 2011, transactions increased more than
10 percent, to 84,463 during the following one-year period. Overall collections
increased from $13.8 million to $14.7 million. Accounts receivable over 180
days--considered the write-off point by the hospital--dropped more than 6
percent.â€
If you want to
read the full article, you can find it at:
Medicare Influenza Vaccine Fees – 2012-13
Payment Allowances Effective for Dates of Service between
October 1, 2012 and September 30, 2013 are:
|
Q2035
|
Afluria vacc
|
$11.54
|
|
Q2036
|
Flulaval vacc
|
$9.83
|
|
Q2037
|
Fluvirin vacc
|
$14.05
|
|
Q2038
|
Fluzone vacc
|
$12.05
|
|
Q2039
|
Not otherwise specified flu vacc
|
Individual Consideration
|
|
90654
|
INFLUENZA VIRUS VACCINE
|
$18.98
|
|
90655
|
INFLUENZA VIRUS VACCINE
|
$16.46
|
|
90656
|
INFLUENZA VIRUS VACCINE
|
$12.40
|
|
90657
|
INFLUENZA VIRUS VACCINE
|
$6.02
|
|
90660
|
INFLUENZA VIRUS VACCINE
|
$23.46
|
|
90662
|
INFLUENZA VIRUS VACCINE
|
$30.92
|
|
90669
|
PNEUMOCOCCAL CONJUGATE VACCINE
|
$95.48
|
|
90670
|
PNEUMOCOCCAL CONJUGATE VACCINE
|
$137.03
|
|
90732
|
PNEUMOCOCCAL POLYSACCHARIDE VACCINES (PPV)
|
$65.77
|
|
90740
|
HEPATITIS B VACCINE (HBV)
|
$119.42
|
|
90743
|
HEPATITIS B VACCINE (HBV)
|
$24.22
|
|
90744
|
HEPATITIS B VACCINE (HBV)
|
$24.22
|
|
90746
|
HEPATITIS B VACCINE (HBV)
|
$59.71
|
|
90747
|
HEPATITIS B VACCINE, DIALYSIS
|
$119.42
|
Vaccine Administration Codes:
- G0008 - ADMINISTRATION OF INFLUENZA VIRUS VACCINE
- G0009 - ADMINISTRATION OF PNEUMOCOCCAL VACCINE
- G0010 - ADMINISTRATION OF HEPATITIS B VACCINE
- G9141 - INFLUENZA A (H1N1) IMMUNIZATION ADMINISTRATION