September 2017 Client Newsletter
ICD-10 FYI
We have analyzed the Oct. 1 2017 ICD-10 updates and have started to contact clients to discuss how it impacts their practice. We will also be updating charge forms for clients whose forms we manage.
Collecting Patient Balances
It is important to courteously remind patients when they make their appointments to bring their copay when arriving for their appointment. This begins to set the tone.
Collecting copays and coinsurance amounts can be easy. After you hire the right personality for the front desk, setting the patient's expectation is next. Often a simple script sends the right message - payment is due on the date of service prior to seeing the provider. Below is a sample script that the front desk person could be used when a patient arrives:
We determined that you have a $XX.00 copayment due for your visit today. I also see that you have an outstanding balance of $XXX.00. How do you want to pay? We accept cash, checks, and MC/Visa/Discover/Amex credit cards (whichever you accept - or not).
They should make eye contact with the patient during the entire encounter, smile and then stop talking and wait for their response.
When hiring a front desk person, be sure he/she is pleasant and welcoming (think SMILE!), is comfortable asking for payments, and not distracted by other activities during these few seconds.
Getting patient payment on the date of service provides the money to you that day rather than wait for a patient statement. It also guarantees you will at least be paid that much!
G0505 - Cognitive Impairment Assessment and Care Planning
Recently we have seen several organizations suggesting that providers can bill G0505 in order to make an additional $250 per patient. We wanted to provide some additional information in case you decided to consider that code.
- As always, it does require medical necessity.
- It can be billed with office visits: 99201-99215. But requires a modifier if performed as a separate and distinct service.
- Can be billed with AWV's - G0402, G0438, G0439.
- Approximate payment is $250 - but Medicare does apply co-insurance (about $50) and deductible. If you are interested, best to do later in the year to avoid deductibles. Be sure to ask the patient if this has already been performed.
UHC Multiple Procedure Payment Reduction on Cardiology Diagnostic Services is Now in Effect
Beginning September 1, United Healthcare and Oxford will apply multiple procedure payment reductions to align their commercial product payment policies for cardiology diagnostic services with Medicare.
Post Office and Electronic Fund Transfers
Recently the US Postal Service announced another record deficit for FY 2017. Along with mentioning a possible rate increase, they also mentioned possible delivery service changes. While delivery changes are not likely, this may be a good time to make a list of the paper checks you are receiving. Then coordinate with us to start transitioning to electronic payments if those insurers offer it. You need to coordinate so we can ensure we will receive Electronic Remittance Advices (ERAs) in order to post the payments and bill the next insurance.
Electronic payments don't get lost in the mail, misplaced, or worst case, stolen. Be sure NOT to agree to accept Virtual Credit Cards (VCCs) as you should not have to pay the insurer to pay you! You want direct deposit to YOUR bank account.
Billing G0180 on the Same Date as 99495 or 99496
Medicare will not pay G0180 on the same date of service as a 99495 or 99496 (Transitional Care). Be sure to do G0180 on a separate day and make sure the signature also reflects the date performed.
UnitedHealthcare Commercial Reimbursement Policies - Stopping Consults
Effective for claims with dates of service on or after Oct. 1, 2017, UnitedHealthcare will reimburse the appropriate evaluation and management (E/M) procedure code which describes the office visit, hospital care, nursing facility care, home service or domiciliary/rest home care reported in lieu of a consultation services procedure code.
UnitedHealthcare will align with the Centers for Medicare and Medicaid Services (CMS) and no longer reimburse consultation services represented by CPT codes 99241-99245 and 99251-99255. Similar to CMS's findings, our extensive data analysis has revealed misuse of consultation services codes for this population."
Care Plan Oversite (G0179 - G0180)
Aetna has a policy that Care Plan Oversite (Home Health, Hospice, Nursing facilities) is NOT eligible for payment (with ow without modifiers) unless those services were preauthorized by their Patient Management Dept. Aetna's stated logic is that they do not pay for time without direct patient contact.
Thus, consider bringing the patient in for an office visit, or make a Home Call if the patient is unable to come to the office. Without the authorization, the service is free if you are a participating provider.