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October 2017 Client Newsletter

ICD-10 Codes Now Effective
Reminder that the 2018 ICD-10 codes were effective October 1st.  We have updated all Charge forms for clients whose forms we manage. 
 Patient Email Addresses
For all practices that are participating in CPC+, the program requires patient surveys using the patients' email.  We are receiving quite a few email addresses and entering them into the software so they will be available for reporting.  However, please be sure to take a look at them before sending - we are getting a small percentage of them that are NOT legible.  If not legible, we will not be able to read or enter them. 
AmeriHealth Payment Policy Change
As you are probably aware (but just in case you aren't!), as of August 1, AmeriHealth changed its payment policy to pay evaluation and management (E&M) codes appended with modifier 25 at 50% when they are:
  • Submitted for the same date of service by the same provider as a minor procedure or
  • Submitted for the same date of service by the same provider as a preventive E&M.
The 25 modifier is used to show that the OV is separate and distinct from the procedure or Well visit.  Without the 25 - that code is denied. 
Clearly they are devaluing your services in these cases.  The only way to avoid this is to bring the patient back for a separate appointment.  That also has the benefit of being able to more accurately schedule patients to make you most efficient and minimize their waiting time.
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."
New Medicare Patient Policy Numbers
Effective Starting April 1, 2018
For those interested, we can send you a PDF from CMS about the new Medicare Policy Numbers that will be issued to patients. starting April 1, 2018.  The only requirement for offices will be to get a copy of the new card for each pt. and forward it to Cape Medical Billing.  We will handle the rest as usual.  We do this now when any patient's insurance changes.
About a year ago we updated our software to make sure the # format is verified.  We do not expect there to be any issues - UNLESS the Medicare MAC's systems do not function properly.  We think there has been sufficient lead time that this is unlikely.  As April approaches, we will let you know if we see any issues.
If you have any questions, please call Rich.  
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! 
2017 Client Newsletter Archive