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February 2021 Client Newsletter

HHS Public Health Emergency (PHE) Extended
Alex Azua, Secretary of HHS, has extended the Public Health Emergency (PHE) another 90 days to April 21st. That means that many of the copays will continue to be paid by insurers.
We now have one forward-thinking client doing Remote Physiologic Monitoring (RPM) and another still cogitating (that means thinking deeply!) on it. It appears to be working well. Devices that can be used include Automated blood pressure cuffs, glucometers, scales, oximeters, etc., and Medicare will pay you for the equipment and the time to manage the patient. 
Chronic Care Management (CCM) is another opportunity to add a service for patients with 2 or more chronic conditions expected to last 12 or more months. 
For both programs, the actual calls can be handled by your clinical staff (includes RN’s, LPN’s, medical assistants, etc.) with your supervision. 
AND, both are billable the same month. For patients who qualify, the above 2 programs can make a positive difference to their health.  
Billing G0180 & G0179 on the Same Day as an Office Visit or Other E&M Code
Reminder, Medicare will not pay for an office visit, home visit, etc. on the same day as G0180 or G0179. We suggest you wait until the next day to sign the Home Health Certification unless the earlier date is necessary.  
SOC 2, Type 1 Audit
Cape Professional Billing, Inc. (CPB) is proud to announce that we have once again received our SOC-2 Certification which applies to all CPB business processes, and cloud services. The certification validates CPB’s compliance with strict data security and privacy standards established by the American Institute of Certified Public Accountants (AICPA).
The certification is an arduous process that involves months of compiling and submitting data, as well as a comprehensive review by an independent, third-party provider. We’re required to demonstrate the standardization of our information security policies with an additional layer of outside accountability.
CPB constantly evaluates our business processes and procedures as technology and cybercrime evolve to minimize vulnerabilities. Maintaining our SOC-2 certification is perhaps the greatest example of these efforts.
Please contact us if you would like a copy of our SOC report for your compliance needs.
OIG Pandemic Related Target Audits for 2021
HHS OIG Work Plan Indicates Focus on Pandemic Assistance
The Department of Health and Human Services (HHS) Office of Inspector General (OIG) posted its October updates to its work plan of areas it will focus on monitoring for fraud and abuse. The updates include several pandemic-related relief programs. The OIG will not directly audit providers but its findings could encourage other agencies to improve their efforts to combat fraud and abuse.
  • The OIG will audit the Health Resources and Services Administration’s (HRSA) responsibilities to ensure Medicare providers were compliant with the attestation and revenue information requirements for the $50 billion General Distribution from the Provider Relief Fund (PRF).
  • OIG will also audit the PRF program that reimburses providers for uncompensated COVID-19 testing services.
  • This program is also administered by HRSA. OIG will also examine “program integrity risks” of Medicare telehealth services that were expanded during the pandemic.
For telemedicine, in addition to the usual visit documentation, be sure you documented the type of video software that was used in the medical record. Zoom,, Face Time, etc. Medicare allows Face Time, BUT some other insurers did not. We have also seen Horizon auditing telemedicine. 
As with ANY audit, be sure to make sure your medical records are properly signed & dated before submitting any charts. If you need to know the requirements for a legal signature, contact Rich.  
2021 Client Newsletter Archive