December 2007 Client Newsletter

CPB HOLIDAY CLOSURE DATES

Just a reminder that CPB will be closed on Tuesday, December 25th & January 1st for the Christmas & New Years holidays. Monday, December 24th we will be open from 9:00 – 1:00. We hope each of you enjoy your own special holidays.

Hospital Consult vs. Patient Visit

The question is whether there was a request for consultation for the management of a problem that another physician requested under the definition of a Consult or if the patient was in the hospital admitted by someone else and you are merely rounding or continuing management of an ongoing problem while the patient is in the hospital.

Deposit of Checks Without Leaving Your Office

We are now seeing bank activity offering the option to deposit your checks without going to the bank. You simply scan the checks and send them via internet to the bank where they process the file electronically. We have not investigated the cost (if any) but wanted to let you know of this new option. If you are interested your bank will have the details if they offer it.

2008 PART B DEDUCTIBLE

The Centers for Medicare & Medicaid Services (CMS) announced the Part B annual deductible for 2008 is $135.00 (up from $131 for 2007).

ANNUAL CHARGE FORM CHANGES

This is a good time to review your Charge forms for new CPT, ICD-9 and HCPCS codes and to decide whether to add your new NPI # before you re-order. The Charge form is a key part of any insurance audit so ensuring it is current is important. CPB will be glad to review all codes on the form for you and provide any necessary corrections at no cost. Many clients also have their Tax ID#, Medicare # or other numbers on their Charge form but they are not required unless the patient does their own billing.

PQRI 2008

The 2008 Medicare Physician Fee Schedule (MPFS) Final Rule, effective for services on or after January 1, 2008, is on display in the Federal Register and was published on November 27, 2007. The rule identifies 119 measures CMS has selected for eligible professionals to use to report quality-of-care information under the 2008 PQRI. The rule can be found at: http://www.cms.hhs.gov/center/physician.asp. The Physician Quality Reporting Initiative (PQRI) provisions begin on page 653.

A summary of these provisions is available at: http://www.cms.hhs.gov/PQRI/downloads/2008PQRIMPFSSummary.pdf .

CMS Online Internet Applications

The Centers for Medicare & Medicaid Services (CMS) has announced new online enterprise applications that will allow Medicare fee-for-service providers to access, update, and submit information over the Internet. Details of these provider applications will be announced as they become available. Even though these new internet applications are not yet available, CMS recommends that providers take the time now to set up their online account so they can access these applications as soon as they are available. The first step is for the provider or appropriate staff to register for access through a new CMS security system known as the Individuals Authorized Access to CMS Computer Services - Provider Community (IACS-PC). This does NOT apply to DMEPOS suppliers at this time. This is the first step in the PECOS On-Line Provider Enrollment process which is expected to begin in about 60 days.

A recent MLN Matters article, the first in a new series on IACS-PC, addresses key questions and answers about the registration process and can be found at
http://www.cms.hhs.gov/MLNMattersArticles/downloads/SE0747.pdf on the CMS website.

What is particularly important is that a provider can designate an authorized representative to access the system on their behalf. This will allow physicians and other providers to designate the billing company as a designated representative. As the designated representative, the billing company will be able to complete the on-line enrollment, as well as update information as necessary.

A key point is when someone should register as an “individual” versus an “organization”. If the provider registers as an “individual” ONLY he or she is authorized to enter or change information. If the provider wishes to allow someone else access (an employee, billing company, etc.), then he/she must register as an “organization” even if it is a solo practicing physician.

CPB will be glad to do this on your behalf at no cost – just fax a request to Rich.