February 2013 Client Newsletter

Slow Medicare Payments

Just a reminder that that Medicare patients must meet their annual deductible in January which causes a slowdown in cash flow.  But due to Congress’ delay in approving the Conversion factor until January 2^nd, it is even slower paying than usual.  The reason is that all of the Medicare contractors (MAC’s) could not process any claims until the fee schedules were updated.  CMS gave the MAC’s until January 23^rd to get that done.  Novitas released their fee schedule on 1/22.  So, instead of being able to process a charge to deductible and releasing it to the 2’ early in the month, all of those charges were delayed nearly 3 weeks.  Cash flow should start to pick up by mid-February and improve from then on. 

FREE Eligibility Checking for CPB Appointment System Users!

Patient eligibility is now offered to all clients using the CPB Scheduler.  If you are interested in using it, please call Rich.  At least for the next few months, CPB will cover the cost.

EHR’s – CHOOSE WISELY THE FIRST TIME

According to Medscape.com (August 13, 2012 edition) half of EHRs sold are replacements!  “Use of electronic health records (EHRs) is snowballing, and so is the number of unhappy users. Half of EHR systems sold to physician practices are now replacements, up from 30% last year, according to a recent study by research firm KLAS. The leading reason for switching systems, cited by 44% of practices, is product issues. Service issues (15%) and group consolidation (14%) - such as when a hospital converts newly hired physicians to a new EHR - are a distant second and third.

Morale of the Story:  Choose carefully and thoroughly evaluate your choice before purchasing.  It is disruptive enough to move from paper to electronic.  Switching to another EHR is a 2^nd major impact to your practice.

TherAPy Cap 2013 update

CMS announced that the Therapy Cap will be $1,900 for 2013.  Once the total gets to $3,700, then Medicare is required to perform a mandatory review the same as late in 2012. 

The other new items are the new “G” codes, Proper Modifier Reporting, and Multiple Procedure Payment Reduction (MPPR) process.

ICd-10

ICD-10 is still about 20 months away, but after attending an ICD-10 coding class earlier this month, thought you might enjoy some statistics.  Someone took the time to count the # of ICD-9 codes commonly used by several specialties and compare them to the same ICD-10 codes. 

Aetna Medicare Advantage (MA) plans

Per Aetna, “Aetna Medicare Advantage (MA) plans now cover an annual wellness visit; no longer cover annual physicals.   Effective January 1, 2013, Aetna MA plans include coverage for an annual wellness visit. The CPT codes for a wellness visit are G0438 and G0439.

Aetna MA plans no longer cover annual physical exams. The CPT codes for the annual physical exam are 99381-99397, 99401-99404, 99201-99205 and 99211-99215 with primary diagnosis of preventive. The preventive diagnosis codes that are not covered are:  V03.0-V03.9, V04.0-V04.89, V05.0-V05.9, V06.0-V06.9, V20.0-V20.2, V70.0, V70.3, & V70.5.

 This change was made as a result of a change in coverage made by the Centers for Medicare and Medicaid Services (CMS).”

PATIENT BALANCES

According to a recent article in MGMA Connexion, $1 of every $4 owed is now paid by the patient.  That is 25% of the average practice’s revenue. 

Ways to collect these balances: