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June 2014 Client Newsletter





June 1, 2014




On May 1st, CMS has now specified that ICD-10 will go into effect on October 1, 2015.  CPB saved the status information for each of our clients so we can pick up where we left off in January 2015. 




Another thought, for patients who elect to pay on the day of service and ask you not to bill their insurance, your signature form needs to specify that if that happens, and they do not pay (check bounces, credit card rejects, etc.) that you will then bill their insurance and they agree to that.  If you want us to modify your signature form accordingly, please notify Rich. 




According to CMS as reported in Medical Economics (Chris Mazzolini; May 8, 2014), only 50 eligible professionals (EPs) have attested Meaningful Use 2 (MU2) in the current reporting year (2014). Only 4 hospital facilities have attested Meaningful Use 2 seven months into the reporting year (which began on October 1, 2013).

With MU2, EHRs are required to provide greater interoperability between systems as well as boost health information exchange between providers and provide patients with secure online access to their health information. Unfortunately, many EHR companies have had problems "certifying to the 2014 edition necessary for MU2" with the total number of vendors offering a complete EHR system with 2014 certification reaching 97 as of mid-April 2014 (according to data from ONCHIT). CMS notes that 17% of EPs use software that has not been certified to the "2014 edition" - a requirement needed to successfully complete MU2.

Physicians who cannot attest to MU2 or do not receive a hardship exemption will receive Medicare reimbursement penalties. Hardship applications are due to CMS by July 1, 2014.  If you are a Medicare provider who was unable to successfully demonstrate Meaningful Use for 2013 due to circumstances beyond your control, CMS is accepting applications for hardship exceptions to avoid the upcoming Medicare payment adjustment for the 2013 reporting year


Virtual Credit Card Payments


If your practice accepts virtual credit card (VCC) payments from health plans, you may be losing a significant amount of your contractual payments to high interchange fees. There are three steps you can take to make sure you aren't paying unnecessary charges.

  1. Register for electronic funds transfer (EFT) payments. HIPAA requires all health plans to offer standardized EFT using the Automated Clearinghouse (ACH) Network. Similar to direct deposit, ACH EFT allows health plan payments to be directly paid into a physician's designated bank account. Each ACH EFT transaction carries only one fee of about 34 cents, far less than the potential 5 percent fee charged to VCC transactions. In order to receive ACH EFT, physicians should request and register for this payment method. View
  2. Be aware of restrictions in payment methods when contracting with health plans. Even though HIPAA requires health plans to make EFT payments available upon request, health plans may try to require other payment methods, such as VCC, within their contracts with physicians. Be cognizant of any restrictions and avoid signing contracts with inflexible payment terms.
  3. Educate your practice staff. If your practice staff processes both patient and health plan payments, make sure they know how to differentiate between patient and health plan credit card payments to avoid authorization of VCC payments from health plans.


Avoid the 2016 PQRS Penalty


Eligible professionals and group practices that fail to successfully report data on quality measures during 2014 will be subject to a two percent (2%) reduction on Medicare Fee Schedule amounts for services furnished by the eligible professional or group practice between January 1, 2016 and December 31, 2016. 


Successfully reporting in 2014 results in a .5% incentive payment. CPBfor 2 reasons:

  1. You only need to report 20 patients, with the majority being Medicare, vs. at least 50% of all patients who meet the requirement. 
  2. You get immediate verification whether all criteria have been met. 


The only difference is that the registries have a small fee, usually about $299 or less.  But you are then virtually guaranteed to have qualified for the incentive money and avoided an expensive 2% decrease in 2016. 



2014 Client Newsletter Archive