Even with the Centers for Medicare & Medicaid Services' (CMS) recently announced 90-day discretionary enforcement period (March 21 versus Jan. 1) for physicians to transition to HIPAA Version 5010 for claims transmission, physician practices must stay on task, making a "good faith effort" toward on-time compliance.
According to a report released by the Kaiser Commission on Medicaid and the Uninsured, almost every state is cutting costs related to Medicaid. Many states are implementing cost-cutting initiatives, such as restricting Medicaid benefits, implementing new and higher copayments for beneficiaries, and/or enacting provider rate restrictions. In fact, since July 1, 2010, 22 states have already slashed physician pay rates.
Several GroupOne Health Source employees recently attended the 2011 eClinicalWorks National Users Conference in Phoenix, AZ. During its 2011 National Users Conference, eClinicalWorks unveiled four new and exciting product initiatives designed to further enhance medical practices and change the EHR industry. When combined with the already impressive assortment of product features like Patient Portal, eClinicalMobile, and eClinicalMessenger, eClinicalWorks continues to improve upon its industry leading EHR solution.
The Centers for Medicare & Medicaid Services (CMS) would like to remind eligible professionals and group practices that the deadline to request a hardship exemption for the 2012 Medicare Electronic Prescribing (eRx) Incentive Program adjustment is November 1, 2011.
GroupOne's eClinicalWorks revenue cycle management experience has helped thousands of physicians with claim management and revenue cycle management. With an end-to-end solution customized for eClinicalWorks users, we help our customers overcome eCW RCM challenges such as declining reimbursement, low cash flow, and lack of EHR optimization.
Walked Into a Lamppost? Hurt While Crocheting? Burn Due to Water Skis on Fire? – There’s a Code for that. This is an article from the Wall Street Journal that was posted on Sept 13, 2011 regarding ICD-10. Some may find this interesting/amusing. ICD-10 is a good reason for medical practice to partner with a professional billing service firm like GroupOne Health Source.
For detailed timelines of activities that providers, physicians, medical practices, payers, and vendors need to; undertake to prepare for Version 5010 and ICD-10, download our timeline widget to your desktop or mobile device.
Practices face a variety of daunting challenges — dealing with healthcare reform, increased regulation and reporting requirements, shortages of primary care providers, and endless others — and they all seem to lead to or involve negative consequences.
WASHINGTON, D.C. – The U.S. Department of Health and Human Services (HHS) reported an estimate of nearly $48 billion in improper Medicare payments during the 2010 fiscal year, or approximately 38 percent of the total $125.4 billion estimate for the entire federal government, according to a summary of testimony recently delivered by representatives with the U.S. Government Accountability Office (GAO) – but officials labeled even that lofty estimate “incomplete” because HHS has yet to develop a comprehensive projection for the Medicare prescription drug benefit.
The GAO has made a series of recommendations intended to help the Centers for Medicare & Medicaid Services (CMS) strengthen its ability to prevent or detect and recoup improperly distributed reimbursements, officials announced last week. Those recommendations were unveiled as part of GAO testimony delivered before the U.S. House of Representatives Subcommittee on Government Organization, Efficiency and Financial Management, which is part of the House’s Committee on Oversight and Government Reform.
“It is important to recognize that the $48 billion is not an estimate of fraud in Medicare,” the summary noted. “Because the improper payment estimation process is not designed to detect or measure the amount of fraud that may exist, there may be fraud that is not reflected in HHS’s reported estimate.”
The GAO cited inadequate documentation, medically unnecessary services, coding errors and payment calculation errors as several causes for the improper payments, noting that CMS is facing challenges in designing and implementing internal controls to prevent or detect and recoup improper payments. In 2010, CMS established the Center for Program Integrity to serve as its focal point for all national Medicare integrity issues, and based on past work, the GAO identified five key strategies to help reduce fraud, waste and abuse in Medicare.
Meaningful use expert Jim Tate has written that the Medicaid EHR incentive program reminds him of 'zero entry' swimming pools: very easy to get into, with almost no barriers. Given its less stringent requirements compared to the Medicare EHR incentive program, Tate writes, he's surprised that more eligible professionals are "not jumping into this incentive program with both feet."