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GroupOne Health Source Practice Management Blog

      

The GroupOne Health Source Blog

 Answers and Insights Every Healthcare Professional Needs.

 

Avoiding 2015 PQRS Payment Adjustments

by Kaitlyn Houseman on March 29, 2013

Purpose

This article provides information on the 2015 PQRS payment adjustment and guidance on how individual eligible professionals and group practices can avoid the 2015 PQRS payment adjustment. Information provided in this article is based on the 2013 Medicare PFS Final Rule.
This article focuses on the PQRS payment adjustment and does not provide guidance for Value-Based Payment Modifier upward adjustment or payment adjustments from other Medicare sponsored programs. See the Additional Information section below for links to the CMS Value-Based Payment Modifier website, and the Medicare and Medicaid EHR Incentive Program website.

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Topics: EHR, CMS, PQRS, Incentive Programs

ACA Provides New Revenue Opportunities to Some Physicians

by Kaitlyn Houseman on March 3, 2013

Why Physicians May Seek Out Medicare Patients Under New ACA Rules

Like clockwork, once again, physicians would have faced a 26.5 percent reduction in the Medicare physician payment rate on January 1, 2013, as a result of the sustainable growth rate (SGR) formula.  Congress has intervened 14 times since 2002 with a stopgap measure to prevent major cuts in physician Medicare reimbursement.  Created as part of the Balanced Budget Act of 1997, the SGR formula and has never been corrected permanently by Congress.

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Topics: Revenue Cycle Management, Medical Business, Practice Management, CMS, Affordable Care Act, Incentive Programs

Do Not Ignore Medicare's Revalidation Process!

by Kaitlyn Houseman on January 31, 2013

Have you received your Medicare Revalidation Letter Yet?

Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers and suppliers to revalidate their enrollment information under new enrollment screening criteria. This revalidation effort applies to those providers and suppliers that were enrolled prior to March 25, 2011. Newly enrolled providers and suppliers that submitted their enrollment applications to CMS on or after March 25, 2011, are generally not impacted.

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Topics: Medical Business, Practice Management, CMS, Affordable Care Act

SGR Fiscal Cliff Updates and Medical Practice Impact

by Kaitlyn Houseman on January 2, 2013

Yesterday, the United States Congress approved legislation that prevents most taxpayers from experiencing a tax increase; prevents the scheduled 26.5% SGR related cut in physician fee schedule payments; and delays (until early March) the 2% across-the-board cut in Medicare payments due to sequestration.

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Topics: Revenue Cycle Management, Medical Business, Practice Management, CMS, Affordable Care Act, Incentive Programs

EMR Incentive Program Updates

by Kaitlyn Houseman on July 18, 2012

CMS and ONC Announce Over 100,000 Providers Have Been Paid Under the EHR Incentive Programs

The Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced that over 100,000 health care providers have been paid under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

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Topics: Medical Business, CMS, Incentive Programs

Save the Date: Certified EHR Technology Call on June 27

by Kaitlyn Houseman on June 19, 2012

Register for CMS and ONC's Joint National Provider Call on Using Certified EHR Technology to Meet Meaningful Use

CMS and ONC are holding a joint National Provider Call on Wednesday, June 27, from 2:00 – 3:30 pm ET for eligible professionals (EPs) and eligible hospitals to hear an overview of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, and learn about the use of certified EHR technology to meet meaningful use. 

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Topics: eClinicalWorks, Medical Business, Practice Management, CMS

Medical Billing Changes Coming Soon

by Kaitlyn Houseman on June 9, 2012

Starting July 1, 2012, Medicare Fee For Service Will Reject 4010 Transactions: Are You Ready?

Effective July 1, 2012 only ASC X12 Version 5010 (Version 5010) or NCPDP Telecom D.0 (NCPDP D.0) formats will be accepted by Medicare Fee-For-Service (FFS). Providers that are still conducting one or more of the Version 4010 transactions electronically, such as submitting a claim or checking claim status, or rely on a software vendor, billing service or clearinghouse to do this on their behalf, are affected by this change. Now is the time to contact your software vendor, billing service or clearinghouse, when applicable, if you have not done so already to ensure you are ready. Transactions conducted by Medicare Administrative Contractor (MAC), fiscal intermediary (FI) or carrier telephone interactive voice response (IVR) systems, Direct Data Entry (DDE) and Internet Portals, for those contractors with Internet Portals, are not impacted.

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Topics: Revenue Cycle Management, Medical Business, HIPAA, CMS

Meaningful Use: Last Chance for Docs?

by Kaitlyn Houseman on May 18, 2012

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Topics: Medical Business, EHR, Practice Management, CMS, Incentive Programs

Complete Survey: Help End the Underpayment of Med Insurance Claims

by Kaitlyn Houseman on May 8, 2012

Are your claims underpaid by private payers?  Do you have any way of checking the accuracy? 

According to the 2011 AMA Health Insurer Report Card, 1 in 5 claims are processed incorrectly.  In addition to measuring overall claims processing accuracy, the report card examined how accurately insurers reported the correct contract fees to physicians. Contracted fees were correctly reported 62.08% on low side (Anthem BCBS) to 98.91% on high side (Medicare).  For more information, read this.   

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Topics: Revenue Cycle Management, Medical Business, Practice Management, CMS

Pay For Performance/Value Based Purchasing Initiative Heats Up

by Kaitlyn Houseman on May 7, 2012

Thousands of physicians received a sneak-peek at their future recently when CMS sent them quality reporting data that could be used to determine Medicare payments. 

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Topics: Revenue Cycle Management, Medical Business, EHR, CMS

CMS Provides New EHR Incentive Program Q&As

by Kaitlyn Houseman on April 16, 2012

Review Important Questions and Answers about Registration for the EHR Incentive Programs

After determining your eligibility for the Electronic Health Record (EHR) Incentive Programs, you should then register as early as possible for the Medicare and/or Medicaid program. CMS’ EHR Information Center is open to assist the EHR provider community with registration and other program-related inquiries.

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Topics: EHR, CMS, Incentive Programs

EHR Incentive Program - Feb. 2012 Participation Data

by Kaitlyn Houseman on March 31, 2012

Latest Success Data on Provider Participation in the EHR Incentive Programs

CMS has released February 2012 data that highlights program-to-date (since January 2011) participation and payment totals under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. The February report documents continued growth in  registrations and payments, including:

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Topics: eClinicalWorks, EHR, CMS, Incentive Programs

EHR Registration & CMS National Provider Calls

by Kaitlyn Houseman on March 24, 2012

Ensure Your Success in the EHR Incentive Programs by Registering Early

CMS recommends that all eligible professionals (EPs) register as early as possible for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs.

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Topics: Medical Business, EHR, CMS, Incentive Programs

New FAQs on Meaningful Use and Attestation

by Kaitlyn Houseman on March 10, 2012

Provided by the CMS, we at GroupOne are happy to pass along some new FAQs for you regarding Meaningful Use and Attestation.

We want to help keep you updated with information on the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs. CMS has recently added five new FAQs on meaningful use and attestation. Take a minute and review them below:

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Topics: Medical Business, CMS, Incentive Programs

Upcoming CMS Sponsored Calls

by Kaitlyn Houseman on January 16, 2012

January 17, 2012 National Provider Call with Question & Answer Session on 2012 Physician Quality Reporting System and Electronic Prescribing (eRx) Incentive Program; 1:30 - 3:00pm ET.

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Topics: EHR, CMS, PQRS

Cuts in Medicaid Pay to Physicians by State

by Kaitlyn Houseman on November 11, 2011

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.

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Topics: Revenue Cycle Management, EHR, CMS

eRx Hardship Exemption Deadline - Nov 1, 2011

by Kaitlyn Houseman on October 6, 2011

The Deadline to Request a Hardship Exemption for the eRx Incentive Program is November 1, 2011

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.

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Topics: eClinicalWorks, EHR, CMS

CMS Posts Guides to Help Care Providers Plan HIPAA, ICD-10 Changes

by Keith Lage on September 14, 2011

Implementation Widget and Timelines 

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.

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Topics: Practice Management, CMS, ICD-10

Webinar: EHR Incentive Program Registration and Attestation

by Kaitlyn Houseman on August 25, 2011

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Topics: EHR, CMS, Incentive Programs

Differences Between the Medicare and Medicaid EHR Incentive Programs

by Kaitlyn Houseman on August 1, 2011

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Topics: EHR, CMS, Incentive Programs