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Insights to guide your practice. 

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2013 PQRS Program: What Providers Need to Know

by Kaitlyn Houseman on September 3, 2013

Providers are encouraged to join the next CMS eHealth webinar, which will be held on Wednesday, September 11th from 12:00 – 1:30 p.m. ET. The webinar is titled, “2013 PQRS Program: What Providers Need to Know about Upcoming PQRS Deadlines.” CMS experts will focus on upcoming deadlines for the 2013 PQRS and Value Based Payment Modifier programs, with topics including the following:

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Topics: CMS, PQRS

The Real World Impact of Meaningful Use

by Kaitlyn Houseman on July 25, 2013

A CMS press release from a few weeks ago provided an update on the EHR Incentive Programs. Specifically, the release discussed the real impact of Meaningful Use requirements on the nation’s health care system.

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Topics: Practice Management, CMS, Incentive Programs

Improve the Health of Your Medical Practice

by Kaitlyn Houseman on July 15, 2013

You Are Not Alone

1 in 5 Physicians Are Worried  But One Visit Can IncreaseYour Practice's Financial Health
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Topics: Revenue Cycle Management, Practice Management, CMS

EHR Incentive Program Milestones | Key Deadlines Coming in 2014

by Kaitlyn Houseman on July 13, 2013

2014 will be a big year for CMS eHealth programs— there are key deadlines for the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs; an expansion of eReporting will be coming up; the implementation of quality reporting program alignment begins; and the ICD-10 transition takes place on October 1st. Each of these milestones supports the overall goals of the eHealth initiative—helping health care providers deliver better patient care by simplifying the use of electronic standards and encouraging the adoption of health information technology.

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Topics: CMS, ICD-10, Affordable Care Act

Annual Wellness Visit Increases Profitability

by Kaitlyn Houseman on July 6, 2013

300% More Revenue Than an Office Visit?

New Technology Greatly Simplifies Medicare Program Requirements

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Topics: Practice Management, CMS

Learn How the New ACA Benefit Leads to Boost in Practice Revenue

by Kaitlyn Houseman on July 1, 2013

The Medicare Annual Wellness Visit Simplified - Free Webinar

Find Out How the Underutilized Program Can Increase Medical Practive Revenue Significantly 

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Topics: Medical Business, Practice Management, CMS

Medicare ePrescribe (eRx) Deadline Approaching This Month

by Kaitlyn Houseman on June 5, 2013

A significant deadline for the Medicare eRx Incentive Program is fast approaching.   This June 30, 2013 deadline affects any provider who submits Medicare Part B Fee for Service (FFS) claims.  Act now to ensure that you avoid the 2.0% payment adjustment (penalty) that would be imposed in 2014. 

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Topics: Practice Management, CMS, PQRS

Meaningful Use: Pre-Payment Audits in 2013

by Kaitlyn Houseman on April 12, 2013

It’s not just about demonstrating Meaningful Use in 2013.  CMS will now be performing pre-payment audits in addition to the post-payment Meaningful Use audits.  Before mailing out some bonus checks, CMS says the audits (which will affect 5-10% of incentive applications) will be random and start with attestations submitted during and after January 2013.

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

Medicare PECOS Edits Begin May 1, 2013 - Claim Denials Possible

by Kaitlyn Houseman on April 6, 2013

Effective May 1, 2013, the Centers for Medicare & Medicaid Services (CMS) will turn on the Phase 2 denial edits. This means that Medicare will deny claims for services or supplies that require an ordering/referring provider to be identified and that provider is not identified, is not in Medicare's enrollment records, or is not of a specialty type that may order/refer the service/item being billed. 
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Topics: EHR, CMS, Affordable Care Act

CMS U-turn on Medicare Advantage Payment Cuts

by Kaitlyn Houseman on April 4, 2013

Medicare Advantage Payments to be Increased Instead of Cut

Medicare Advantage customers need not fear the painful benefit cuts in 2014 as anticipated by Health Insurers. CMS backtracked on plans to cut Medicare Advantage payments to insurers by 2.2% in 2014 and instead decided on a 3.3% increase. 

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Topics: Medical Business, EHR, CMS

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

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