Effective March 14, 2016, the CMS Final Rule regarding the reporting of overpayments took effect. This ruling clarifies the standards that have been unclear for years since the the PPACA created what is called the "60-day rule." The problem has been the unclear standards on what it means to "identify" an overpayment and when the 60 day clock begins running.
Now, the 60-day rule requires anyone who has received an overpayment from either Medicare or Medicaid to report and return the overpayment within the latter of:Read More
When submitting a claim for payment, it is important to bill the correct amount of units. Entering the CPT or HCPCS procedure code that identifies the service provided is the first step. However, in many cases, a procedure or supply has a specified number of units as part of the definition of the code. It is important to correctly report the units within the guidelines for the code as well as the requirements of the payer.
The following are some important considerations when billing units:Read More
Telehealth has experienced significant growth over the last several years. Providers need to understand the important role it should play in their practice.
The PQRS program continues for 2016. CMS has recently began to publish a list of preferred measures by specialty. Keep in mind that these are preferred lists which means that there can be additional measures which apply.
The following are the CMS preferred 2016 Specialty Measure Sets:Read More
Telehealth or telemedicine continues its growth trend which is largely propelled by patient demand. Regardless of your feelings about implementing telehealth in your practice, it is essential to realize that the majority of the new generation (Gen-X or Millennials) prefer electronic interaction over face-to-face encounters. They like the cost, convenience and savings. Healthcare providers are now beginning to compete with providers nationally or even globally to provide patient services.Read More