Medicare

It appears that the repeal of the Sustainable Growth Rate formula (SGR) could finally be a real possibility. On Thursday, March 26, The U.S. House of Representatives overwhelmingly passed H.R 2, The Medicare Access and CHIP Reauthorization Act which includes both repeal and replace the flawed SGR formula that has caused a great deal of disruption to the Medicare payment system over the last several years. H.R.

Sustainable Growth Rate (Resource 230)

What is the Sustainable

Modifier Resources (Resource 343)

Modifiers proved a way for the practitioner to report or indicate that a procedure or service has been performed but has been altered by some specific circumstance. Modifiers are essential tools in the coding process. They are used to enhance a code narrative to describe the circumstances of each procedure or service and how it individually applies to the patient. The appropriate use of modifiers enable practitioners to effectively respond to payment policy requirements to payer policies.

Instructions for: Medicare Redetermination Request (Resource 241)

The Medicare Redetermination Request is the first step in the Medicare Appeals process.

After the initial determination and denial, the Redetermination review process is performed by your contractor. Your request must be submitted in written form. Your contractor generally makes a decision within 60 days from the timethey receive your request. This decision will be in the form of a letter, Medicare Summary Notice (MSN), or Remittance Advice (RA).

Of nearly 15,000 test claims received by the Centers for Medicare & Medicaid for the first round of end-to-end ICD-10 testing, 81 percent were accepted, according to statistics revealed by the agency Wednesday.

EHR Hardship Exemption

The following information is from the Centers for Medicare & Medicaid Services (CMS) regarding the Electronic Health Records (EHR) payment reduction hardship exemption:

    Hardship Exceptions for Medicare EPs

The MLN Connects Provider eNews for February 5, 2015 included the following notice:

CMS Intends to Engage in Rule making for EHR Incentive Program Changes for 2015

If you are an eligible professional participating in the Medicare EHR Incentive Program, you have until February 28, 2015 to attest to demonstrating meaningful use of the data collected during your EHR reporting period for the 2014 calendar year.

If you are an eligible professional participating in the Medicare EHR Incentive Program, you have until February 28, 2015 to attest to demonstrating meaningful use of the data collected during your EHR reporting period for the 2014 calendar year.

40-Effect of Beneficiary Agreements Not to Use Medicare Coverage

(Rev. 160, Issued: 10-26-12, Effective: 01-28-13, Implementation: 01-28-13)

(Rev. 194, 09-03-14)

 

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