Submitting the CMS-855 Enrollment Application and Billing Effective Date Changes

As of May 14, 2012, the billing effective date can be made retroactive as far back as 30 calendar days from the date the application was received in Medicare's office.

Provider offices must submit the CMS 855 form as soon as the provider begins seeing Medicare patients to ensure their services will be processed by Medicare. With CR7797, the CM-855 form can be now submitted up to 60 days in advance of the provider seeing Medicare patients.

CMS is pleased to announce that the 2013 Physician Quality Reporting System (PQRS) incentive payments are now available for eligible professionals and group practices who submitted data for Medicare Physician Fee Schedule Part B services between January 1, 2013 and December 31, 2013. The PQRS incentive payments are for EPs and group practices who met the PQRS satisfactory reporting criteria, regardless of participation in another program (i.e., Medicare Shared Savings Program Accountable Care Organization, Comprehensive Primary Care Initiative, etc.).

MEASURE COMPLIANCE - Meeting the Patient Electronic Access Objective

Starting in 2014, CMS requires that providers participating in both Stage 1 and Stage 2 of the EHR Incentive Programs must meet the Patient Electronic Access objective, which gives patients access to their health information in a timely manner. Providers participating in Stage 1 are required to meet one patient electronic access measure, and providers participating in Stage 2 need to meet two measures.

Measure #1 for Stage 1 and Stage 2:

CMS has added more PQRS training modules to help simplify the process, including one for beginner, intermediate and advanced PQRS reporting.  The modules are designed to help you find the information you need to satisfactorily participate in PQRS and other programs that offer incentive payments in 2014.

Questions and Answers for Psychologists and PQRS. In 2007, Psychologists had very limited opportunity to participate in PQRS. As of 2014, there are 11 measures available for claims-based reporting and two for registry reporting.  

For the entire article read more here:

Below are the 11 new measures for 2014

October 3rd is Last Day for 1st-year Medicare EPs to Begin a 2014 Reporting Period

January 26-30, 2015

During the week of January 26 through 30, 2015, a sample group of providers will have the opportunity to participate in ICD-10 end-to-end testing with Medicare Administrative Contractors (MACs) and the Common Electronic Data Interchange (CEDI) contractor. The goal of end-to-end testing is to demonstrate that: 

A HIC number (HICN) is a Medicare beneficiary’s identification number. Also, remember when billing, ALWAYS use the name as it appears on the patient's Medicare card.

Both CMS and the Railroad Retirement Board (RRB) issue Medicare HIC numbers. The format of a HIC number issued by CMS is a Social Security number followed by an alpha or alphanumeric Beneficiary Identification Code (BIC).

RRB numbers issued before 1964 are six-digit numbers preceded by an alpha character.

In order to qualify for an EHR incentives, providers must show they are using their EHR's and demonstrate MEANINGFUL USE of their EHR's.  This means they are using their EHR's in ways that improves the affect of the quality of care to their patients and have successfully captured the data in a standard format using a certified EHR. 

ATTENTION In-Patient Hospitals

CMS has announced a settlement request to Inpatient hospitals for claims in appeal status! Due to the unprecedented growth in claim appeals the demand continues to exceed Medicare’s available resources. CMS has made an offer in hopes of quickly reducing inpatient status claims currently pending in the appeals process. CMS is cleaning house and has made this administrative offer to Inpatient hospitals only.


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