CMSIn 2013, in an effort to clarify Medicare medical necessity policy around hospital inpatient admissions, CMS issued a policy specifying that an admission will qualify for Part A reimbursement when a physician certifies that a patient’s treatment is expected to require an inpatient stay spanning two midnights.

Doctor with MoneyIn our last blog post, we began a deeper dive into the MACRA legislation - the legislation recently passed by the House to fix the Sustainable Growth Rate (SGR) system that creates such uncertainty in physician reimbursement every year.

House VoteOn March 26, 2015, the U.S. House of Representatives overwhelmingly approved the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). This comprehensive Medicare legislation will, among other things, repeal the detested Sustainable Growth Rate (SGR) formula, a statutory mechanism creating perennial headaches for both physicians and Congress.

DeniedEliminate Denials Historically, practices have focused on billing claims and kept their fingers crossed.  This leads to delay in payments, increased bad debt, and additional expense. Practices today need to find an efficient way to manage denial volume and successfully appeal claims for adjudication. Top focus should be on denial prevention.

eMDsMerger Offers Customers a Single Point Clinical and Revenue Cycle Management Solution

MDeverywhere is pleased to announce that we signed an agreement to merge with eMDs, a leading provider of electronic health records. The merger allows us to offer a fully integrated clinical and financial system designed to help physicians build a better practice.

Significant changes will be introduced starting April 1, 2015 by the New York State Legislature to add a layer of protection against out-of-network billing on patients. Under this new law, health care providers will be obligated to provide patients with their plan affiliations prior to the provision of non-emergency services, and verbally at the time of the appointment.

Health and Human ServicesOn March 20th, the HHS and CMS announced the release of the proposed Meaningful Use Stage 3 rules for the Medicare and Medicaid EHRs Incentive Programs. Concurrently, the Office of the National Coordinator for Health Information Technology (ONC) released the 2015 Edition Health IT Certification Criteria proposed rule.

Doctor with PatientCollect the Patient’s Responsibility of the Service Patient responsibility is increasing year after year – it is now at nearly 25% of the value of the total bill.[1]   Practices need to develop a core competency in collecting the patient portion.

United States CongressUPDATE: There will be no “doc fix” until mid-April. The Senate adjourned for spring break on Friday morning without taking up legislation to permanently repeal the SGR formula.

Urology: Continuing our series on ICD-10-CM basics we are offering high-level primers to illustrate the differences on specific documentation requirements for various specialties.