congressDespite calls from the AMA and some statewide medical societies (New York and Texas most notably) to include an additional two-year delay of ICD-10 in the $1 trillion omnibus 

CMS recently announced changes to the use of the -59 modifier which could impact medical billing submissions and provider reimbursement. Modifier -59 indicates that a code represents a service that is separate and distinct from another service with which it would usually be considered to be bundled for payment purposes. Per CMS, due to “chronic overuse” of modifier -59, they have created a new series of modifiers which provide more specificity of the distinct procedural service.

Doctor with MoneyThe Affordable Care Act (ACA) provision to increase Medicaid reimbursement to primary care physicians is set to end on December 31. Unless Congress acts to extend so-called Medicaid parity, primary care physicians (PCPs) will face reimbursement decreases.

certificateThere are four main organizations that accredit or certify PCMHs:

PatientSatisfactionOnline reviews are an increasingly important tool used by people to make decisions about what doctor to see and what practice to visit. If you are a doctor or practice administrator, you should realize that more and more patients are visiting the web to see how your practice measures up in terms of service and patient-reported quality.

CMSOn December 1, the Center for Medicare and Medicaid Services (CMS) issued a new proposed rule that would institute some major changes to the regulations that govern Medicare’s ACO (Accountable Care Organization) programs.

CMSIn a press release issued earlier today, CMS announced enhancements to their Medicare provider oversight rule that will make it more difficult for practices to commit Medicare fraud.

Doctor with PatientNow that we’ve covered the ABCs of provider enrollment, let’s move on to making this process a little easier, specifically as it relates to credentialing. First, it’s important to identify the most common roadblocks.

Doctor with PatientAs we all know, the healthcare environment is changing rapidly. While this is an exciting time, change can be scary, especially with regard to changing professional roles and responsibilities.

money_stethoscopeCMS recently finalized its proposal to make a separate payment for non-face-to-face chronic care management (CCM) for Medicare beneficiaries who have multiple (i.e., two or more) significant chronic conditions.