Apr 5, 2017 | Uncategorized
Week 1 – Industry Hot Buttons!nnMACRA: As a result of Congress repealing the historic SGR (Sustainable Growth Rate) reimbursement formula last year, a new pay–for–performance model has been introduced that will directly impact Part B reimbursement. Physician practices across the country will either be incentivized or penalized via reimbursement based on performance and quality care outcomes. The new model, specific to Part B providers, called MIPS (Merit–Based Incentive Payment System) will consolidate all other CMS alternative merit-based incentive programs (PQRS, VBM, EHR incentives) and provide bonus payments to participating providers of eligible APMs (alternative payment models). MIPS helps link fee-for- service payments to quality and value. This epic change became effective on January 1, 2017, so it imperative that your practice is ready to comply with these new requirements.nnModifier 25: Modifier 25 landed itself on both private payer and the OIG hit lists again this year for overuse and blatant misuse leading to millions in overpayments – and everyone wants their money back! Applying Modifier 25 incorrectly can cost your practice tens of thousands of dollars! Understanding this modifier’s appropriate application can be very tricky.nnHere are a few questions to consider before sticking that modifier on your next claim:n
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- Was the patient scheduled to come in for a planned study or procedure only? Did any notable events occur that would affect the service beyond the study or procedure?
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- Was the evaluation and management service provided significant and separately identifiable to the procedure or diagnostic study provided at the same encounter?
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- Is active management of a significant and separately identifiable illness/ailment with preventive services for additional problems identifiable in the provider’s documentation?
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CLICK HERE TO SUBMIT A CASE STUDY TO THE SURGERY CODING SERIES, DEBUTING NEXT WEEK!
Apr 5, 2017 | Uncategorized
Welter Healthcare Partners is pleased to announce that our brand new website is launched and LIVE!! nnThat’s right, you can head over to WHPelter.com right now to explore our new, and polished website! This is a massive step forward for Welter Healthcare Partners. A huge amount of work has been put into this launch, and we are thrilled to share the results.nnMoving to this new website means we now have easier navigation and access to new features, plugins, a new format for coding information, and everything in between. We have published a plethora of resources outlining our capabilities and services relating to credentialing, recruiting, interim management, and medical billing and coding.nnWe offer personalized accounting services designed to help you identify opportunities for increased profitability and growth. Our recruitment team is ready to find the perfect, qualified personnel at a lower cost. Welter Healthcare Partners practice management consultants can immediately step in to maintain day to day operations, provide experienced leadership and keep the current processes and systems in place during the transitional period. Our complete coding services can help you navigate through the complicated coding maze to maximize your revenue and stay current with the constantly changing coding rules and guidelines.nnFor your convenience, you will find a revamped newsletter featuring:nnWeek 1 – Industry Hot Buttons!n
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- Welter Healthcare Partners is excited to provide insight and guidance on complex and obscure topics in healthcare. Including the OIG work plan, Modifier 25, Incident To, HCC, etc.
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nWeek 2 – Surgery Coding Series!n
nWeek 3 – Code Spotlight!n
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- Welter Healthcare Partners will pick a unique CPT or ICD-10 code to profile for that week and discuss practice applications of the code as well as pertinent guideline reminders.
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nWeek 4 – Professional Development Tidbit!n
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- Welter Healthcare Partners will share helpful career advancing tips and strategies to sharpen the skills prospective employers look for in a coder!
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AMRSCO.com Is Officially Live!
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On top of this, we also launched the new AMRS website! AMRS is a team of advanced medical billing specialists offering comprehensive revenue cycle management services. They pride themselves in accurate and effective coding, billing, and collecting in order to boost company profitability. Boasting over 50 years of coding and billing experience, AMRS already knows how to bill and—above all—fight for due payments in a timely fashion! AMRS’ medical billing services increase current revenue by 10% or more, with our team of experts working hard to increase cash flow and prevent volatile ups and downs.
Mar 30, 2017 | Uncategorized
This serves as a reminder that the Colorado Department of Regulatory Agencies (DORA) has designated April 30, 2017 as the expiration date for all physician medical licenses. Therefore, if Centura hospitals are unable to verify that your license has been renewed, your clinical privileges will be suspended effective May 1, 2017.nnNo grace period will be accepted and DORA will need time to process your application, so please take actions now to ensure you are able to meet this deadline.nnVerifications must be completed via the DORA website, so you do not need to submit a copy of your wallet card.nnA few bullet points from the DORA website regarding licensure renewal are referenced below:n
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- If you received a renewal notice recently, your license is open for renewal. To review renewal fees and to check the Division of Professions and Occupations renewal schedule, please CLICK HERE.
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- Click the “Start Your Renewal” button below and use the log in information provided in your renewal notice email to access your account or CLICK HERE.
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- All future communication from DORA will be electronic, please keep your email address current in DORA’s online services system. Licenses renewed after the expiration date will be charged a $15.00 late fee by DORA.
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CLICK HERE TO START YOUR RENEWAL
Mar 30, 2017 | Uncategorized
March 30th marks the annual observation of National Doctors Day. nnThis day was established to recognize physicians, their work and their contributions to society and the community. On National Doctors Day, we say “thank you” to our physicians for all that they do for us and our loved ones.nn
nnThank Eudora Brown Almond, a Winder, Ga., doctor’s wife, who, in 1933, led the charge to set aside a special day for MDs. Why? Because they take care of us. Why March 30? Because it was a painless choice; it commemorated the day in 1942 when anesthesia was first used in surgery. In 1990, President George H.W. Bush signed legislation establishing the date as a national day for Marcus Welbys.nnThis article originally posted on NYDailyNews.com.
Mar 30, 2017 | Uncategorized
We are done right? We made it, we are ok… keep rolling on… NOT so fast!nnICD-10 is key to a lot of the new regulations that are rolling out—MIPS and MACRA being great examples. As always it is all about documentation of services. ICD-10 has a lot more granularity, lots more codes to describe conditions and causes. It is this level of granularity that is so powerful. It is incredibly important to accurate HCC (Hierarchical Condition Category) scoring. This is an absolute MUST when it comes to Medicare Advantage plans! Good and especially thorough ICD-10 coding and documentation helps better define conditions. This directly affects HCC scoring. HCC scoring is the Golden Nugget in the MA world.nn
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About R. Todd Welter • MS, CPCnFounder and President of Welter Healthcare Partners
nMr. Welter has over 25 years of healthcare industry experience assisting physicians and other providers, hospitals and other facilities with the business side of medicine. Through strategic planning and analysis, Mr. Welter’s main focus is to strategically increase revenues and profitability in this radically changing health care environment.
Mr. Welter has a Masters Degree in Organizational Leadership from Regis University in Denver where he has had an appointment as affiliate faculty in the School for Professional Studies for over ten years. In addition, Mr. Welter holds a faculty appointment at the University of Denver’s University College. In the Health Care Leadership program he teaches Macro Economics in Health Care and Innovative Strategies and Change in Health Care to graduate students.
Week 1 – Industry Hot Buttons!nnMACRA: As a result of Congress repealing the historic SGR (Sustainable Growth Rate) reimbursement formula last year, a new pay–for–performance model has been introduced that will directly impact Part B reimbursement. Physician practices across the country will either be incentivized or penalized via reimbursement based on performance and quality care outcomes. The new model, specific to Part B providers, called MIPS (Merit–Based Incentive Payment System) will consolidate all other CMS alternative merit-based incentive programs (PQRS, VBM, EHR incentives) and provide bonus payments to participating providers of eligible APMs (alternative payment models). MIPS helps link fee-for- service payments to quality and value. This epic change became effective on January 1, 2017, so it imperative that your practice is ready to comply with these new requirements.nnModifier 25: Modifier 25 landed itself on both private payer and the OIG hit lists again this year for overuse and blatant misuse leading to millions in overpayments – and everyone wants their money back! Applying Modifier 25 incorrectly can cost your practice tens of thousands of dollars! Understanding this modifier’s appropriate application can be very tricky.nnHere are a few questions to consider before sticking that modifier on your next claim:n