Incident-To Audit Alert
nnRecently the Office of Inspector General’s (OIG) website has posted cases of recent penalties that practices and providers have been charged due to incorrect billing of Incident-To. Are you at risk? The numbers are stomach turning and something that every practice should be aware of. We aren’t just talking about the huge hit in penalties, which are in the hundreds of thousands of dollars, but factor in the 15% hit you will take to your reimbursement for claims. With numbers like that it could mean a small practice having to close it’s doors.nnIncorrect submission of these claims is not something any practice aims to do. However, not submitting these claims is leaving money on the table. Read below for the enforcement actions as stipulated by the OIG and contact us today for more information.nnEnforcement ActionsnnCriminal and Civil EnforcementnThese cases often result from OIG’s work as part of its Most Wanted Health Care Fugitives initiative, the Medicare Fraud Strike Force, and other similar efforts. Since this work culminates in legal action by the U.S. Department of Justice (DOJ), links are provided to relevant news releases issued by DOJ or one of their 93 U.S. Attorneys.nState Enforcement ActionsnMedicaid Fraud Control Units (MFCU) investigate and prosecute Medicaid fraud as well as patient abuse and neglect in health care facilities. Currently, MFCUs operate in 49 States and in the District of Columbia. OIG certifies, and annually recertifies, each MFCU. OIG also collects information about MFCU operations and assesses whether they comply with statutes, regulations, and OIG policy.nCivil Monetary Penalties and Affirmative ExclusionsnThe Office of Inspector General (OIG) has the authority to seek civil monetary penalties (CMPs), assessments, and exclusion against an individual or entity based on a wide variety of prohibited conduct.nCorporate Integrity Agreement EnforcementnThe OIG has, as a contractual remedy, the right to impose stipulated penalties for non-compliance with the requirements of a Corporate Integrity Agreement (CIA). A material breach of the terms of the CIA also may result in the provider’s exclusion from participation in the Federal health care programs.nnClick here for more information on the E&M document changes.
Welter Healthcare Partners acknowledges the contributions of physicians to the overall health and well being of our communities. We would like to wish all physicians and specialists a very Happy Doctor’s Day, 2019. nnWe value your service and dedication.nn
You’ve just been assigned a major project. Naturally your mind is racing with a million different thoughts on where to start and what you’ll need to get the job done on time. As a result, you start creating a to-do-list that is massively bulky.nnThe problem with these out-of-control to-do-lists is that they’re overwhelming and prevent you from being productive. That’s because you’re multitasking and directing your energy to unimportant tasks and activities.nnInstead, keep your to-to-lists lean and mean by only focusing on your 3 to 5 most urgent, important, and challenging tasks for the day, aka your Most Important Task (MIT). Focus on one task at a time before moving on to less critical tasks. When you do, you’ll feel more productive and less anxious.nnLou Babauta of ZenHabits suggests that at least one of your MITs should be related to your goals and you should work on them in the AM Whether if it’s at home or in the office, tackle your MIT first thing in morning.nnAccording to Lou, “If you put them off to later, you will get busy and run out of time to do them. Get them out of the way, and the rest of the day is gravy!”nn2. Measure your results, not your time.nWhen it comes to productivity we often focus on how long something takes to complete; as opposed to what we actually accomplished in a day. For example, you just spent four hours writing a 1,000-word blog post. You may be be a bit bummed since that took a nice chunk out of your day.nnBut, what if you focused on the smaller parts of the blog post? For example, you broke into five 200-word sections, formatted it properly, added headings, ran a spellcheck and added images. Suddenly you realize you actually completed a lot in that timeframe.nnIn fact, research from the Behance team found “that placing importance on hours and physical presence over action and results leads to a culture of inefficiency (and anxiety).”nn”The pressure of being required to sit at your desk until a certain time creates a factory-like culture that ignores a few basic laws of idea generation and human nature: (1) When the brain is tired, it doesn’t work well, (2) Idea generation happens on its own terms, (3) When you feel forced to execute beyond your capacity, you begin to hate what you are doing.”nnOne way to assist you with measuring results instead of time is by generating done lists. This is simply an ongoing log of everything you completed in a day. By keeping this list you’ll feel more motivated and focused since you can actually see what you accomplished.nnAdditionally, according to Buffer co-founder Leo Widrich, done lists allow “you to review your day, gives you a chance to celebrate your accomplishments, and helps you plan more effectively.”nn3. Have an attitude adjustment.n
The team over at Mind Tools state that we’re more effective at work when we have a “positive attitude.”nn”People with a good attitude take the initiative whenever they can. They willingly help a colleague in need, they pick up the slack when someone is off sick, and they make sure that their work is done to the highest standards.”nnAnd, you’ll never hear them say that their work is “Good enough.” That’s because they go above and beyond.nnFurthermore, a good attitude at work will help you set standards for your work, ensure that you’re taking responsibility for yourself, and make decisions easier since they’re based on your intuition. “This admirable trait is hard to find in many organizations. But demonstrating ethical decision-making and integrity could open many doors for you in the future.”nn4. Communicate, communicate, communicate.nRegardless if you’re freelancer, entrepreneur, or employee, there will be times when you will have to work with others. As such, you should strengthen your communication and collaboration skills. When you do, you’ll eliminate unnecessary rework and wasted time from straightening out any misunderstandings and miscommunications.nnYou can start by enhancing your active listening skills and staying on one topic when communicating. For example, when composing an email, keep it short and to point. Don’t throw too much information in the message since it will only confuse the recipient.nn5. Create and stick to a routine.n”We are creatures of habit, and so are our brains. When we establish routines, we can carry out tasks faster since we don’t have to ‘think’ about the task – or prepare for it – as much, and can work on autopilot,” says Hallie Crawford, a certified career coach, speaker, and author.nn6. Automate more tasks.n
Want to the secret of getting more done? Reduce the amount of decisions you have to make throughout the day. That’s why Mark Zuckerberg wore that same outfit for years. Most days he still does. It prevented fatigue. I will say though, I tried this and it was hard on my relationship with my wife. Make sure you find your balance.nn”The counterintuitive secret to getting things done is to make them more automatic, so they require less energy,” wrote Tony Schwartz, president and CEO of The Energy Project, in the Harvard Business Review.nn”It turns out we each have one reservoir of will and discipline, and it gets progressively depleted by any act of conscious self-regulation. In other words, if you spend energy trying to resist a fragrant chocolate chip cookie, you’ll have less energy left over to solve a difficult problem. Will and discipline decline inexorably as the day wears on.”nnIn other words, build routines and habits so that you’re not deciding. You’re just doing. Hence why Zuck wore the same clothes everyday. By eliminating those silly or frivolous, he could focus all of his energy on more important work decisions.nn7. Stop multitasking.nWe all believe that we’re multitaskers. In fact, humans just aren’t capable of doing multiple things at once.nn”People can’t multitask very well, and when people say they can, they’re deluding themselves,” said neuroscientist Earl Miller. “The brain is very good at deluding itself.”nnInstead, we’re simply shifting our attention from one task to another very quickly.nn”Switching from task to task, you think you’re actually paying attention to everything around you at the same time. But you’re actually not,” Miller said.nn”You’re not paying attention to one or two things simultaneously, but switching between them very rapidly.”nnIn fact, researchers have found that they can actually see the brain struggling when multitasking.nnSo the next time you have the urge to multitask, stop. Take a breather and then go back to focus on the one thing that needs to get done right now. Once that’s done, then you can move on to something else.nn8. Take advantage of your procrastination.nThis may sound counterproductive. But, there’s actually a method to the madness here.nnAccording to Parkinson’s Law, which was named after after historian Cyril Northcote Parkinson, “If you wait until the last minute, it only takes a minute to do.”nnThink about it. You’ve had a deadline at work looming over your head for a month, but you just cranked it during the final week.nnThis doesn’t give you permission to wait until the 11th hour. It does, according to Thai Nguyen of the TheUtopianLife.com, provide “great leverage for efficiency: imposing shorter deadlines for a task, or scheduling an earlier meeting.”nn9. Relieve stress.n
Since stress can cause physical, emotional, and behavioral problems – which can impact your health, energy, well-being, and mental alertness – it’s no surprise that stress hinders your work performance.nnThe good news is that you may be able to relieve that workplace stress.nnAccording to the American Psychological Association, “the most effective stress-relief strategies are exercising or playing sports, praying or attending a religious service, reading, listening to music, spending time with friends or family, getting a massage, going outside for a walk, meditating or doing yoga, and spending time with a creative hobby.”nnThe least effective strategies, however “are gambling, shopping, smoking, drinking, eating, playing video games, surfing the Internet, and watching TV or movies for more than two hours.”nnAnother effective stress management technique is to increase your control of a situation in advance. You can start by planning tomorrow the night before and sticking to your routine. This way you know what to expect in the morning.nn10. Do more of the work you enjoy.nNot everyone is privileged enough to do what you love for a living. Even if you are chasing your dreams and following your passions, there will still be tasks you’re not fond of doing. In either case, focus more on the work that you actually enjoy doing.nnFor example, if you’re a chef, then you obviously have a love for cooking. Instead of spending your days doing administrative tasks, outsource or delegate those tasks so that you can spend more time in the kitchen or at the market finding fresh ingredients.nnWhen you do, you’ll feel more fulfilled, inspired, challenged, and productive.nnOriginal 
With nearly a 10% expected growth rate throughout the medical coding market, there will be a high demand for medical coders within the industry. Coding related jobs are expanding among the business side of healthcare. Are you prepared?nnContact Welter Healthcare Partners today to learn more about our 
Just another piece in the telehealth puzzle, Remote Patient Monitoring, or RPM, is adding to the patient/provider relationship. New CPT codes 99453, 99454, and 99457 allow for reimbursement of services providers can utilize to manage and coordinate care at home. Best yet, code 99457 can be reported by clinical staff such as RN’s and medical assistants.nn99453: Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; set-up and patient education on use of equipment.nn99454: Remote monitoring of physiologic parameter(s) (eg, weight, blood pressure, pulse oximetry, respiratory flow rate), initial; device(s) supply with daily recording(s) or programmed alert(s) transmission, each 30 days.nn99457: Remote physiologic monitoring treatment management services, 20 minutes or more of clinical staff/physician/other qualified healthcare professional time in a calendar month requiring interactive communication with the patient/caregiver during the month.
The Trump administration says offering health insurance across state lines will enhance competition and lower premiums, but states may raise objections if their regulatory authority is challenged.nnKey Takeawaysn
Trump’s 2017 executive order also directs the Secretary of Labor “to consider expanding access to Association Health Plans, which could potentially allow American employers to form groups across State lines.” That would allow health insurance providers to bypass state coverage requirements.nnHealth insurance oversight is left largely to the purview of states, which has created a regulatory patchwork that varies widely from state to state.nnState and federal lawmakers, mostly Republican, have for the past decade pushed to sell health insurance across state lines, but the issue has proved to be nettlesome. The National Association of State Legislatures reports that at least 23 state legislatures have considered the idea over the past 10 years.nnThe National Association of Insurance Commissioners hasn’t taken a firm stand on the idea, because it represents independent state insurance commissioners, many of whom may have varying levels of support for the idea.nnIn