Jan 17, 2017 | Uncategorized
Tom Price’s Vision – Commercial & Individualn
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- Encourage Private Exchanges for purchase of individualized products across state lines
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- Create federal Grants for States to create high-risk pools
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- Eliminate individual Mandate
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- Comprehensive Medical Liability Reform allowing conformity to clinical guidelines to serve as an affirmative defense to liability
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- Claims Transparency from insurers to employers and individuals
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- Freedom of choice for any patient to contract directly with any willing provider
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- Anti-trust Exemption for non-economically aligned physicians to negotiate collectively with insurers (except Medicare, Medicaid, SCHIP, FEHB, or Indian Healthcare)
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Jan 4, 2017 | Uncategorized
Written By: Toni Elhoms, CCS, CPC, AHIMA-Approved ICD-10-CM/PCS Trainern Director of Coding/Compliance Consulting ServicesnnIt’s that time of the year again! The new 2017 CPT code changes take effect January 1st. Understanding the myriad of upcoming changes is crucial to obtaining the proper reimbursement for your services! The changes for 2017 address a number of interrelated issues. Clinical practice and technology have evolved and several issues required much needed CPT expansion and clarification. CPT 2017 offers the most changes in spine and orthopedic procedures, chronic care management, physical and occupational therapy, as well as significant changes in the reporting of moderate sedation services.n*Please note, this article is not an all-inclusive list; review your 2017 CPT book for complete descriptions of all changes. Appendix B of 2017 CPT provides a summary of additions, deletions, and revisions.nnHighlights of the most significant changes:n
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- Moderate Sedation
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- Chronic Care Management
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- Flu Vaccinations
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- Spinal Instrumentation
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- Orthopedics
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- Physical and Occupational Therapy
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- Diagnostic and Interventional Radiology
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- Spinal Steroid/Epidural Injections
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Jan 4, 2017 | Uncategorized
Moderate sedation services have historically always been bundled into the majority of all applicable CPT procedures. More than 400 codes that were previously defined as including moderate sedation have been deleted from Appendix G. In addition to six new CPT codes and one new endoscopy-specific HCPCS code, CMS intends to create a “uniform methodology for valuation of the procedural codes that currently include moderate sedation as an inherent part of the procedure” with this year’s CPT updates. Providers who perform moderate sedation with a procedure must report the appropriate new moderate sedation codes to receive full reimbursement. As a result of removing this long time bundling edit, many procedures will see a slight reduction in RVU.n
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- 99151 – Moderate sedation services provided by the physician or other qualified health care professional performing the diagnostic or therapeutic service that the sedation supports, requiring the presence of an independent trained observer to assist in the monitoring of the patient’s level of consciousness and physiological status; initial 15 minutes of intraservice time, patient younger than 5 years of age
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- 99152 – Initial 15 minutes of intraservice time, patient age 5 years or older
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- 99153 – Each additional 15 minutes intraservice time
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- 99155 – Moderate sedation services provided by the physician or other qualified health care professional other than the physician performing the diagnostic or therapeutic service that the sedation supports; initial 15 minutes of intraservice time, patient younger than 5 years of age
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- 99156 – Initial 15 minutes of intraservice time, patient age 5 years or older
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- 99157 – Each additional 15 minutes intraservice time
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- G0500 – Moderate sedation services provided by the same physician or other qualified health care professional performing a gastrointestinal endoscopic service that sedation supports
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Go Back To CPT Code Change Directory
Jan 4, 2017 | Uncategorized
Effective Jan. 1st, CMS will begin paying for complex CCM services (99487-99489) in addition to normal CCM (99490). These CPT codes have been around for a while, but CMS has always refused to reimburse for them. Keep in mind, to get paid, you must be able to properly note all the moving parts of this service in the medical record as indicated by the coding guidelines.nnCMS has also created a new add-on G code — G0506 (Comprehensive assessment of and care planning for patients requiring chronic care management services [List separately in addition to primary monthly care management service]).nnIt covers the additional work associated with assessing CCM services and generating a care plan. This used to be bundled into payment for an office visit (99201-99215), but in 2017 you can get paid EXTRA for it if you nail down your documentation. You’ll also find relaxed billing rules for CCM services in 2017, which include getting rid of a beneficiary consent form and removing the requirement for 24/7 access to care.n
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Jan 4, 2017 | Uncategorized
Several new codes will replace long time spinal biomechanical device code 22851. The new codes are more specific regarding the type and location of the biomechanical devices.n
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- 22853 – Insertion of interbody biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to intervertebral disc space in conjunction with interbody arthrodesis, each interspace (List separately in addition to code for primary procedure)
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- 22854 – Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh) with integral anterior instrumentation for device anchoring (eg, screws, flanges), when performed, to vertebral corpectomy(ies) (vertebral body resection, partial or complete) defect, in conjunction with interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
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- 22859 – Insertion of intervertebral biomechanical device(s) (eg, synthetic cage, mesh, methylmethacrylate) to intervertebral disc space or vertebral body defect without interbody arthrodesis, each contiguous defect (List separately in addition to code for primary procedure)
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nAdditional codes have been created to replace temporary codes for interspinous process decompression devices (IPD).n
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- 22867 – Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; single level
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- 22868 – Insertion of interlaminar/interspinous process stabilization/distraction device, without fusion, including image guidance when performed, with open decompression, lumbar; second level (List separately in addition to code for primary procedure)
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- 22869 – Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; single level
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- 22870 – Insertion of interlaminar/interspinous process stabilization/distraction device, without open decompression or fusion, including image guidance when performed, lumbar; second level (List separately in addition to code for primary procedure)
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Go Back To CPT Code Change Directory
Jan 4, 2017 | Uncategorized
Influenza codes received a makeover with this year’s CPT update. The codes are no longer classified based on age. The descriptions of these codes now reflect dosage amounts. Codes now state “becomes 0.25 mL dosage” in place of “when administered to children 6-35 months of age” and “becomes 0.5 mL dosage” in place of “when administered to individuals three years and older”. These changes affect codes 90655 – 90661 and 90685 – 90688.nn
Go Back To CPT Code Change Directory
Jan 4, 2017 | Uncategorized
Physical and occupational therapy codes received a major overhaul with this year’s CPT update. Codes have been expanded to take into account the overall evaluation complexity. The new codes incorporate a tiered level of complexity for physical and occupational therapy as well as athletic training evaluations. These new codes also require a substantial increase in the volume and quality of clinical documentation needed to capture these services compliantly.n
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- 97161 – Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.
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- 97162 – Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.
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- 97163 – Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.
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- 97164 – Re-evaluation of physical therapy established plan of care, requiring these components: An examination including a review of history and use of standardized tests and measures is required; and Revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome Typically, 20 minutes are spent face-to-face with the patient and/or family.
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- 97165 – Occupational therapy evaluation, low complexity, requiring these components: An occupational profile and medical and therapy history, which includes a brief history including review of medical and/or therapy records relating to the presenting problem; An assessment(s) that identifies 1-3 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of low complexity, which includes an analysis of the occupational profile, analysis of data from problem-focused assessment(s), and consideration of a limited number of treatment options. Patient presents with no comorbidities that affect occupational performance. Modification of tasks or assistance (eg, physical or verbal) with assessment(s) is not necessary to enable completion of evaluation component. Typically, 30 minutes are spent face-to-face with the patient and/or family.
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- 97166 – Occupational therapy evaluation, moderate complexity, requiring these components: An occupational profile and medical and therapy history, which includes an expanded review of medical and/or therapy records and additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 3-5 performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of moderate analytic complexity, which includes an analysis of the occupational profile, analysis of data from detailed assessment(s), and consideration of several treatment options. Patient may present with comorbidities that affect occupational performance. Minimal to moderate modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 45 minutes are spent face-to-face with the patient and/or family.
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- 97167 – Occupational therapy evaluation, high complexity, requiring these components: An occupational profile and medical and therapy history, which includes review of medical and/or therapy records and extensive additional review of physical, cognitive, or psychosocial history related to current functional performance; An assessment(s) that identifies 5 or more performance deficits (ie, relating to physical, cognitive, or psychosocial skills) that result in activity limitations and/or participation restrictions; and Clinical decision making of high analytic complexity, which includes an analysis of the patient profile, analysis of data from comprehensive assessment(s), and consideration of multiple treatment options. Patient presents with comorbidities that affect occupational performance. Significant modification of tasks or assistance (eg, physical or verbal) with assessment(s) is necessary to enable patient to complete evaluation component. Typically, 60 minutes are spent face-to-face with the patient and/or family.
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- 97168 – Re-evaluation of occupational therapy established plan of care, requiring these components: An assessment of changes in patient functional or medical status with revised plan of care; An update to the initial occupational profile to reflect changes in condition or environment that affect future interventions and/or goals; and A revised plan of care. A formal reevaluation is performed when there is a documented change in functional status or a significant change to the plan of care is required. Typically, 30 minutes are spent face-to-face with the patient and/or family.
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- 97169 – Athletic training evaluation, low complexity, requiring these components: A history and physical activity profile with no comorbidities that affect physical activity; An examination of affected body area and other symptomatic or related systems addressing 1-2 elements from any of the following: body structures, physical activity, and/or participation deficiencies; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 15 minutes are spent face-to-face with the patient and/or family.
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- 97170 – Athletic training evaluation, moderate complexity, requiring these components: A medical history and physical activity profile with 1-2 comorbidities that affect physical activity; An examination of affected body area and other symptomatic or related systems addressing a total of 3 or more elements from any of the following: body structures, physical activity, and/or participation deficiencies; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.
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- 97171 – Athletic training evaluation, high complexity, requiring these components: A medical history and physical activity profile, with 3 or more comorbidities that affect physical activity; A comprehensive examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures, physical activity, and/or participation deficiencies; Clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.
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- 97172 – Re-evaluation of athletic training established plan of care requiring these components: An assessment of patient’s current functional status when there is a documented change; and A revised plan of care using a standardized patient assessment instrument and/or measurable assessment of functional outcome with an update in management options, goals, and interventions. Typically, 20 minutes are spent face-to-face with the patient and/or family.
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Go Back To CPT Code Change Directory
Jan 4, 2017 | Uncategorized
There are 8 new CPT codes to reflect epidural spinal injections. These new codes are classified by both anatomy and whether imaging guidance was used and replace codes 62310 – 62319.n
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- 62320 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance
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- 62321 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)
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- 62322 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance
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- 62323 – Injection(s), of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, including needle or catheter placement, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)
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- 62324 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; without imaging guidance
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- 62325 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, cervical or thoracic; with imaging guidance (ie, fluoroscopy or CT)
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- 62326 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); without imaging guidance
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- 62327 – Injection(s), including indwelling catheter placement, continuous infusion or intermittent bolus, of diagnostic or therapeutic substance(s) (eg, anesthetic, antispasmodic, opioid, steroid, other solution), not including neurolytic substances, interlaminar epidural or subarachnoid, lumbar or sacral (caudal); with imaging guidance (ie, fluoroscopy or CT)
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Jan 4, 2017 | Uncategorized
Bunionectomy codes underwent expansion and revision in this year’s CPT update. Two new codes were added to reflect more accurate procedural options as well as many revisions to the technical descriptions of existing bunion correction codes.n
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- 28291 – Hallux rigidus correction with cheilectomy, debridement and capsular release of the first metatarsophalangeal joint; with implant
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- 28295 – Correction, hallux valgus (bunionectomy), with sesamoidectomy, when performed; with proximal metatarsal osteotomy, any method
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Go Back To CPT Code Change Directory
Jan 4, 2017 | Uncategorized
The most significant changes this year for diagnostic and interventional radiology involve mammography bundling, ultrasound screenings for AAA, and fluoroscopy services. Fluoroscopy codes 77002-77003 are now subject to the global period concept and are designated add-on codes.nnMammography services now include computer – aided detection (CAD), which eliminated the add-on codes reported in previous years. CMS is still requiring the use of HCPCS G-codes and will not eliminate these codes until 2018.n
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- 77065 – Diagnostic mammography, including computer-aided detection (CAD) when performed; unilateral
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- 77066 – Diagnostic mammography, including computer-aided detection (CAD) when performed; bilateral
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- 77067 – Screening mammography, bilateral (2-view study of each breast), including computer-aided detection (CAD) when performed
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- G0202 – Screening mammography, producing direct digital image, bilateral, all views
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- G0204 – Diagnostic mammography, producing direct 2D digital image, bilateral, all views
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- G0206 – Diagnostic mammography, producing direct 2D digital image, unilateral, all views
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nA new code has been created to specifically screen for an abdominal aortic aneurysm. This CPT code will replace G0389, which has been used in previous years.n
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- 76706 – Ultrasound, abdominal aorta, real time with image documentation, screening study for abdominal aortic aneurysm (AAA)
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Go Back To CPT Code Change Directory
Jan 4, 2017 | Uncategorized
At the end of the day, contracting in this day of pay–for–performance and adding value to the relationship is about the bottom line. What is the bottom line? The Spend!nnIn most states, including Colorado, the commercial health plans have to tell the state what their premiums are. Their premiums come from their estimate as to what their network and covered population will cost. I find it fascinating to look and see what the various payers are declaring! You can tell a lot about a network and its management by looking at these numbers.nnCan a provider help a payer lower its spend? Can you control costs? Not necessarily your own costs but the costs of those you refer to? You may be surprised!n
The bottom line, don’t give it (this ability) away!
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Stay tuned for more Todd’s Tips!
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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.
Dec 13, 2016 | Uncategorized
Transition InformationnOn March 1, 2017, Hewlett Packard Enterprises (HPE) will assume fiscal agent operations on behalf of Health First Colorado (Colorado’s Medicaid program) and Child Health Plan Plus (CHP+). These operations include the transition to the Colorado interChange (a new claims payment system) and a new provider Web Portal.nnYou must be enrolled in the new Colorado interChange. All providers must be enrolled (and approved) in the Colorado interChange system by March 1, 2017. Those who are not enrolled and approved will not be able to submit claims or receive payments. Visit Colorado.gov/HCPF/Provider-Enrollment for more information.nnAll ordering, prescribing, or referring (OPR) providers must be enrolled in the new Colorado interChange. The Affordable Care Act (ACA) now requires physicians and other eligible practitioners to enroll in the Medicaid program to order, prescribe, and refer items or services for Medicaid members, even when they do not submit claims to Medicaid. Claims listing an OPR provider that is not enrolled cannot be paid. Visit Colorado.gov/HCPF/OPR for more information.nnClearinghouse Enrollment & TestingnIf you utilize a Clearinghouse to submit batch claims or eligibility transactions, your Clearinghouse MUST apply for an interChange Trading Partner ID (TPID) and pass test transactions for HIPAA compliance. Clearinghouses without an interChange TPID will not be able to submit batch claims or receive reports beginning March 1, 2017.nnPlease check this list to see if your Clearinghouse has enrolled and passed testing. If your Clearinghouse has not started or has not completed their testing, we recommend that you reach out and remind them to do so immediately. Your Clearinghouse can learn more information about applying for a new TPID at: Colorado.gov/HCPF/EDI-support.nnContact UsnIf you need assistance with your revalidation or enrollment application, please call the Health First Colorado Enrollment and Revalidation Information Center at: 1-844-235-2387. Standard operating hours are 8am – 5pm MT, Monday – Friday.nnPlease Note: For billing, claims and Provider ID questions regarding the current Xerox system, please continue to call Xerox State Healthcare at: 1-800-237-0757.nnThis article originally posted on Colorado.gov.
Dec 13, 2016 | Uncategorized
Photo Courtesy of Healthleadersmedia.com.
Click Here To Read More
nThis article was originally posted on Healthleadersmedia.com.
Nov 29, 2016 | Uncategorized
With just over a week before it was scheduled to take effect, a federal judge blocked the implementation of an Obama administration overtime pay rule that would have extended overtime eligibility to some 4 million Americans.nnThe Labor Department’s sweeping overhaul to the overtime rule required employers to pay time-and-a-half to their employees who worked more than 40 hours in a given week and earned less than $47,476 a year. That salary threshold is about twice what currently allows workers to be exempted from overtime. As NPR’s White House Correspondent Scott Horsley told our Newscast Unit, supporters of the rule called it “long overdue” as inflation took its toll on overtime protection.nn”The rule was one of the administration’s most far-reaching efforts to boost pay for workers at the lower end of the income ladder. It’s one of many administrative actions that was already facing the threat of reversal from the incoming Trump administration.” The measure, which had been set to take effect Dec. 1, was intended to send a jolt to slow-growing U.S. incomes.nnOn Tuesday, U.S. District Judge Amos Mazzant III issued a preliminary injunction in the case, siding with plaintiffs who said the new overtime rules would have caused an uptick in government costs in their states and made it mandatory for businesses to pay millions in additional salaries. Business groups said the new rule changes would have eventually led to layoffs.nnThe timing of the block brings an early answer for workers who were wondering about the rule’s fate after the election. As NPR’s Business Correspondent Yuki Noguchi reported earlier this month: “In any presidential transition, previous policies are subject to review. Trump has pledged to undo President Obama’s executive orders, dismantle the Affordable Care Act, reverse policies on clean air, immigration and on Dodd-Frank financial reform. This [month], the Congressional Budget Office said canceling the overtime rule would reduce employers’ compliance costs and boost profits, a point advocates refute. This leaves businesses wondering how they should proceed on rules that might be unwound.”nnWith Republicans controlling both houses in Congress and the Trump administration set to take office in less than two months, the new overtime rule’s long-term future remains in limbo. The Department of Labor issued the following statement regarding the federal court’s preliminary injunction.n
Click Here To Read More
nThis article was originally posted on Npr.org.
Nov 23, 2016 | Uncategorized
Happy Thanksgiving! We are very happy whenever the season of Thanksgiving is fast approaching because we consider this as a wonderful holiday that permit us the best opportunity to thank all our valued friends, supporters and clients. These previous years have really been good to our company, and so we thank all of you for continuing to patronage us and for experiencing our remarkable service.nnWishing you and your family a wonderful Thanksgiving!n— Welter Healthcare Partners
Nov 17, 2016 | Uncategorized
The new Overtime Rule law implemented by the Department of Labor REQUIRES you to modify how you pay some of your full-time salaried employees, or fall victim to expensive lawsuit nightmares.nnEffective Dec. 1st, the new Fair Labor Standards Act (FLSA) rule changes the threshold for salaried employees. In a nutshell, this means you could be among the thousands of practices REQUIRED to pay overtime to full-time employees making less than $47,476 a year. And, noncompliance really isn’t an option.nnSo what can you do about it…nnHuman Resources Expert, Lori Kleiman, SPHR, SHRM-SCP, is offering a healthcare-specific FLSA Overtime Compliance online training session just for you. In only 60-minutes, you’ll receive a step-by-step breakdown of the new FLSA requirements as they relate to healthcare. You’ll learn how to ensure compliance with this new rule – which includes avoiding overpaying your staff too – and have time to get your specific questions as well.nnHere are just a few of the proven tactics you’ll receive by attending this step-by-step, plain-English online training:n
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- Raise salaries or switch to hourly … learn when and how to draw the line.
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- More than just overtime eligibility … we’ll show you how to avoid the other big headaches in this rule too
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- Must-use language in employee conversations … and which words you should skip
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- Policy manual compliance — identify which policies you need to change today
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- Using bonuses as part of your compensation package? Find out what you really need to know
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- Reduce how much overtime pay will really affect your practice’s bottom line
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- Pin down which of your employees the rule change affects: RNs, Office Manager, Front Desk Staff, PAs, NPs, etc.
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- And so much more…
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nWARNING: Every medical practice, clinic, and hospital that has full-time employees, no matter how big or small, is responsible for complying with the new Overtime Rule law — FLSA rule modifications. No one is immune, you must comply by the Dec. 1st deadline. You must take steps NOW to ensure your compliance. Don’t wait, register today.
Nov 17, 2016 | Uncategorized
Sneaky Sneak!nI am seeing some pretty sneaky fee schedules lately! If you cannot explain a fee schedule on the way up the elevator between two floors of your building, it is either too complicated to know if your being paid properly or so vague that you won’t be.nnSome new carriers are popping up to take on older programs or member groups, very often these out of state payers first start off on fishing expeditions trying to catch those who don’t know, don’t pay attention or don’t care. Don’t be one of them!nStay tuned for more Todd’s Tips!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.
Nov 17, 2016 | Uncategorized
The Colorado Department of Health Care Policy and Financing made the decision to postpone the Go Live date of:n
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- The new claims payment system (the Colorado interChange),
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- The new provider web portal, and
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- The new Pharmacy Benefits Management System.
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nThe new Go Live date is March 1, 2017.nnProviders should continue to use their current processes for submitting claims, prior authorization requests and provider enrollment updates to the Department. Claims will continue to be processed and paid as they are currently.nnThe additional four months will allow providers and partners more time to complete the enrollment and revalidation process, receive comprehensive training and prepare for associated changes in their business processes. The Department will conduct additional systems testing during this time.nnThe Department will post updates and resources including revised deadlines on The Department’s Provider Resources web page.nnWe appreciate your continued commitment to serving our more than 1.3 million Health First Colorado (Colorado’s Medicaid Program) and Child Health Plan Plus (CHP+) members.
Nov 17, 2016 | Uncategorized
The 2017 Medicare Part B Physician’s Fee Schedules have been posted to the Novitas Solutions website. Downloads are available in Adobe PDF, Microsoft Excel, and Plain Text formats. The Code Search feature will not have 2017 fees loaded until the first week of January, 2017.nnClick Here to Download Copies.
Nov 7, 2016 | Uncategorized
It doesn’t matter who does the math, Thomas: Amendment 69 would be a disaster for Colorado taxpayers. This week the Tax Foundation, an independent research organization, released a report on the impacts of passing ColoradoCare into law — and it’s as bad as we thought.nnHere are some of the Tax Foundation’s findings:n
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- “Amendment 69 would hurt Colorado’s tax climate as the state would surpass California with the highest individual income tax rate in the country.”
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- “Amendment 69 would create a new bureaucracy, with immense authority to change taxes, outside of the state’s current balance of powers, eliminating transparency for taxpayers.”
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- “The economic incidence of payroll taxes is borne by employees, not employers. Splitting responsibility for the payment of the tax between employer and employee does not change the economic incidence.”
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- “Colorado would plummet from 16th to 34th nationally on the State Business Tax Climate Index, confronting voters with an important choice in the Centennial State.”
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nExperts from all across the political spectrum — as well as independent research entities like the Tax Foundation — all agree: Amendment 69 is wrong for Colorado.
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