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NEWS FOR THE DAY: 7-11-2011 CMS has released the Medicare proposed physician fee schedule for 2012. The ruling estimates the 2012 conversion factor to be $23.9635, which represents a 29.5% cut to Medicare physician payments unless Congress intervenes. CMS will accept public comments as always on the rule until August 30th, 2011. Please get your comments in before this time so we can work together to avoid this disaster.
6-22-2011 Please remember that you have until June 30, 2011 to report on the e-prescribe measures for your practice to avoid the penalties. Remember that if your office sees less than 100 cases containing an encounter code in the measure denominator you do not have to participate in e-prescribe. Please call my office for any further information you may need.
5-11-2011 A bill introduced in the House last Wednesday and also supported by organized medicine, would let physicians set their fees for Medicare patients as high as the market will allow, balance bill them for the amount above Medicare's allowable charge and still ramain in the program. The program titled Medicare Patient Empowerment Act, enables the freesetting and billing freedom by allowing physicians to privately contract with patients on what they will pay for medical services. You can only do this now as a physician if you drop out of the Medicare program altogether. This would help physicians make up for the paltry Medicare rates that deter them from treating seniors. This legislation will also insure that our seniors do not loose access to healthcare professionals and physicians, many of which are finding it harder to treat Medicare eligable patients. I will keep everyone posted on the news as I get it on this issue.
5-2-2011 To all my clients. MIFS is currently keeping a close watch out for flood waters. As of right now the levels behind Lowes on Germantown Parkway have subsided to 15 to 16 feet. Last Friday when the flooding was in our driveway they were at 26.6 feet. The EMA is keeping my downstairs neighbor up to date on all of this and if there is even a slight risk for flooding in my building we will be moving servers and other vital equipment and information to a different location. Periodic backups during the day are being maintained and I feel confident that we will have no interruption of service. Unless power goes out due to this we are working and if it does I have two very powerful generators that will be moved here to run the servers. Please call us with any questions or concerns.
4-22-2011 We are HIRING. Please submit resumes to 901-821-0384. Need expierenced payments posters that understand medical line item posting and can read an explanation of benefits correctly. Also need patient account reps to follow up on claims.
2-24-2011 You will not have to worry about your Medicare payments falling by 30% or more until 2014 if a pay fix provision in President Obama's proposed budget for fiscal 2012 is enacted. Your payments would see 0% updates in 2012 and 2013, paid for by $62 billion in savings the White House expects to get out of Medicare and Medicaid. Beyond this time the Administration is determined to work with Congress to put in place a long-term plan for reform.
2-10-2011 MIFS is open today. If you are an employee and did not make it in you can make up your time on Saturday if you choose to do so.
2-10-2011 As previously posted on 12-8-2010 The Center for Medicare & Medicaid (CMS) has announced a process to address inaccurate payments for some 2010 claims. Retroactive provisions in the Patient Protection and Affordable Care Act, coupled with technical corrections to the 2010 Medicare physician fee shedule, resulted in some overpayments and many underpayments on millions of Medicare fee-for-service claims during the first five months of 2010. To address this CMS announced it will begin reprocessing some of them over the next few weeks a process CMS sats will take some time to complete. According to CMS claims will not be automatically reprocessed at higher rates. You must send in a request to have these reprocessed through the reopening area of their carriers company.
01-04-2011 Happy New Year everyone.
12-20-2010 Wishing everyone a Happy Holiday season and a wonderful New Year.
12-9-2010 Yesterday the Senate passed by unanimous consent, legislation preventing a 24.9 % cut to Medicare physician payments. H.R. 4944 extends the current Medicare payment rates through Dec 31, 2011. The House is expected to act quickly on this as well. I will keep you posted on this as well as other issues pending with Congress.
12-8-2010 We would like to let everyone know that Cahaba Government Services is going to retro back claims to January 1, 2010 and pay the additional 2.3 percent that you are currently getting for your work. If you are a client of mine we will do this for you. If you are not a client contact my office for further details and I can let you know how we can guide you on this. This could potentially mean increased revenue for your practice so do not wait. The filing dead line for Medicare is now one year from date of service.
12-3-2010 A group called the National Commission on Fiscal Responsibility and Reform that was appointed by President Obama has proposed a plan titled " The Moment of Truth" that would freeze physician reimbursment rates through 2013 and then reduce the rates by 1% in 2014. After this period the commission report calls for a revamped formula for setting Medicare pay in 2015 that stresses care coordination and rewards providers for - quality not quantity- of their services. The formula would replace the SGR that will trigger the 25% cut next year unless Congress acts this month to avert it. I will try and keep everyone posted as I get news from the Centers of Medicare and Medicaid and other sources.
11-30-2010 Late yesterday afternoon the House passed a one month patch to the Medicare sustainable growth rate (SGR) formula. This bill will now freeze current physician rates through December 31, 2010. It temporarily halts the 23 percent cut to physician payments that were slated to take effect on December 1, 2010. The patch will be paid for by using 1 billion from a 20 percent cut in payments for outpatient therapy services. The bill will now remove those payments from the overall pool of money known as the PFS or physician fee schedule. Physicians and their staff need to continue to urge congress to call on Congress for an additional 12 month fix so that lawmakers can find a permanent fix to this ever present problem facing our physicians, the elderly and governmental workers.
11-18-2010 Late this evening the Senate approved by unanimous consent a bill that would provide a payment patch to the Medicare sustainable growth rate (SGR) formula. This is a 31 day fix only. This bill will hold the current rates for services provided through December 31, 2010 and temporarily avert a 23 percent cut to physician payments slated to take effect on December 1, 2010. The House had adjourned for the week and is expected to vote on the bill when they return. This is only a short term fix for what will be a national disaster if it is not put in place permanently. Many organizations are calling for a 12 month fix that will give lawmakers time to find a permanent solution to the matter.
11-10-2010 When federal lawmakers return to Washington the week of November 15 for a lame duck session, their first order of business will be to pass at most a month-long pay fix to get over the Dec 1 cuts that are expected. This is news from a industry lobbyist actively involved in this process. This lobbyist states that they are going to pass something short-term to get over the hump then later they are going to pass something during the lame duck session that is a longer-term deal. Both parties agree that a 23% cut to physician payments is unacceptable but will argue over how to pay for it. Please urge your congress men and women to get a fix for this and make it a permanent one at that.
11-3-2010 Again I am urging all of you to contact members of congress and urge them to vote against the Medicare cuts due to take effect on 12-1-2010 and again on 1-1-2011. Your groups are facing a whopping 30.10 percent cut in Medicare reimbursment alone if this is not stopped. That cuppled with the cuts to speciality groups and the doing away of the consultation charges may mean that you will have to close your doors for good. Again, please urge everyone even your Medicare patients to get on the phone and let Congress know that this is a disaster in the making for our seniors and for the Medical profession as a whole. Know one will benefit from this especially our aging population.
10-25-2010 Unless Congress intervenes, all physicians will face a 23.6 percent Medicare cut on December 1, 2010. Additionally, another 6.5 percent cut that is scheduled for January 1, 2011 will take effect as well. Many practices are taking unheard of measures due to this. Many are limiting the number of Medicare patients they are seeing or not taking these patients at all. Practices are holding off purchasing new equipment due to the uncertainty that surrounds this as well as holding off adopting EMR programs that are being forced on them. Please contact your members of Congress and urge them to vote to end this and end it now. The impact this is having on day to day operations is deplorable and what it is doing to Medicare recipients is even worse. While physicians are being cut to the bone the pharmacutical, insurance and other sectors of Medicine are not being impacted. We urge you to take action now before its to late.
10-18-2010 October 1, 2010 was deadlin to make sure you 2011 ICD-9 file was updated with the new and deleted codes. Check your practice management systems for this very important issue.
10-13-2010 Upcoming elections will have a major impact on how and when the massive Medicare cuts could take place. Keep checking in with us to see all the news. I will post anything I hear as soon as I receive notification.
9-16-2010 Please call us for updated pricing on EMR licenses. Sage has updated their pricing for my office and we have some great discounts on provider licenses and programs right now. They also now offer a patient portal for meaningful use criteria that is really nice and that is necessary to aquire the incentive money being offered by the government. Please remember that even if you run a different EMR from the Sage Intergy Practice Management we can still help you with all your billing needs. An HL-7 interface is all that is needed to import information from one system to another. Call me with any questions you may have.
8-23-2010 I have received many calls from Administrators and Physicians in regards to the reimbursments that are currently being posted to your accounts. As you all recall The Center for Medicare Medicaid released money early in the last two weeks of July causing all of you to have record collections for the month. Because of the early release, money for August has been slow coming from Medicare and has effected your bottom line. Remember, money that should have been here in August came in late July. Please refer back to your letters I sent to you explaining this. If you have any other questions or need more clarification on this issue please call me. I want every one to be cautious with purchases and making decisions that could effect your practices operation for now. Please remember that again we will be faced with the possibility of the cuts that are on the agenda in Congress in late November. Every governing board of most major practice management firms are cautioning their clients not to make bold or rash moves until after the first of the year. I agree with this and am advising everyone to think long and hard about any changes that could effect your bottom line.
8-13-2010 Here we go again. Changes to the formats that we have to file claims with is set to implement on January 1, 2012. If you think you have time to waste, think again. The new Version 5010 for electronic claims submission is a good one but complicated. We have begun testing with Sage and our outlook is very promising. What this all means for you is that we will be ready when the start date rolls around. Version 5010 or Accredited Standards Committee (ASC) X12 for electronic claims submission is what all the hype is about. The new features include the following but are not limited to:
1)Field size adjustment for ICD codes 2) An additional didget will be added to seperate ICD-10 from ICD-9 3) Spaces for diagnosis will increase. 4) Will elaborate between admitting diagnosis, patient reason for visit and presentation on admission conditions. 5) Uses very precise reporting elements called TR3 that will represent the data more clearly. 6)
These changes will greatly affect the way your charges are entered into a practice management system and reimbursment. Please make arrangements now to start reading and looking over what could greatly affect your bottom practice line in the near future.
8-12-2010 No new news from Cahaba which is good for all. Please keep in mind the hold for the first 2 weeks of August.
8-9-2010 Just a reminder that Cahaba is holding reimbursments for the first 2 weeks of August.
8-5-2010 I received lots of calls in regards to the 8-4-2010 post. Remember that the first 2 weeks of August there will be no Medicare disbursments due to the early release of money the last week of July. Please budget wisely.
8-4-2010 July posted record months for many of you but please keep in mind that due to the early release of money from Cahaba on your Medicare claims, your total overall collections were effected. That combined with the additional money paid for the cutbacks taken in May also made for record collections. I will keep you all posted on any new developments that may arise.
7-27-2010 Please look at the faxed notices I sent to all offices today concerning the release of checks early from Cahaba during the last days of July 2010. Please take note that due to the early release of these checks CMS has instructed the carriers to hold checks for the first 2 weeks of August thus causing another drop in income for you. Keep this in mind when budgeting for the end of July and August.
7-19-2010 We began receiving Medicare checks today with an adjustment for the 21.3% that was previously taken out of your reimbursments at the begining of June 2010. These checks also included the 2.2% raise you were given. We have gotten payments for dates of services through 6-25-2010 on some clinics. I will personally make sure that every claim is re-paid at the proper amount. I will post news as I get it each day.
7-13-2010 We are now receiving checks that have dates of service 6-1-2010 through 6-12-2010. The 2.2% increase continues to be attached. I have not seen any of the checks dated 6-29-2010 and 6-30-2010 being adjusted to date with cuts you all took or the raise. I will keep you all posted.
7-5-2010 As stated previously checks from Cahaba started coming in on June 29, 2010. All checks dated June 29, and June 30, 2010 had various cuts made to them. These cuts, again, ranged from 9.5% to 18.5%. Begining on July 1, 2010 any checks we have received had the 2.2% increase on them. We will be watching this closely and I will keep you posted on this.
7-2-2010 To all my Providers. Checks cut for dates of service June 1 and forward began coming in on June 29, 2010. They did show cuts ranging from 9.5% to 18.5 %. To date I have no answere for why as each rep you talk to at Cahaba Government Services tells a different story and cannot give me a straight answere. The checks cut yesterday on 7-1-2010 have the correct rates on dates of service June 1 and forward with the 2.2% raise. We are carefully watching all this and will keep everyone informed on this very important issue. Please call me for further information if you need to.
6-24-2010 This evening the House of Representatives passed the Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (HR 3962) by a vote of 417 to 1. The legislation blocks the 21.3 percent cut to Medicare physician payments until November 30, 2010. The Senate passed similar legislation late last week. The President is expected to sign the bill into law shortly. Practices will then see the 2.2 percent increase in physician payments for claims with dates of service June 1, 2010 through November 30, 2010. I urge you all to write your congressman and women and encourage them to address this issue through the immediate repeal of the Medicare Substantial Growth Rate Formula.
6-17-2010 The Senate Democratic leaders introduced a substitute amendment to the HR 4213 bill that will include a provision for a 2.2 % increase to Medicare payments to physicians for claims dated June 1, 2010 to Nov 30, 2010. The House approved version of the bill failed yesterday. The Senate is expected to hold votes as early as today but this is little comfort for physicians facing a cut of this magnitude. The financial impact of this to our medical community cannot be measured here. I will keep you all posted as I get information on this highly watched issue.
6-14-2010 Per CMS. CMS has now directed its contractors to continue holding June 1, 2010 claims and later through Thursday, June 17th, 2010, lifting the hold on Friday June 18th. This will greatly impact your practice cash flow so please make sure steps are in place to help you get through this period of time.
5-10-2010 Congress is considering a multiyear solution to the payment crisis our physicians are facing as early as next week. The massive cut will take effect on June 1, 2010 unless lawmakers act to avert it. Congressional democrats appear ready to enact a longer term solution to Medicare reimbursment that may even include a raise for physicians. Organized medicine has lobbied Congress for a permanent fix, namely a repeal of the sustainable growth rate (SGR) formula that Medicare uses to calculate physician pay. I will keep everone posted as to what is happening up on Capital Hill.
4-30-2010 Uploads from Cahaba are starting to show April payments. Good News For All.
4-28-2010. Please call our office for a copy of the recent live webinar from MGMA outlining the Healthcare Reform Law/ The Patient and Affordable Care Act Reference Implementation Timeline. It outlines many topics that we are all interested in and clearly defines what is in store for all of us. Call Marlene today for a copy.
Click here for more information from the Centers for Medicare and Medicaid.
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