iATROS Bloghttp://www.iatroshealth.com/blog/RSS feeds for 60http://www.iatroshealth.com/blog/bid/161326/Medical-Practice-Revenue-Theft-4-out-of-5-practices-are-victims#Comments0Medical Practice Revenue Theft – 4 out of 5 practices are victimshttp://www.iatroshealth.com/blog/bid/161326/Medical-Practice-Revenue-Theft-4-out-of-5-practices-are-victims<p>&nbsp;</p> <p>According to MGMA, a resounding 82.8% of practices they’ve interviewed have experienced employee fraud/theft.&nbsp; In 28.7% of those occurrences, the Practice Administrator or Billing Manager was the perpetrator. In 25.9%, the receptionist was the perpetrator.&nbsp; Most commonly, the fraud relates to theft of receipts, theft of cash, or altering/forging checks.&nbsp;</p> <p>As a billing company, we’ve spoken with countless practices whom, at some point or another, have been the victim of employee theft.&nbsp; The most frequent occurrence relates to cash payments.&nbsp; Most practices do not have enough controls in place to ensure transparency within their operations.&nbsp; The same employees often handling the cash are the same employees entering transactions.&nbsp; It becomes very tempting and very easy to key payments, settle balances, or remove obligations from accounts once the patient has paid.&nbsp;</p> <p><em><strong>Can it happen to you?</strong></em></p> <p>Over the past year, we began working with a client, whom was a sole practitioner, who had two staff whom she considered trusted long term employees working in her office. Within weeks, we began noticing a trend which later proved to be a case of theft by the front desk employee.&nbsp; This had been ongoing, unbeknownst to the practitioner; however prior to partnering with iATROS, it had gone un-noticed.&nbsp; How’d we do it?</p> <p><strong>From the origination of working with a practice, we establish two controls.&nbsp;</strong></p> <p><strong>&nbsp; 1. We do not handle any paper money, ever.&nbsp; </strong></p> <p><strong>&nbsp; 2. We utilize our own state of the art practice management system, and our internal staff are the only users allowed to reconcile balances on any accounts.</strong></p> <p>By design, these controls separate those who are handling paper money, from those who are recording paper money.&nbsp; This design increases transparency, as well as ensures the integrity of the data for your patient accounts.</p> <p>In the case of the example above, we removed the capacity for our client’s staff to edit or manage the recording of funds for any accounts.&nbsp; The perpetrator continued to pocket cash payments from patients paying up-front; meanwhile they were not reporting the cash payments to us.&nbsp; Naturally, we continued to contact patients to collect funds, through statements and phone calls.&nbsp; It was only a matter of time until we encountered enough patients whom had paid their balance, yet were still being pursued for payment.&nbsp; Working with our client, we were able to identify the perpetrator and they were then able to take the necessary steps on their end to remediate the problem.</p> <p><img id="img-1350489990470" src="http://www.iatroshealth.com/Portals/141935/images/save-money-health-care-main_full.jpg" alt="medical practice revenue, physician income, insurance revenue" border="0" height="225" width="375"></p> <p><em><strong>What can you do to minimize your risk?</strong></em></p> <p>Separation of Duties:&nbsp; Ensure those staff who are receiving cash payments, do not have the authority or capacity to key or manipulate the records.&nbsp;</p> <p>Ensure each and every patient who makes a cash payment, receives a written receipt.&nbsp; This should be a written policy in your practice, and your patients should expect to receive a receipt upon payment.&nbsp; If you do not have the technology to print a receipt, which stores a record on your behalf, purchase a receipt book from an office supply store which records a duplicate for your records.</p> <p>Read the full MGMA study at: <a href="http://www.mgma.com/WorkArea/DownloadAsset.aspx?id=40054">http://www.mgma.com/WorkArea/DownloadAsset.aspx?id=40054</a></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/161326/Medical-Practice-Revenue-Theft-4-out-of-5-practices-are-victims&bvt=rss">Scott QuinnWed, 17 Oct 2012 13:52:00 GMTf1397696-738c-4295-afcd-943feb885714:161326http://www.iatroshealth.com/blog/bid/155843/30-of-physicians-didn-t-accept-new-Medicaid-patients-in-2011#Comments030% of physicians didn't accept new Medicaid patients in 2011http://www.iatroshealth.com/blog/bid/155843/30-of-physicians-didn-t-accept-new-Medicaid-patients-in-2011<span>30% of physicians didn't accept new Medicaid patients in 2011. &nbsp;With an expected 30 million people to gain health insurance through health reforms new health insurance exchanges and expanded Medicaid programs in 2014, questions have to rise about the capacity for our healthcare system to&nbsp;accommodate&nbsp;this influx. &nbsp;</span><a class="ot-anchor" href="http://www.healthcarefinancenews.com/news/three-ten-doctors-2011-didnt-accept-new-medicaid-patients">http://www.healthcarefinancenews.com/news/three-ten-doctors-2011-didnt-accept-new-medicaid-patients</a> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/155843/30-of-physicians-didn-t-accept-new-Medicaid-patients-in-2011&bvt=rss">Scott QuinnTue, 04 Sep 2012 16:50:00 GMTf1397696-738c-4295-afcd-943feb885714:155843http://www.iatroshealth.com/blog/bid/148631/Practice-Revenue-Apathy-Your-Medical-Practice-Income#Comments0Practice Revenue Apathy: Your Medical Practice Incomehttp://www.iatroshealth.com/blog/bid/148631/Practice-Revenue-Apathy-Your-Medical-Practice-Income<p>&nbsp;</p> <p>&nbsp;<img id="img-1342463934807" src="http://www.iatroshealth.com/Portals/141935/images/transparent piggy bank.png" border="0" alt="Medical Billing Income, Piggy bank" width="297" height="220" class="alignCenter" style="height: 220px; width: 297px; display: block; margin-left: auto; margin-right: auto;" /></p> <p>Do you know how much money your practice should be generating?&nbsp; Or as long as there is money in the checking account, are you satisfied?</p> <p>Every day, I encounter physicians who have no idea how much money they should be making.&nbsp; Even worse, I meet several who simply don&rsquo;t seem to care.&nbsp; How much money should you make if you see 15 patients on an average day? Do you really know?&nbsp; Sure you can look at your bank account average.&nbsp; Or you deduce from your total charges what your allowed amount should be roughly.&nbsp;</p> <p>If you&rsquo;re apathetic to being able to answer the question of how much you should be making, then your staff is too.&nbsp; MGMA estimates practices commonly leave over 20%-25% of their revenues uncollected.&nbsp; As higher deductible health plans continue to thrive, this # will go up.&nbsp;</p> <p>What can you do to ensure your practice is financially optimized?</p> <ol></ol><ol></ol><ol></ol><ol></ol><ol><ol> <li><strong>Weekly Forecasting:</strong>&nbsp; Monitor your total charges and total claims filed each week.&nbsp; Charge totals provide insight into productivity levels, but also allow you to &ldquo;estimate&rdquo; the bulk of projected payments due to your practice over the next 15-45 days.</li> <li><strong>A/R Management:</strong>&nbsp; You should be capturing 95% or more (90%+ for family practice/Internal Medicine) of your insurance due funds within 120 days. &nbsp;If you&rsquo;re not, you&rsquo;re losing money, period.&nbsp; The value of a dollar decreases each passing day.&nbsp; The longer you go without capturing that money, the greater the likelihood you&rsquo;re not going to increases.&nbsp; Oh, and watch your write-offs&hellip;</li> <li><strong>Write-offs/Denials:&nbsp;</strong> You&rsquo;re likely not doing your billing.&nbsp; Who is?&nbsp; This person needs to be trusted like your accountant.&nbsp; If the same person managing your claims has the ability to write off any/all funds without your approval, you&rsquo;re setting yourself up for losing money.&nbsp; Audit your write-offs and I guarantee you&rsquo;ll find easy money lost.&nbsp; Writing balances off and poor denial management go hand-in-hand.&nbsp; Not to mention, if your staff messes up, i.e. fails to bill a claim within the timely filing limit or mistakenly completes the claim, its way too easy to write that balance off rather than pursue it or admit their error.&nbsp; Run a detailed adjustment report once a month, at a minimum.&nbsp; And audit random accounts, you&rsquo;ll be glad you did.</li> <li><strong>Periodic Billing/Coding Audits:&nbsp;</strong> Every 6 &ndash; 12 months, (more if you transition through staff), pick two random days from 120 &ndash; 180 days prior.&nbsp; Select the appointment register for that day, the correlating super bills you completed, and the EOB&rsquo;s returned for those specific encounters and review each against your one another.</li> <ul> <li>Were all the patients accounted for?&nbsp; Do you have EOBs or payments posted in your practice management software for each patient?&nbsp; If not, is there a posted reason why?</li> <li>For any denials, why were they denied?&nbsp; What did your staff do to resolve the denial?</li> <li>What balances or portions of balances were written off?&nbsp; For what reason code where they written off?</li> <li>For those patients, what % have paid or made a payment?&nbsp; How many statements has your staff logged as being sent?</li> <li>Did all CPT&rsquo;s and corresponding ICD-9 codes get billed and were they correct?&nbsp; What % were not or were missing?</li> <li>For the no-shows, how many of those patients rescheduled?&nbsp; Did they re-schedule?&nbsp; What is your follow up policy for no-shows?</li> </ul> </ol></ol> <p>&nbsp;</p> <p>These are just a handful of ways you can ensure your practice is generating the revenue it should.&nbsp; If you&rsquo;re not doing these steps, you&rsquo;re not alone, but unfortunately, you&rsquo;re not running your practice like an efficient business either.&nbsp; As the volume of higher deductible health plans increase, HMO plans increase, and payers continue to cut reimbursement, it will be imperative to your success to focus on these areas or to employ financial experts like iATROS Healthcare Solutions to help you optimize your finances while you optimize your patient care.</p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/148631/Practice-Revenue-Apathy-Your-Medical-Practice-Income&bvt=rss">Scott QuinnMon, 16 Jul 2012 18:21:00 GMTf1397696-738c-4295-afcd-943feb885714:148631http://www.iatroshealth.com/blog/bid/144361/HIPAA-5010-News#Comments0HIPAA 5010 Newshttp://www.iatroshealth.com/blog/bid/144361/HIPAA-5010-News<p><strong>REMINDER!</strong> The CMS Office of E-Health Standards and Services has released a reminder to the industry that the end of its enforcement discretion period is quickly approaching. As of June 30th, 2012, "covered entities are required to comply with the updated transactions standards adopted under the Health Insurance Portability and Accountability Act of 1996 (HIPAA): ASC X12 Version 5010 and NCPDP Versions D.0 and 3.0." Once this date passes, organizations that have not taken the proper steps to become compliant will be subject to enforcement under the existing HIPAA transaction enforcement process. If you would like to speak with a professional regarding the enforcement of HIPAA 5010 and/or your level of compliance, please contact iATROS Healthcare Solutions today, our healthcare experts are standing by to help you assess the health of your practice.</p> <p>&nbsp;</p> <p style="text-align: center;"><SPAN id=hs-cta-wrapper-bd12355c-a0f3-4f0f-89e9-21e73f89c630 class="hs-cta-wrapper" style=" border-width: 0px;" ><!--HubSpot Call-to-Action Code --><SPAN id=hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630 class="hs-cta-node hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630"><A href="http://www.iatroshealth.com/contact-us" data-mce-href="http://www.iatroshealth.com/contact-us"><IMG style="BORDER-RIGHT-WIDTH: 0px; BORDER-TOP-WIDTH: 0px; BORDER-BOTTOM-WIDTH: 0px; BORDER-LEFT-WIDTH: 0px" id=hs-cta-img-bd12355c-a0f3-4f0f-89e9-21e73f89c630 class=hs-cta-img alt=contact-us src="http://d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" data-mce-style="border-width: 0px;" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" mce_noresize="1"></A> </SPAN> <SCRIPT type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=bd12355c-a0f3-4f0f-89e9-21e73f89c630"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="visible"}, 2000); })(); </SCRIPT> <!-- HubSpot Call-to-Action Code --><!-- hs-cta-wrapper --></SPAN></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/144361/HIPAA-5010-News&bvt=rss">Jackie KennedyFri, 15 Jun 2012 18:54:00 GMTf1397696-738c-4295-afcd-943feb885714:144361http://www.iatroshealth.com/blog/bid/133710/iATROS-Healthcare-Solutions-Exhibiting-at-FICPA-Healthcare-Conference#Comments0iATROS Healthcare Solutions Exhibiting at FICPA Healthcare Conferencehttp://www.iatroshealth.com/blog/bid/133710/iATROS-Healthcare-Solutions-Exhibiting-at-FICPA-Healthcare-Conference<p>iATROS Healthcare Solutions will be exhibiting at the 2012 FICPA Healthcare Industry Conference, held April 26th through 27th at the Hyatt Regency in Orlando, Florida. This is the perfect conference for any CPA who works with physicians, clinics, or hospitals so stop by our booth to learn more about how our revenue cycle management solutions can assist you and your clients in optimizing their revenue.</p> <p><a href="http://www.ficpa.org/public/Conference/Description.aspx?courseID=12HCC" target="_blank"><img id="img-1334161357454" src="http://www.iatroshealth.com/Portals/141935/images/HCC_brochure-resized-600.jpg" border="0" alt="HCC brochure resized 600" width="255" height="272" class="alignCenter" style="display: block; margin-left: auto; margin-right: auto;" /></a></p> <p>Please click the image above to learn more about the FICPA Health Care Industry Conference.</p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/133710/iATROS-Healthcare-Solutions-Exhibiting-at-FICPA-Healthcare-Conference&bvt=rss">Jackie KennedyWed, 11 Apr 2012 16:15:00 GMTf1397696-738c-4295-afcd-943feb885714:133710http://www.iatroshealth.com/blog/bid/130237/Is-Your-Billing-Company-Maximizing-Your-Revenue#Comments0Is Your Billing Company Maximizing Your Revenue?http://www.iatroshealth.com/blog/bid/130237/Is-Your-Billing-Company-Maximizing-Your-Revenue<div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">The capability and proficiency of a professional billing company in a physician's practice is a critical factor in the speed at which you get paid. Revenue cycle management is a continuous process that needs to be attended to constantly and in an efficient manner. When it comes to maximizing reimbursements from insurance companies, the billing company entrusted must have an established, effective process in place. How does your billing company stack up?</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><br /><strong style="color: #000000;">Financial Stability</strong></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><br />The success of a physician&rsquo;s practice is dependent upon its ability to maintain financial stability, which is accomplished&nbsp;by using a&nbsp;competent billing company. Your billing company must have a trusted process in place for the entire revenue cycle. These processes will ensure that payments are timely, as well as reduce billing burdens. The right medical billing company will: <br /> <ul> <li>Reduce the burden on, or eliminate the need for, internal billing staff</li> <li>Minimize administrative costs</li> <li>Help maintain positive patient rapports through efficient billing</li> </ul> <div></div> </div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><strong style="color: #000000;">Verification of Insurance&nbsp;</strong></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">A professional billing company understands that the revenue cycle starts <em>before</em> your patients arrive in the office and will stress that you institute an insurance verification policy for your patients. When appointments are made, the insurance information should be verified - every time. Even regular patients&rsquo; insurance information needs to be consistently verified because of member eligibility requirements. Below are some of the benefits of instituting an insurance verification policy prior to the arrival of patients:</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"> <ul> <li>Pre-registration is more efficient</li> <li>Verification of covered medical services</li> <li>Clear co-pay and deductible ensures on-time payments</li> <li>Reduction of claim denials</li> <li>Prior authorizations mean less denial of claims</li> <li>Upfront payment means less collections efforts</li> </ul> </div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">Additionally, the payment process will go much more smoothly by notifying patients prior to arrival what their estimated financial responsibility will be. Patients should understand that payment is due prior to services rendered. <br /><br /></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><br /><strong style="color: #000000;">Prompt Denial Processing</strong></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><br />A professional billing staff can also facilitate the requirements from most insurance carriers to pay claims or provide denials within the timely filing limit. Claims not processed within this time period are subject to penalties or denials. Billing professionals take over the entire follow up process and take a proactive approach to processing claims and/or denials to substantially improve your A/R.&nbsp;The medial billing company may utilize the following denial processing strategy:</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"> <ul> <li>Follow up on electronic claims in 10 business days</li> <li>Follow up within 15 business days of paper bills</li> <li>Ensure that claims were received</li> <li>Ascertain whether claims have already been processed.</li> </ul> </div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><br /><strong style="color: #000000;">Payment Review Process</strong></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"><br />The last step in the physician revenue management cycle is reviewing payments for accuracy. Ensuring that full reimbursement is received, according to the insurance contract, is a key factor in your revenue cycle process that your billing company will handle.&nbsp;All payment inconsistencies should be handled and/or addressed promptly to resolve them in as short a time period as possible.</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">With a billing company that has an efficient process for each of the above aspects, it is much more likely that your revenue cycle process will yield greater reimbursments, which means more success for your practice.</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">Would you like to learn more about how partnering with iATROS Healthcare Solutions can maximize your revenue cycle? Contact us today for your free performance analysis and at no cost to you, we will simply help you answer:</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"><em><strong>Can it be better? How much better? Better at what cost?</strong></em></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"><em><strong><span class="hs-cta-wrapper" style=" border-width: 0px;" id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" data-mce-style="border-width: 0px;"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span> <br /></strong></em></div> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/130237/Is-Your-Billing-Company-Maximizing-Your-Revenue&bvt=rss">Jackie KennedyThu, 05 Apr 2012 14:29:00 GMTf1397696-738c-4295-afcd-943feb885714:130237http://www.iatroshealth.com/blog/bid/130238/Maximizing-Your-Patient-Collections#Comments0Maximizing Your Patient Collectionshttp://www.iatroshealth.com/blog/bid/130238/Maximizing-Your-Patient-Collections<div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">Maximizing patient collections requires that medical practitioners take a hard look at their billing procedures and payment options in order to discover ways to resolve common patient payment issues. Typically, maximizing the collections process will require that you streamline and change your current office processes and payment acceptance program.<br /><br /><strong>Payment Policy</strong><br /><br />One way to maximize patient collections in your medical practice is to create a payment policy that clearly outlines to your patients your expectations in regards to timely payment and the types of payment options available such as insurance or financing. If you don't have a policy in place and you expect payment at the time of service, a patient can claim that he didn't know or understand your payment expectations. Instead of an immediate payment, it may take weeks or months to collect on the bill, or worst case, never.<br /><br /><strong>Payment Arrangements</strong><br /><br />Include payment arrangements as part of your financial policy, such as a discount to any patient who agrees to pay cash up front or a multiple payment option to patients who can't pay their bill because of financial hardship. When setting up a multiple payment option, design the plan to help patients pay at the level they can afford while still helping you to collect on their bills in a timely fashion. Treat the arrangements like a loan with a set term such as 6 or 12 months and a minimum payment amount. <br /><br /><strong>Employee Training</strong><br /><br />Establish a patient collections training program for your front office and billing staff that clarifies any questions about the payment policy and establishes your expectations in regards to how your employees should address the policy with patients and deal with situations that can cause payment delays. During training, discuss with your employees ways to announce and post the policy such as hanging a sign that outlines the types of insurance you accept and handing out or emailing copies of the policy to new patients. Ask your employees to role play various types of patient collection situations that have posed challenges to them in the past to brainstorm ideas of ways to quickly resolve issues. <br /><br /><b>Monitor Your Progress<br /></b><br />Monitor the performance of your patient payment policy on a regular basis. Allow a couple weeks for changes to take effect then begin evaluating how well everything is working. Be sure to gather information on collections rates from the weeks and months prior to your changes and then compare the data to the weeks following. If something doesn't seem to be working, don't be afraid to change it. Especially in these inital stages, you must manage the new policy and make additional changes where necessary. And remember, maximizing your patient collections is an ongoing process, but if done right, it can yield drastic improvements in your revenue cycle.</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;">Want to learn more about streamlining your patient collections process and optimizing your revenue cycle? Initiate your free practice analysis with iATROS Healthcare Solutions and find out:</div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"><strong><em>Can it be better? How much better? Better at what cost?</em></strong></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"><strong><em><br /></em></strong></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"></div> <div style="font-size: 16px; font-family: Arial; color: #000000; text-align: center;"><strong><em><span class="hs-cta-wrapper" style=" border-width: 0px;" id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" data-mce-style="border-width: 0px;"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span> <br /></em></strong></div> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/130238/Maximizing-Your-Patient-Collections&bvt=rss">Jackie KennedyTue, 27 Mar 2012 14:19:00 GMTf1397696-738c-4295-afcd-943feb885714:130238http://www.iatroshealth.com/blog/bid/130210/The-Pros-and-Cons-of-In-House-Medical-Billing#Comments0The Pros and Cons of In-House Medical Billinghttp://www.iatroshealth.com/blog/bid/130210/The-Pros-and-Cons-of-In-House-Medical-Billing<div style="font-size: 16px; font-family: Arial; color: #000000; text-align: left;"> <p style="background-color: transparent;">Due to the&nbsp;current challenges surrounding the management of medical practices, challenges that are constantly exacerbated by government requirements, financial limitations and new technologies, practice owners find themselves continually faced with a decision on which operation methods are most cost effective and generate the most revenue.&nbsp;Whether to use in-house medical billing or not is one such decision.&nbsp;Below are a few advantages and disadvantages of this system.</p> <p style="background-color: transparent;"><b>Pros</b></p> <p style="background-color: transparent;">&middot; &nbsp; &nbsp; &nbsp; Greater control over day to day billing activities.&nbsp;Questions are addressed in real time and changes are implemented&nbsp;promptly, all on your watch.&nbsp;</p> <p style="background-color: transparent;">&middot;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;With in-house medical billing, the practice has more control over client&rsquo;s private health records.&nbsp;A company's reputation can be&nbsp;ruined if its patients' medical records are leaked to&nbsp;unauthorized&nbsp;parties or compromised in any way by a&nbsp;third&nbsp;party billing provider.</p> <p style="background-color: transparent;">&middot; &nbsp; &nbsp; &nbsp; Some outsourced companies may be reluctant to go after small balances. The company can lose significant amounts&nbsp;of money if&nbsp;these small balances are allowed to accumulate. Having an&nbsp;in-house billing department can&nbsp;help collect such payments in a consistent manner.&nbsp;<br /><b><br />Cons</b></p> <p style="background-color: transparent;">&middot;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;High start up costs&nbsp;-&nbsp;Depending on how big your practice&nbsp;is,&nbsp;your&nbsp;billing department may consist of two to three trained billers for every three providers.&nbsp;Apart from payroll expenses, the average&nbsp;start up cost of an in-house medical&nbsp;billing&nbsp;department includes equipment, software, registration with&nbsp;a&nbsp;clearinghouse, more space for storage of records and&nbsp;the cost of&nbsp;reference&nbsp;materials like annual&nbsp;coding courses or&nbsp;books.</p> <p style="background-color: transparent;">&middot;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Inadequate&nbsp;Human Resources - It's not&nbsp;easy&nbsp;to find employees with adequate&nbsp;medical&nbsp;billing experience. It is possible that when starting out, you employed a few people with some medical billing&nbsp;experience&nbsp;who have over&nbsp;time, grown into&nbsp;the job and have become very experienced.&nbsp;Sadly, the possibility of losing them is very real. Replacing a billing specialist has to be done instantly if you are to&nbsp;maintain&nbsp;the cash flow, which could end up forcing you to hire&nbsp;inexperienced employees.</p> <p style="background-color: transparent;">&middot;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;Employee costs - The cost of employing a &nbsp;team of in-house billing specialists can be quite high. Apart from paying them, the practice has to cover their healthcare, benefits, federal and state employee charges among other expenses.<br /><br /></p> <p>For a small practice, it may be sufficient to use an in-house billing department, but as your practice grows, revenues will increase exponentially as will the medical coding and billing workload. Whether you currently process claims in-house or outsource, now is the time to ensure you&rsquo;re set to maximize your practice&rsquo;s revenue.</p> <p>The experts at iATROS Healthcare Solutions can guide you to success.&nbsp; Our team of professional claims managers, financial analysts, and collections professionals will review your practice to evaluate how well things are working and what areas need your attention.&nbsp; The best part is, we do this all for <b><em>FREE!</em></b>&nbsp; Contact us today for your free practice analysis!</p> <p>&nbsp;</p> <p style="background-color: transparent; text-align: center;"><strong><em><span id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" class="hs-cta-wrapper" style=" border-width: 0px;" > <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/freeanalysis" data-mce-href="http://www.iatroshealth.com/freeanalysis"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332172840521/get-your-free-practice-analysis.png?v=1332172840.79" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width: 0px;" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332172840521/get-your-free-practice-analysis.png?v=1332172840.79" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span> <br /></em></strong></p> <p style="background-color: transparent; text-align: center;"><strong><em><br /></em></strong></p> </div> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/130210/The-Pros-and-Cons-of-In-House-Medical-Billing&bvt=rss">Jackie KennedyMon, 19 Mar 2012 16:07:00 GMTf1397696-738c-4295-afcd-943feb885714:130210http://www.iatroshealth.com/blog/bid/125451/Best-Practices-for-HIPAA-5010-Implementation-Preparation-Compliance#Comments0Best Practices for HIPAA 5010 Implementation, Preparation & Compliancehttp://www.iatroshealth.com/blog/bid/125451/Best-Practices-for-HIPAA-5010-Implementation-Preparation-Compliance<div style="font-size: 16px; font-family: arial; color: #000000; text-align: left;"> <div align="left" style="color: #000000; background-color: transparent;"> <div style="color: #000000; background-color: transparent;"> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;">The looming compliance deadline has come and gone. Beginning on January 1, 2012, the health care industry begun implementing HIPAA 5010, and HIPAA covered entities are now required to conduct electronic transactions using the 5010 upgrade. This includes eligibility, claims submission, referral authorizations, remittance advice and other electronic transactions performed by covered entities. Institutions that haven&rsquo;t been impacted by the challenges of the transition will soon begin to notice increased claim rejections in the coming months. Below are best practices for becoming compliant to avoid rejected claims, payment interruptions and other industry challenges.</span></p> <p style="color: #000000; background-color: transparent;" align="">&nbsp;</p> <p style="color: #000000; background-color: transparent;" align=""><b><span style="background-color: transparent; color: #000000;">Learn how the 5010 format will impact new claims data</span></b></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;">Although your clearinghouse or vendor can assist in converting your claims to adhere to the 5010 standard, the data used is still provided by your institution. For example, submitting claims that do not include the correct address and zip code requirements will not be converted and sent for payment. Reaching out to other practices within your specialty will help you to identify possible challenges, and can provide resolution to those challenges without exposing your practice to the &ldquo;pain&rdquo; firsthand. When a rejection occurs, monitor the rejections while paying close attention to any address related issues (i.e. remittance, EDI), to ensure claims are reimbursed without delays.</span></p> <p style="color: #000000; background-color: transparent;" align=""><b><span style="background-color: transparent; color: #000000;">&nbsp;</span></b></p> <p style="color: #000000; background-color: transparent;" align=""><b><span style="background-color: transparent; color: #000000;">Monitor rejection reports to identify these key factors (not an all inclusive list):</span></b></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;"><span style="background-color: transparent; color: #000000;">&middot;<span style="background-color: transparent; color: #000000;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><b><span style="background-color: transparent; color: #000000;">Ambulance claims</span></b><span style="background-color: transparent; color: #000000;">&mdash;pick-up and drop-off locations must be reported, as well as the number of patients transported in the vehicle.</span></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;"><span style="background-color: transparent; color: #000000;">&middot;<span style="background-color: transparent; color: #000000;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><b><span style="background-color: transparent; color: #000000;">Drug reporting</span></b><span style="background-color: transparent; color: #000000;">&mdash;claims for injected medicine must include additional drug information as well as the <span id="RadESpellError_0" style="color: #000000; background-color: transparent;">HCPCS</span> code.</span></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;"><span style="background-color: transparent; color: #000000;">&middot;<span style="background-color: transparent; color: #000000;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><b><span style="background-color: transparent; color: #000000;">Billing provider address</span></b><span style="background-color: transparent; color: #000000;">&mdash;5010 guidelines mandate the need to enter the billing provider as the physical address. PO Boxes or lock box addresses will need to be reported as &ldquo;pay-to&rdquo; addresses, when needed for payments and payer correspondence.</span></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;"><span style="background-color: transparent; color: #000000;">&middot;<span style="background-color: transparent; color: #000000;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><b><span style="background-color: transparent; color: #000000;">Zip codes&mdash;</span></b><span style="background-color: transparent; color: #000000;">providers must now submit claims with a nine-digit zip code when reporting the location of service facilities and billing providers. This includes the five-digit zip code with the correct four-digit extension.</span></p> <p style="color: #000000; background-color: transparent;" align=""><b><span style="background-color: transparent; color: #000000;">&nbsp;</span></b></p> <p style="color: #000000; background-color: transparent;" align=""><b><span style="background-color: transparent; color: #000000;">Conduct thorough testing, both internally and externally</span></b></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;">All changes made will not go according to plan. Therefore, internal testing should be performed to determine if the software changes for implementing HIPAA 5010 transactions are functioning correctly. Testing will allow you to discover and resolve any possible system issues that could occur as a result of a 5010 transaction, and can help determine if a failure is internal or external. Two levels of testing include: </span></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;"><span style="background-color: transparent; color: #000000;">&middot;<span style="background-color: transparent; color: #000000;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><span style="background-color: transparent; color: #000000;">Level 1 Testing: A practice is able to create and receive 5010 transactions successfully, within the organization.</span></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;"><span style="background-color: transparent; color: #000000;">&middot;<span style="background-color: transparent; color: #000000;">&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; </span></span></span><span style="background-color: transparent; color: #000000;">Level 2 Testing: A practice is able to send and receive 5010 transactions externally, with business associates, clearinghouses, payers and other partners, using the same channels as those used to conduct current transactions.</span></p> <p style="color: #000000; background-color: transparent;" align="">&nbsp;</p> <p style="color: #000000; background-color: transparent;" align=""><b><span style="background-color: transparent; color: #000000;">Encourage the use and expansion of automation</span></b></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;">Automation can be used to improve the internal and external testing process. Automation allows completing these tasks in a shorter period of time with more consistency across the board. Creating scenarios to test the processes which are most vital to production will prove beneficial for time-strapped institutions, as opposed to testing every single scenario. </span></p> <p style="color: #000000; background-color: transparent;" align=""><span style="background-color: transparent; color: #000000;">Although the Centers for Medicare and Medicaid Services announced that enforcement actions against non-compliant organizations will not take place until March 31, 2012, there is no breathing room remaining to become complacent. The entire HIPAA covered medical industry should begin implementing HIPAA 5010 by working with business associates and other collective organizations within the industry, to ensure successful testing and a painless transition. Refusing to move towards compliance now will inevitably cause administrative nightmares and payment headaches in the near future. </span></p> <p style="color: #000000; background-color: transparent;" align="">&nbsp;</p> <p style="color: #000000; background-color: transparent;" align="">Does your practice have the proper measures in place for the implementation of HIPAA 5010? Find out today by initiating iATROS Healthcare Solutions' complimentary practice analysis.</p> <p style="color: #000000; background-color: transparent;" align="">&nbsp;</p> <p style="color: #000000; background-color: transparent;" align=""><span id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 328px; height: 51px; display: block; border-width: 0px;" > <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width: 0px;" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span> <span style="background-color: transparent; color: #000000;"></span></p> </div> </div> </div> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/125451/Best-Practices-for-HIPAA-5010-Implementation-Preparation-Compliance&bvt=rss">Jackie KennedyTue, 21 Feb 2012 14:57:00 GMTf1397696-738c-4295-afcd-943feb885714:125451http://www.iatroshealth.com/blog/bid/111394/SGR-update-Senate-approves-a-31-day-patch-House-to-act-next#Comments0SGR update - Senate approves a 31-day patch; House to act next http://www.iatroshealth.com/blog/bid/111394/SGR-update-Senate-approves-a-31-day-patch-House-to-act-nextThis evening the Senate approved by unanimous consent a bill that will provide a 31-day payment patch to the Medicare sustainable growth rate (SGR) formula. The bill will freeze current rates for services provided through Dec. 31, and temporarily avert a 23 percent cut to physician payments that was slated to take effect on Dec. 1.<br /><br />The House of Representatives has adjourned for the week. The representatives are anticipated to vote on the bill upon their return.<br /><br />While the 31-day fix, if approved, is a step in the right direction, it is only a temporary patch. Physicians still face a 25 percent cut on January 1, 2011. MGMA continues to call for an additional 12-month fix to give lawmakers time to find a permanent solution. Additional member grassroots advocacy during December is necessary to halt the 25 percent cut on Jan.1. We will continue to keep you apprised as we receive further updates.<br /><br /><em>Source: Washington Connexion </em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111394/SGR-update-Senate-approves-a-31-day-patch-House-to-act-next&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:17:00 GMTf1397696-738c-4295-afcd-943feb885714:111394http://www.iatroshealth.com/blog/bid/111393/From-Multiplication-to-Calculus-ICD-9-has-16-000-codes-ICD-10-has-155-000-codes#Comments0From Multiplication to Calculus: ICD-9 has 16,000 codes, ICD-10 has 155,000 codeshttp://www.iatroshealth.com/blog/bid/111393/From-Multiplication-to-Calculus-ICD-9-has-16-000-codes-ICD-10-has-155-000-codesImagine finishing up and turning in a multiplication quiz at the age of 8 while your teacher hands you a calculus exam simultaneously?&nbsp; Now realize that if you can't handle that test, then you don't make your allowance.&nbsp; Physicians livelihoods are about the get that much harder.&nbsp; Reimbursement cuts may be looming, but figuring out how to even get reimbursed may even be more painful.&nbsp; By Oct. 1, 2013, U.S. physicians are required to adopt an updated version of the International Classification of Diseases.&nbsp; The current code-set used is called ICD-9, which consists of 16,000 codes, while the new code-set, ICD-10 has 155,000 codes.<br /><br />As a prerequisite to the adoption of ICD-10, entities must adopt updated electronic transition standards, known as HIPAA 5010 by Jan 1, 2012, less than one year away.&nbsp; HIPAA 5010 (HIPAA - Health Insurance Portability and Accountability Act) was initially scheduled to occur much sooner - April 1, 2010, but were pushed back near the term of the Bush Administration.<br /><br />ICD-10 is commonly used across the globe in other countries, but what makes the U.S. that much different, is that those countries do not pay physicians according to diagnosis and procedural codes.&nbsp; As a result, in the U.S., the preparation on behalf of all parties involved in the <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111393/From-Multiplication-to-Calculus-ICD-9-has-16-000-codes-ICD-10-has-155-000-codes&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:16:00 GMTf1397696-738c-4295-afcd-943feb885714:111393http://www.iatroshealth.com/blog/bid/111392/The-iATROS-Billing-and-Collections-Team-Raises-the-Bar#Comments0The iATROS Billing and Collections Team Raises the Barhttp://www.iatroshealth.com/blog/bid/111392/The-iATROS-Billing-and-Collections-Team-Raises-the-Bar<p>Earlier this year one of our new clients had only been collecting 80 % of their total AR within 120 days, as of month end July 2010, six months after joining iATROS, our billing and collections team is capturing 98.47 % of revenue within 120 days. iATROS Healthcare Solutions strives to collect the maximum amount of revenue for each of our clients and we feel that the efforts of our billing and collections team reflects our company&rsquo;s goals. iATROS is continually raising the bar to provide a more effective billing and collections effort for our clients. <br /><br />Interested in seeing what iATROS Healthcare Solutions can do to maximize your revenue? Please intiate your free performance analysis today!</p> <p>&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 328px; height: 51px; display: block; border-width: 0px;" id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111392/The-iATROS-Billing-and-Collections-Team-Raises-the-Bar&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:15:00 GMTf1397696-738c-4295-afcd-943feb885714:111392http://www.iatroshealth.com/blog/bid/111391/Medicare-Other-Health-Plan-Changes-Coming-in-2012#Comments0Medicare & Other Health Plan Changes Coming in 2012http://www.iatroshealth.com/blog/bid/111391/Medicare-Other-Health-Plan-Changes-Coming-in-2012Florida medical billing professionals, listen up! Changes to Medicare policies and other health insurance policies are on the way for 2012, making patient verification benefits all the more crucial in Florida. Many plans have new limitations, exclusions or waiting periods that your medical billing staff will need to be aware of. Among the changes:<br /><br /> <ul> <ul> <li>Medicare Part B premiums are increasing, but deductibles are decreasing;</li> </ul> </ul> <br /> <ul> <ul> <li>Medicare Part C plans are expected to drop in price;</li> </ul> </ul> <br /> <ul> <ul> <li>For State of Florida employees, HMO options are changing and many won't be available next year;</li> </ul> </ul> <br /> <ul> <ul> <li>Capital Health Plan next year will consider chiropractic treatment a specialty service requiring specialist co-pay;</li> </ul> </ul> <br /> <ul> <ul> <li>Some plans that offered benefits covering both eye glasses and contacts will now cover only eye glasses or contacts.</li> </ul> </ul> <br /><br />The myriad of different benefits, restrictions, exclusions, waiting periods, etc. can be overwhelming to say the least. Verification of patient benefits is time consuming and can be confusing, taking time, energy and expertise away from helping other patients. But it's a crucial element of your business. Failing to accurately and thoroughly verify patient benefits can leave you holding the bag for uncovered treatments that your patients can't afford to self-pay.<br /><br />To help keep your medical practice running efficiently and profitably, iATROS Healthcare Solutions offers <a href="http://www.iatroshealth.com/patient-verification-of-benefits.php" title="Pre-Verification of Patient Benefits" target="_self">pre-verification of benefits </a>conducted prior to your patients' appointment. This allows your staff to more accurately collect patient co-payments and deductibles at the time of the appointment, reducing the number of patient collections days in your A/R to zero. Consider that after the customary 180-day collections window, each dollar gone uncollected is worth an average 45 cents. In today's shaky economy, collecting as much of your earned payments as early as possible is all the more important to your practice's bottom line.<br /><br />To find out more, contact iATROS Healthcare Solutions, based in Florida but serving clients nationwide, at (877) 900-6763. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111391/Medicare-Other-Health-Plan-Changes-Coming-in-2012&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:14:00 GMTf1397696-738c-4295-afcd-943feb885714:111391http://www.iatroshealth.com/blog/bid/111395/Contingency-Plan-Needed-for-HIPAA-5010-Compliance-Florida-Health-Experts-and-Others-Say#Comments0Contingency Plan Needed for HIPAA 5010 Compliance, Florida Health Experts and Others Sayhttp://www.iatroshealth.com/blog/bid/111395/Contingency-Plan-Needed-for-HIPAA-5010-Compliance-Florida-Health-Experts-and-Others-SayWho's ready for the January 1 HIPAA 5010 <a href="http://www.iatroshealth.com/healthcare-compliance.php" target="_self">compliance</a> deadline? Not many, according to results of a new study by the Medical Group Management Association (MGMA). Those results have prompted industry officials to ask the Department of Health and Human Services (HHS) to immediately issue a comprehensive contingency plan.<br /><br />The MGMA wants the HHS to develop a plan that will allow health insurance plans to adjudicate claims even if they lack a portion of the required data content. This will allow practices that are unable to fully meet the New Year's Day deadline to continue practicing without a cash flow disruption. According to the MGMA's study:<br /><br /> <ul> <ul> <li>Nearly a fourth of study respondents say they have yet to even hear from their practice management system software vendors regarding the HIPAA 5010 transition;</li> </ul> </ul> <br /> <ul> <ul> <li>Only 35 percent say they've begun internal testing of their new systems;</li> </ul> </ul> <br /> <ul> <ul> <li>Almost a quarter of respondents (21.7percent) have yet to schedule internal testing;</li> </ul> </ul> <br /> <ul> <ul> <li>Just 5.7 percent say they've been contacted by all of their major health plans'</li> </ul> </ul> <br /> <ul> <ul> <li>35 percent report that a few of their major health plans have contacted them;</li> </ul> </ul> <br /> <ul> <ul> <li>Only 15 percent have begun external testing with all of their major health plans;</li> </ul> </ul> <br /> <ul> <ul> <li>A full 27 percent say external testing has not yet been scheduled;</li> </ul> </ul> <br /> <ul> <ul> <li>Just 4.5 percent say their 5010 implementation is complete;</li> </ul> </ul> <br /> <ul> <ul> <li>40 percent say their implementation is less than one quarter complete.</li> </ul> </ul> <br /><br />"It is clear that a significant number of medical groups will not have the ability to transmit claims and other electronic transactions using the Version 5010 format by the January 1 deadline," said Susan Turney, MD, MS, FACP, FACMPE, MGMA president and CEO.<br /><br />Turney noted study results that show physician practices are developing contingency plans of their own to help dodge financial hardship caused by the expected interruption in cash flow. More than a third (33.3 percent) plan to establish a line of credit at a local financial institution; 35.6 percent will set aside cash reserves to help sustain operations; and more than half (50.6 percent) say they'll go back to paper claims.<br /><br />"It is unacceptable to expect physician practices to take such drastic action, such as reverting to paper claims, to avoid serious cash flow issues resulting from this mandate," Turney said. "The shift in the industry to electronic transactions in recent years could amplify the problem. Many health plans have transitioned staff away from handling paper claims, and we are concerned that a sudden, large increase in volume could also result in delayed payments."<br /><br />Are you ready for the Jan. 1 HIPAA 5010 deadline? If you're still having issues, <a href="http://www.iatroshealth.com/contact.php" title="Contact iATROS Healthcare Solutions" target="_self">contact iATROS Healthcare Solutions</a> at 877-900-6763. Our expert EMR and healthcare compliance consultants can help walk you through all portions of your transition to make sure you're up and running with little or no disruption in your cash flow or business operations. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111395/Contingency-Plan-Needed-for-HIPAA-5010-Compliance-Florida-Health-Experts-and-Others-Say&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:13:00 GMTf1397696-738c-4295-afcd-943feb885714:111395http://www.iatroshealth.com/blog/bid/111396/A-Code-for-What-Ails-You-Florida-Medical-Codes-From-Lightning-Strikes-to-Turtle-Bites#Comments0A Code for What Ails You - Florida Medical Codes From Lightning Strikes to Turtle Biteshttp://www.iatroshealth.com/blog/bid/111396/A-Code-for-What-Ails-You-Florida-Medical-Codes-From-Lightning-Strikes-to-Turtle-BitesHave you ever looked at exactly what ICD-10 entails, <a href="http://www.iatroshealth.com/medical-coding-florida.php" target="_self">Florida? Medical codes</a> for diagnoses and procedures together number 155,000, up from 24,000 just a few years ago. And some of what you'll find in those codes may seem strange.<br /><br />Get injured in a chicken coop as opposed to on a squash courts? There's a code for that. Was it an accident in the driveway of a mobile home or a house? There's a code for that, too. Struck by lightning, pecked by a macaw or injured while playing a tuba - it's all in there. And many of these codes have people scratching their heads and wondering if medical coding has gone a bit overboard.<br /><br />We're unsure why it matters whether you slipped and hit your head on the floor of an art gallery or the opera house. But we assure you there's a medical code that differentiates the two. And it's up to Florida's medical coders to get every detail correct when submitting claims to insurance companies for a physician's reimbursement.<br /><br />For many physicians in Florida, medical coding, along with multiple other ever-changing functions, has become a strain on their human, time and financial resources. That's why <a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Services</a> offers services including medical coding and billing, patient scheduling and pre-verification of insurance coverage, EMR conversion and consulting and more. If the business of healthcare is limiting your ability to actually deliver quality healthcare to your patient, call iATROS at 877-900-6763. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111396/A-Code-for-What-Ails-You-Florida-Medical-Codes-From-Lightning-Strikes-to-Turtle-Bites&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:13:00 GMTf1397696-738c-4295-afcd-943feb885714:111396http://www.iatroshealth.com/blog/bid/111397/Five-Ways-to-Better-Florida-Medical-Coding-Compliance-for-Your-Surgery-Center#Comments0Five Ways to Better Florida Medical Coding Compliance for Your Surgery Centerhttp://www.iatroshealth.com/blog/bid/111397/Five-Ways-to-Better-Florida-Medical-Coding-Compliance-for-Your-Surgery-CenterHere at iATROS Healthcare Solutions, we're constantly asked for advice on improving medical coding compliance in Florida. <a href="http://www.iatroshealth.com/medical-coding-florida.php">Medical coding</a> has undergone massive changes in the past few years. ICD-10 alone increased the number of diagnosis codes from 13,000 to 68,000 and the number of procedure codes from 11,000 to 87,000, making an already tough job even tougher. Here are five top ways to improve your surgery center's medical coding compliance.<br /><br /><ol><ol> <li><strong>Keep detailed operative notes.</strong> Include descriptive keywords, measurements and counts. For instance, many surgeons miss out on compensation earned because they'll list, for instance, removal of two colon polyps, failing to note that the second polyp was removed via a different method from a different location. Removal of that second polyp can be billed as a second procedure.</li> </ol></ol><br /><ol><ol> <li><strong>Hire or outsource to experienced coders.</strong> Those who have been doing medical coding for a significant amount of time have a better understanding of the subtle difference between certain codes and modifiers. Although schools are churning out new coders in record numbers willing to work for less money, an experienced coder, whether in-house, freelance or via a medical coding provider like iAtros, will be well worth the investment and could help save you from being charged tens of thousands of dollars for coding compliance mistakes.</li> </ol></ol><br /><ol><ol> <li><strong>Insist upon open communication between physicians and coders. </strong>Operative notes often lack certain needed details or can simply be confusing. Many centers coders schedule weekly appointments to review operative notes together, making doubly sure that no mistakes, omissions or opportunities for compensation are missed.</li> </ol></ol><br /><ol><ol> <li><strong>Keep your staff up-to-date on medical coding and compliance changes.</strong> Join medical societies and associations, subscribe to coding newsletters and read medical publications that include information on coding compliance issues.</li> </ol></ol><br /><ol><ol> <li><strong>Hire an outside medical coding compliance consultant. </strong>In Florida, medical coding and compliance is particularly critical, considering the higher-than-average number of Medicaid enrollees statewide. <a href="http://www.iatroshealth.com/">iAtros Healthcare Solutions</a> boasts a team of highly experienced medical coding and compliance specialists. We keep up-to-the-minute on all industry changes and trends. Let us handle the headache of medical coding and /or coding compliance issues while you and your staff concentrate on treating patients.</li> </ol></ol><br /><br />Call iAtrost Healthcare Solutions at 1-877-900-6763 to discuss your Florida medical coding compliance needs today. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111397/Five-Ways-to-Better-Florida-Medical-Coding-Compliance-for-Your-Surgery-Center&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:12:00 GMTf1397696-738c-4295-afcd-943feb885714:111397http://www.iatroshealth.com/blog/bid/111398/Newly-Uninsured-Often-Skip-Needed-Healthcare#Comments0Newly Uninsured Often Skip Needed Healthcarehttp://www.iatroshealth.com/blog/bid/111398/Newly-Uninsured-Often-Skip-Needed-HealthcareNEW YORK CITY &ndash; Nearly 75 percent of people who lost their employer-sponsored health insurance when they lost their jobs over the last two years said that they skipped needed healthcare or did not fill prescriptions because of cost, according to a new&nbsp;Commonwealth Fund brief.<br /><br />&ldquo;Nearly three quarters of people reported they had a problem paying medical bills or were carrying medical debt,&rdquo; said Sara R. Collins, PhD, coauthor of the brief and vice president of the Commonwealth Fund, a private, New York City-based foundation. &ldquo;People didn&rsquo;t access care that they needed because of the cost.&rdquo;<br /><br />According to the Commonwealth Fund brief, an estimated 15 million working-age adults lost their jobs and health benefits from 2008 to 2010. A majority of these individuals (57 percent) became uninsured. One-quarter of adults were able to go on their spouse&rsquo;s insurance policy or find another source of coverage, while 14 percent continued their coverage through COBRA (Consolidated Omnibus Budget Reconciliation Act).<br /><br />&ldquo;This shows how vulnerable people are when they lose their jobs to also losing their health insurance. There are not affordable options outside of jobs,&rdquo; said Collins.<br /><br />The Commonwealth Fund advocates for more intervention from the federal government. &ldquo;To the extent that the jobless situation continues, hiring isn&rsquo;t at levels required to reduce unemployment. Reinstating COBRA subsidies to cover 65 percent of premiums would provide protection for those who have lost benefits,&rdquo; said Collins.<br /><br />Other key findings:<br /><br />&bull; Over the period 2008 to 2010, an estimated 9 million adults ages 19 to 64 lost a job with health benefits and became uninsured.<br /><br />&bull; Eight percent of lower-income workers continued their coverage through COBRA after they were laid off, as opposed to 21 percent of workers with higher incomes.<br /><br />&bull; About one-half of surveyed adults who became uninsured after losing a job with benefits skipped a recommended medical treatment or follow-up test (52 percent), did not get specialist or other physician care when needed (50 percent), or did not fill a prescription (47 <em>percent) in the past year, citing cost as the reason.</em><br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111398/Newly-Uninsured-Often-Skip-Needed-Healthcare&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:11:00 GMTf1397696-738c-4295-afcd-943feb885714:111398http://www.iatroshealth.com/blog/bid/111399/Modernizing-Medicaid-Pharmacy-Could-Save-States-33-Billion#Comments0Modernizing Medicaid Pharmacy Could Save States $33 Billionhttp://www.iatroshealth.com/blog/bid/111399/Modernizing-Medicaid-Pharmacy-Could-Save-States-33-BillionDALLAS &ndash; A new study by the National Center for Policy Analysis shows that states and the federal government could save $33 billion in prescription medication costs by switching to models used by Medicare and other private payers.<br /><br />&ldquo;Drug therapies often substitute for more expensive and less effective surgical treatment and can reduce the need for hospitalization. Americans see their doctors more than 890 million times each year, and two-thirds of office visits to physicians result in prescription drug therapy,&rdquo; said Devon M. Herrick, senior fellow with NCPA and an author of the report. &ldquo;Even though they appear to provide better value for money than other forms of therapy, drug expenditures are one of the fastest growing components of the Medicaid program.&rdquo;<br /><br />&ldquo;Increasing the Cost-Effectiveness of Medicaid Drug Programs&rdquo; identified a number of areas in which states could save money, including increased use of generic drugs, negotiating competitive rates for drug dispensing, coordinating and tracking drug therapies, establishing reimbursement rates similar to what private plans pay, and empowering consumers with some control of the money they spend on medications.<br /><br />Many states pay for Medicaid prescription drugs on a fee-for-service model and are lobbied on the local level to negotiate higher dispensing fees paid to pharmacies. The average state dispensing fee is $4.82 per prescription, with Alabama ($10.64) and Texas ($7.50) having the two highest rates in the country. By comparison, Medicare Part D pays an average dispensing rate of $2.<br /><br />In Texas, Gov. Rick Perry is proposing the state's prescription drug benefits be managed like those in the private sector, a move the state has estimated will save $84 million in the first year alone.<br /><br />&ldquo;This latest research confirms that Governor Perry and Texas policymakers are on the right track. Medicaid shouldn't pay more for drug benefits than private insurers and Medicare," said Mark Merritt, president and CEO of the Pharmaceutical Care Management Association, a national organization representing pharmacy benefit managers. &ldquo;Currently, the program uses fewer generic drugs and pays drugstores more than triple the fees that Medicare or private insurers pay. By modernizing Medicaid drug benefits, Texas will save $3.8 billion over the next decade without cutting benefits to those in need.&rdquo;<br /><br />According to a February 2011 report from the Lewin Group, a healthcare policy research and management consulting firm, states could save more than $25 billion over 10 years by focusing on lowering dispensing fees ($10 billion) and increasing generic use ($15.3 billion).<br /><br />While generic drugs make up more than two-thirds of all medications spent for Medicaid, they account for less than one-quarter of total spending, providing an opportunity for additional saving through wider use of generics. Further, the average price for a generic drug prescription in the Medicaid program is $20.61, compared to the $195.54 average for brand name medications (including drugs for which there are no generic equivalents).<br /><br />The NCPA report also noted that efforts to lower dispensing fees to resemble Medicare and private plan benefits face a stumbling block based on federal law. Most private plans &ldquo;carve in&rdquo; prescription medication benefits and then negotiate dispense rates on a broad basis, either by the health plan itself or through a third-party pharmacy benefits manager. Most state Medicaid programs &ldquo;carve out&rdquo; the prescription benefits based on federal requirements for drug companies to provide rebates of up to 23.1 percent of the average manufacturer&rsquo;s wholesale price for brand drugs and 13 percent for generic drugs. Since these rebates were not available to private plans administering pharmacy benefits, most states run their prescription programs at the state level.<br /><br />&ldquo;State Medicaid programs that carve out drug benefits often do not pay sufficient attention to coordination and management of drug therapies. This responsibility is essentially taken away from health plans and taken over by the state,&rdquo; the NCPA report noted.<br /><br />By allowing states to operate more like Medicare Part D or private plans without jeopardizing rebates from pharmaceutical companies, lowering dispensing fees from the average of $4.81 to near the Medicare average of $2 would save significant money.<br /><br />&ldquo;Many pharmacies can survive on $2 dispensing fees from the PBMs that manage private drug plans. Some chain drug store and big box retail pharmacies succeed on $4 generic prescriptions they fill for consumers without a drug plan,&rdquo; the report stated. &ldquo;This suggests Medicaid fee-for-service dispensing fees are arbitrarily set too high in many jurisdictions.&rdquo;<br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111399/Modernizing-Medicaid-Pharmacy-Could-Save-States-33-Billion&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:10:00 GMTf1397696-738c-4295-afcd-943feb885714:111399http://www.iatroshealth.com/blog/bid/111400/Thomson-Reuters-Healthcare-Consumer-Confidence-Dipped-In-July#Comments0Thomson Reuters: Healthcare Consumer Confidence Dipped In Julyhttp://www.iatroshealth.com/blog/bid/111400/Thomson-Reuters-Healthcare-Consumer-Confidence-Dipped-In-JulyANN ARBOR, MI &ndash; A consumer sentiment index from Thomson Reuters showed that consumers&rsquo; confidence in their ability to pay for healthcare declined in July after two straight months of improvement.<br /><br />The Thomson Reuters Consumer Healthcare Sentiment Index dropped from 99 in June to 96 in July, giving back nearly all the gains made since the index hit a low of 95 in April.<br /><br />"The index hit historic lows in April, rebounded in May and June, and recorded across-the-board declines in July," said Gary Pickens, chief research officer at the Thomson Reuters Center for Healthcare Analytics in a press release. "It is clear that consumer attitudes remain extremely volatile."<br /><br />The index is based on the Thomson Reuters PULSE Healthcare Survey, a national, privately funded household survey of health behavior, attitudes and utilization that has been running for more than 20 years. Data collected in the PULSE Healthcare Survey are weighted to be representative of all U.S. adults and households.<br /><br />The Consumer Healthcare Sentiment Index is published monthly, using results from the 3,000 household monthly survey subset and consists of two parts:<br /><br /> <ul> <ul> <li>A retrospective component gauges respondents' experiences during the past three months. It tracks whether they postponed, delayed or cancelled healthcare services and whether they had difficulty paying for medical care or health insurance. In July, retrospective consumer sentiment dropped from 98 to 96.</li> </ul> </ul> <br /> <ul> <ul> <li>A prospective component gauges respondents' expectations for the next three months. In July, prospective consumer sentiment fell from 100 to 97.</li> </ul> </ul> <br /><br />The scores for both parts are combined to provide a composite index of consumer sentiment.<br /><br />U.S. consumers polled in July indicated that aside from diagnostic tests, they will be more likely to delay, postpone or cancel office visits, elective surgeries and therapies in the next three months. They also said they have had, and expect to continue having, difficulty paying for healthcare services and insurance.<br /><br />&ldquo;This is a significant reversal from June, when consumers generally expressed optimism for the future,&rdquo; the report noted.<br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111400/Thomson-Reuters-Healthcare-Consumer-Confidence-Dipped-In-July&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:10:00 GMTf1397696-738c-4295-afcd-943feb885714:111400http://www.iatroshealth.com/blog/bid/111401/Radiologists-May-Lose-Money-When-Reading-Multiple-Images#Comments0Radiologists May Lose Money When Reading Multiple Imageshttp://www.iatroshealth.com/blog/bid/111401/Radiologists-May-Lose-Money-When-Reading-Multiple-ImagesWASHINGTON - Once again, the Centers for Medicare &amp; Medicaid Services (CMS) is thinking outside the box. This time the CMS is recommending a reduction in the allowable payments for multiple imaging ordered for a Medicare patient and performed on the same day. Under provisions of the <a href="http://www.iatroshealth.com/patient-verification-of-benefits.php">Medicare Physician Fee Schedule</a>, the agency is proposing to pay the full physician's charge for the first patient scan but only 50% of the fee for any additional imaging services to include computed tomography (CT), magnetic resonance imaging (MRI) and ultrasound.<br /><br />The policy change stems from a previous CMS proposal for "multiple procedure payment reductions" based on an assumption that multiple surgeries performed by a doctor on a given patient on the same day would result in a reduction of overall costs. Even though some physicians would agree with CMS's conclusions, at least in part, most believe it is impractical to apply the same logic to a professional's charges for multiple imaging. In fact, a bipartisan committee in Congress called the idea a dangerous precedent for Medicare reimbursement.<br /><br />Since Medicare or Medicaid would only pay a radiologist 50% of their fee for interpreting additional images, lawmakers felt the CMS proposal to be an unfair application of a well-intended policy. After all, a radiologist does not typically order patient procedures so no real economies of scale exist for interpreting multiple scans for a given patient when compared to interpreting images for multiple patients. Regardless of the number of scans ordered, a radiologist must independently interpret each result with same degree of accuracy.<br /><br />The American Medical Association and dozens of other medical societies have called the proposed cuts in reimbursement for imaging services unrealistic as the doctors who would actually be ordering the scans are not the ones that would be impacted. Thus, there would be no accompanying motivation to change policy or procedure to contain costs. Nonetheless, the CMS plans to continue looking at all components of medical imaging for achievable efficiencies that could produce savings to be redistributed to pay for other Medicare services.<br /><br />When you select iATROS Healthcare Solutions for your <a href="http://www.iatroshealth.com/">Florida medical billing</a> and revenue cycle management, we will always keep you well informed of how proposed (and enacted) regulations will impact the running of your practice. Our goal is simple. We want to reduce your concern over regulatory compliance and take any non-medical pressure off your staff. That will allow you the opportunity to better allocate your resources and focus on your patient's needs. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111401/Radiologists-May-Lose-Money-When-Reading-Multiple-Images&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:09:00 GMTf1397696-738c-4295-afcd-943feb885714:111401http://www.iatroshealth.com/blog/bid/111403/Aetna-To-Acquire-Genworth-s-Medicare-Supplement-Business-For-290M#Comments0Aetna To Acquire Genworth's Medicare Supplement Business For $290Mhttp://www.iatroshealth.com/blog/bid/111403/Aetna-To-Acquire-Genworth-s-Medicare-Supplement-Business-For-290MHARTFORD, CT &ndash; Aetna announced today that it has agreed to buy the Medicare supplement and related blocks of in-force business of Genworth Financial for $290 million.<br /><br />Genworth&rsquo;s business, conducted through Continental Life Insurance Company of Brentwood, Tenn., has more than 145,000 Medicare supplement members. The transaction will substantially enhance Aetna's market footprint as a provider of Medicare supplement insurance.<br /><br />&ldquo;By acquiring this business, Aetna will significantly expand its footprint in the Medicare supplement business,&rdquo; said Mark T. Bertolini, Aetna&rsquo;s chairman, CEO and president. &ldquo;This important growth opportunity comes at a time when the Medicare population is anticipated to increase as &lsquo;Baby Boomers&rsquo; reach age 65. Medicare supplement is expected to be a fast-growing product in the coming years as individuals seek peace of mind for out-of-pocket costs and employers look for added retiree coverages.&rdquo;<br /><br />According to its first quarter operating results, Medicare members were the smallest portion of Aetna&rsquo;s book of business, representing just more than 400,000 members. This pales in comparison to the more than 16 million members in its commercial lines and the 1.2 million members in its Medicaid products.<br /><br />Joseph M. Zubretsky, senior executive vice president and CFO, added, &ldquo;This acquisition is in keeping with Aetna&rsquo;s plan to broaden its product portfolio and add new revenue streams, and address the increasing needs of the senior population. Aetna brings capabilities to grow the Medicare supplement business, including access to commercial retirees and Medicare prescription drug plan members, multi-channel distribution and other Aetna product offerings.&rdquo;<br /><br />Aetna said it plans to finance the deal using current internal resources. The company has ample ability to pay all cash for the business, as it has more than $3.5 billion cash on hand as of the end of March. The business being acquired had approximately $317 million in net earned premium for 2010.<br /><br />The deal is projected to be earnings-neutral for Aetna in 2012 and is expected to close in the fourth quarter this year.<br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111403/Aetna-To-Acquire-Genworth-s-Medicare-Supplement-Business-For-290M&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:08:00 GMTf1397696-738c-4295-afcd-943feb885714:111403http://www.iatroshealth.com/blog/bid/111404/Insurers-mishandle-1-in-5-claims-AMA-finds#Comments0Insurers mishandle 1 in 5 claims, AMA findshttp://www.iatroshealth.com/blog/bid/111404/Insurers-mishandle-1-in-5-claims-AMA-finds<p id="Btext1">Chicago -- Barbara McAneny, MD, says insurers' inability to consistently pay claims correctly is costing her practice a lot of money -- hundreds of thousands of dollars a year.</p> <br />"I did a back-of-the-envelope calculation in my own practice and figured if I could get all of the implemented changes the AMA is working for, I could probably drop about $70,000 per physician, per year to our bottom line," said Dr. McAneny, CEO of the New Mexico Cancer Center, an oncology group of 10 doctors in Albuquerque.<br /><br />Dr. McAneny, a member of the American Medical Association Board of Trustees, presented a report during the AMA Annual Meeting showing that seven top private insurers paid the wrong amount for nearly one in five claims.<br /><br />That is well below the 99% accuracy rate the AMA has sought since it launched the National Insurer Report Card in 2008 as part of its Heal the Claims Process campaign.<br /><br />The rate of inaccurate claims is going up, not down, according to the AMA's fourth annual National Insurer Report Card, released June 20. The rate of inaccurate payments increased from 17.3% in 2010 to 19.3% in 2011. The AMA estimates that the increase added 3.6 million inaccurate claims payments in 2011 and an additional $1.5 billion in health care costs. It also said eliminating these payment errors would save $17 billion yearly.<br /><br />No one speculated as to an explanation for the year-over-year increase.<br /><br />The report measured a sample of more than 2.4 million claims paid by seven commercial insurers. There were five publicly traded, for-profit plans -- Aetna, Cigna, Humana, WellPoint and UnitedHealth Group -- and two nonprofit BlueCross BlueShield-affiliated plans -- Health Care Service Corp. and the Regence Group.<br /><br />The report summarized an analysis of nearly 4 million services on those claims, for dates of service between Feb. 1 and March 31.<br /><br /><!--start_subsbox--> <!--subsbox--> <!--end_subsbox-->Analyzed claims were pulled from a database maintained by National Health Care Exchange Services of Sacramento, Calif. Compared with the 80.7% average for commercial payers, Medicare's payments were accurate 96.2% of the time.<br /><br />For the purposes of the report card, accuracy was defined as the percentage of claim lines in which the electronic remittance matched what the physician expected to be paid, based on his or her contracted fee schedule and disclosed claims edits and payment rules.<br /><br />Mark Reiger, CEO of National Health Care Exchange Services, outlined the results. "It's clear commercial payers still have significant room for improvement on payment accuracy," he said. "That is the centerpiece of what we're working with physicians every day on -- the simple question of, 'Was I paid correctly?' "<br /><br />UnitedHealth Group had the best accuracy scores. The company's remittances matched the "expected amount" 90.2% of the time, and the payment rate matched the contracted fee schedule rate 92.3% of the time. For both measures, United was the only private payer to improve from 2010.<br /><br />"We are grateful for the American Medical Association's recognition," United spokeswoman Cheryl Randolph said in a statement. "The report card is an important reflection of our continued investments and focus on improving claims payment clarity, accuracy and transparency over the last few years."<br /><br />Meanwhile, WellPoint, which runs for-profit Blues plans in 14 states, saw a marked drop in payment accuracy, from 73.9% in 2010 to 61.1% in 2011 in the percentage of remittances that matched expected payment.<br /><br />WellPoint spokesman Brandon Davis said the company is working to continually improve its payment accuracy, speed and transparency.<br /><br />As evidence of that effort, he said the company is working on adopting a companywide claims editing process.<br /><br />Robert Zirkelbach, spokesman for insurer trade group America's Health Insurance Plans, said physicians need to help improve the claims payment process by reducing duplicate, inaccurate or delayed claims submissions.<br /><br />Dr. McAneny said physicians need to do their part to help improve speed and accuracy of the claims process. But she said insurers have work to do on their end, as evidenced by the time and money physicians continue to spend in pursuit of fair payment.<br /><br />"Physicians cannot predict what they will get paid," said Dr. McAneny, a medical oncologist and hematologist. "This is something that wouldn't be tolerated in any other industry."<br /> <h3>Prior authorizations</h3> <br />For the first time, the report card included a measure of administrative burden associated with each plan, specifically the percentage of claims that noted a service had required prior authorization.<br /><br />Commercial payers required prior authorization for services on an average of 3.5% of claims, above Medicare's 3.28%. Cigna had the highest rate of required prior authorization, at 6.15% of claims. The lowest rate measured was 0.04%, for Regence.<br /><br />In addition to the time spent getting prior authorizations, confusion about whether prior authorization is required wastes time and money, Reiger said.<br /><br />Because each payer's rules are different, physicians and their staff often call to get approval for a service when it's unnecessary. In a separate AMA survey of 2,400 physicians released in November 2010, 64% of physicians said it was difficult for them to know which tests and procedures require prior authorization.<br /><br />Sixty-three percent said they typically waited "several days" for preauthorizations; 13% said it usually took more than a week to get preapproval.<br /><br />"If we all commit to efficiency, transparency and accuracy at every step of the process, we will achieve an incredible savings of time and money," Dr. McAneny said.<br /><br /><em>Source: amednews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111404/Insurers-mishandle-1-in-5-claims-AMA-finds&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:08:00 GMTf1397696-738c-4295-afcd-943feb885714:111404http://www.iatroshealth.com/blog/bid/111405/Three-Ways-to-Improve-Florida-Medical-Coding-for-Ambulatory-Surgery-Centers#Comments0Three Ways to Improve Florida Medical Coding for Ambulatory Surgery Centershttp://www.iatroshealth.com/blog/bid/111405/Three-Ways-to-Improve-Florida-Medical-Coding-for-Ambulatory-Surgery-CentersIf you're responsible for Florida medical coding in an ambulatory surgical center, you need to be aware of three common mistakes that often lead to denied claims: failing to discuss queries with physicians; ignoring CPT coding updates; and using modifiers that fall short of payor guidelines. <a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions</a> offers these tips for improving accuracy and reducing claims denials:<br /><br /><ol><ol> <li>When in doubt, ask: Coders often make mistakes on claims because they hesitate to follow up with a physician on an unclear or incomplete operative report. The result is an underpayment or an overpayment that violates compliance rules and ends up costing the practice in penalty fees. One culprit may be the physician's busy schedule. A regular review meeting between physicians and coders once every few months can help identify procedural trends - a habit of reporting the main procedure but missing add-on procedures, for example. A little time can help make a lot more money in approved claims and/or save money in compliance violation fees.</li> </ol></ol><br /><ol><ol> <li>Keep up to date on CPT codes: CPT codes are updated on a pretty regular basis. Sign up for the listserv with your local Medicare carrier for automatic updates to Medicare codes delivered right to your email inbox. Online resources for CPT coding updates include the American Medical Association's <a href="http://www.ama-assn.org/" target="_blank">website</a> and the Ambulatory Surgery Center Association <a href="http://ascassociation.org/" target="_blank">website</a>.</li> </ol></ol><br /><ol><ol> <li>Double check those modifiers: Carriers and states have different preferences in modifiers. An effective coder will know which carriers prefer which modifiers before they submit a claim. A little research or a few phone calls can save time and money in denied claims and resubmission processes.</li> </ol></ol> <p><br /><br />iATROS Healthcare Solutions can help make sure your <a href="http://www.iatroshealth.com/medical-coding-florida.php" target="_self">Florida medical coding </a>is thorough, accurate and denial-proof. We offer a full battery of services to medical practices nationwide from our offices in Florida. Medical coding and billing, healthcare regulatory compliance and EMR consulting, patient scheduling and verification of benefits, and full medical practice management are among our services. Contact us today to learn how we can help boost your firm's revenues and operational efficiency.</p> <p>&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 156px; height: 47px; display: block; border-width: 0px;" id="hs-cta-wrapper-bd12355c-a0f3-4f0f-89e9-21e73f89c630" data-mce-style="margin-right: auto; margin-left: auto; width: 156px; height: 47px; display: block; border-width: 0px;"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630" id="hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630"> <a href="http://www.iatroshealth.com/contact-us" data-mce-href="http://www.iatroshealth.com/contact-us"><img id="hs-cta-img-bd12355c-a0f3-4f0f-89e9-21e73f89c630" src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" alt="contact-us" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=bd12355c-a0f3-4f0f-89e9-21e73f89c630"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <p>&nbsp;</p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111405/Three-Ways-to-Improve-Florida-Medical-Coding-for-Ambulatory-Surgery-Centers&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:07:00 GMTf1397696-738c-4295-afcd-943feb885714:111405http://www.iatroshealth.com/blog/bid/111406/Economic-Optimism-Sinks-Among-CFOs#Comments0Economic Optimism Sinks Among CFOshttp://www.iatroshealth.com/blog/bid/111406/Economic-Optimism-Sinks-Among-CFOsDURHAM, NC &ndash; Optimism among chief financial officers in the United States has fallen, but spending plans indicate continued moderate growth over the next year, according to the most recent Duke University/CFO Global Business Outlook Survey.<br /><br />The quarterly survey asked 806 CFOs from a broad range of global public and private companies about their expectations for the economy. The research has been conducted for 61 consecutive quarters.<br /><br />CFO optimism about the economy fell to 57 on a 100-point scale, down from a 61 rating last quarter, but roughly even with a year ago.<br /><br />Projected growth in earnings (8 percent) and capital spending (9 percent) are both down from last quarter, but still reasonably strong, according to respondents.<br /><br />U.S. companies expect domestic employment to increase by 0.7 percent over the next year. This rate of growth is down from last quarter and implies that, over the next year, the U.S. economy will average fewer than 100,000 new jobs created each month.<br /><br />&ldquo;CFOs are telling us we are stuck at 9 percent unemployment for the next year,&rdquo; said Campbell Harvey, a professor of finance at Duke&rsquo;s Fuqua School of Business and founding director of the survey. &ldquo;One leg of the economy is shackled by extraordinarily high unemployment and the other by the housing market still in a free fall. Obviously, it is hard for the economy to move forward.&rdquo;<br /><br />Still, there is some good news on the employment front. Twenty-one percent of companies say they are actively hiring, with the strongest activity in the tech, retail/wholesale and energy sectors. Jobs in high demand include engineers, product development, sales force and finance/accounting.<br /><br />Nearly 10 percent of firms say they would like to hire, but cannot find employees with the right skills, and 16 percent say they would like to hire more but are resource constrained. Only twelve percent of firms say they are overstaffed for current demand.<br /><br />Employment benefits were slashed during the recent recession, but CFOs now indicate many of these benefits will be reinstated in the coming year.<br /><br />Among companies that had cut employee training and development, 46 percent say these programs have already been or will be reinstated to pre-recession levels within the next 12 months.<br /><br />Sixty-one percent of firms indicate weekly hours worked will rise to pre-recession levels. Wages are expected to rise by 3 percent over the next year.<br /><br />&ldquo;Though the expectations for new job creation are weak, those who are employed should see their benefits and wages improve over the next year,&rdquo; said John Graham, professor of finance at Fuqua and director of the survey. &ldquo;This should solidify the financial position of those currently employed, which will bring much-needed spending to the economy. But it will also magnify the gulf between the haves and have-nots.&rdquo;<br /><br />CFOs were asked whether the recent rapid growth in capital spending was leading to machinery that might replace employees and therefore reduce labor force, or whether their capital spending would increase the need for employment. Thirty-eight percent of companies report capital spending will lead to increased employment, while 52 percent say it will have no effect. Only 9 percent say that capital spending will lead to reduced employment.<br /><br />Capital spending plans have weakened, with a planned increase of 9 percent on average over the next 12 months. Although this is below last quarter&rsquo;s planned growth of 12 percent, it is still higher than the long-run average of 5 percent.<br /><br />Spending on research and development, marketing and advertising are both expected to grow slightly, though at slower forecasted rates than last quarter. Earnings are expected to rise about 8 percent, down from last quarter, but still a moderately healthy rate of growth.<br /><br />About 59 percent of capital spending is targeted to replace existing equipment, such as machinery that is obsolete or worn out. The remaining 41 percent will be spent on new investments.<br /><br />Among the industries represented in the survey are retail/wholesale, mining/construction,manufacturing, transportation/energy, communications/media, technology, service/consulting and banking/finance/insurance.<br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111406/Economic-Optimism-Sinks-Among-CFOs&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:06:00 GMTf1397696-738c-4295-afcd-943feb885714:111406http://www.iatroshealth.com/blog/bid/111407/5010-National-Testing-Days-Announced#Comments05010 National Testing Days Announcedhttp://www.iatroshealth.com/blog/bid/111407/5010-National-Testing-Days-AnnouncedWASHINGTON &ndash; With six months to go before the HIPAA 5010 electronic claims submissions compliance date, the Centers for Medicare and Medicaid Services have announced two 5010 national testing days.<br /><br />On June 15 and August 24, all HIPAA-covered entities &ndash; physicians, insurers, pharmacies, hospitals and others &ndash; can test their compliance efforts with enough time to discover and work out the kinks. During each testing day, testers will have access to support services and immediate access to Medicare Administrative Contractors (MACs).<br /><br />Even though two national testing days are on hand, CMS encourages Medicare fee-for-service trading partners to contact their MACs to organize their own testing. Successful testing is required before a trading partner may be placed into production, according to CMS.<br /><br />More details about transactions and state Medicaid agencies participating in the national testing days are to come.<br /><br /><em>Source: healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111407/5010-National-Testing-Days-Announced&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:06:00 GMTf1397696-738c-4295-afcd-943feb885714:111407http://www.iatroshealth.com/blog/bid/111408/Common-Florida-Medical-Billing-Mistakes#Comments0Common Florida Medical Billing Mistakeshttp://www.iatroshealth.com/blog/bid/111408/Common-Florida-Medical-Billing-MistakesWith rising healthcare costs showing no signs of slowing, financial auditors are working harder than ever to zero in on <a href="http://www.iatroshealth.com/">Florida medical billing</a> errors<a href="http://www.iatroshealth.com/"> </a>and clues to medical billing fraud. The American Medical Association's 2010 health insurer report card showed that health insurers had inaccurately processed a full 20 percent of medical claims - that's one in every five. Of the $210 billion in medical claims processed annually, upwards of $777.6 million in unnecessary administrative costs could be saved if the health insurance industry improved claim accuracy by just one percent, the report said.<br /><br />Among the most common Florida medical billing errors that cause a delay or denial of an insurance claim are:<br /><br /> <ul> <ul> <li>Wrong patient identification number</li> </ul> </ul> <br /> <ul> <ul> <li>Wrong ICD-9-CM code without fourth / fifth digits when required</li> </ul> </ul> <br /> <ul> <ul> <li>Duplicate claim</li> </ul> </ul> <br /> <ul> <ul> <li>Wrong date of service</li> </ul> </ul> <br /> <ul> <ul> <li>Wrong rates charged</li> </ul> </ul> <br /> <ul> <ul> <li>Procedure of claim not fully furnished by the other party</li> </ul> </ul> <br /> <ul> <ul> <li>No match between the ICD-9-CM code and CPT code</li> </ul> </ul> <br /> <ul> <ul> <li>Physician's ID not available</li> </ul> </ul> <br /> <ul> <ul> <li>Billing for more operating room time than used</li> </ul> </ul> <br /> <ul> <ul> <li>Type of service code not mentioned</li> </ul> </ul> <br /> <ul> <ul> <li>Billed for cancelled services or tests</li> </ul> </ul> <br /> <ul> <ul> <li>Bill amount totaling mistake</li> </ul> </ul> <br /> <ul> <ul> <li>Treatment or service provided was not validated</li> </ul> </ul> <br /> <ul> <ul> <li>Service or treatment given in an invalid center or place of service</li> </ul> </ul> <br /> <ul> <ul> <li>Service was not a medical necessity</li> </ul> </ul> <br /> <ul> <ul> <li>Place of service code not mentioned</li> </ul> </ul> <br /><br />To help assure that your medical billing is error-free and paid quickly, iATROS Healthcare Solutions offers services in <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php">insurance billing and follow up</a>. Industry statistics indicate as many as 30% of insurance claims are rejected on the first submission, and that 50% of them never get resubmitted. By streamlining certain processes and giving thorough attention to detail, iATROS' Florida medical billing specialists aim for a minimum 97% of insurance claims to be accepted on the first submission and 90% - 95% of claim value (based on specialty) to be collected within 120 days.<br /><br />Mistakes cost money. Make sure your Florida medical billing is free of mistakes. Contact iATROS Healthcare Solutions at 904-296-1160 or via our online email form. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111408/Common-Florida-Medical-Billing-Mistakes&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:05:00 GMTf1397696-738c-4295-afcd-943feb885714:111408http://www.iatroshealth.com/blog/bid/111409/Healthcare-Costs-Continue-To-Rise-But-At-a-Declining-Rate#Comments0Healthcare Costs Continue To Rise, But At a Declining Ratehttp://www.iatroshealth.com/blog/bid/111409/Healthcare-Costs-Continue-To-Rise-But-At-a-Declining-RateNEW YORK &ndash; Healthcare costs in the United States continue to rise but at a declining rate according to the latest S&amp;P Healthcare Economic Composite Index update.<br /><br />The index indicates that the average per capita cost of healthcare services covered by commercial insurance and Medicare programs increased by 5.77 percent over the 12 months ending March 2011. After a temporary increase reported with January's data, healthcare costs have resumed their deceleration in annual growth rates &ndash; in the 12 months ending January and February 2011, the index<br /><br />The S&amp;P Healthcare Economic Indices, which include the commercial and Medicare indices, estimate the per capita change in revenues accrued each month by hospital and professional services facilities for services provided to patients covered by Medicare and commercial health insurance programs.<br /><br />The Composite index, at +5.77 percent, is virtually back to the lowest annual growth rate in its six-year history, which was +5.76 percent in June 2007. The highest annual growth rate for the Composite index was during the 12 months ending May 2010, when it posted +8.74 percent. In the 10 months measured from this peak, this index has gone through a sharp deceleration, down 2.97 percentage points.<br /><br />Over the year ending March 2011, healthcare costs covered by commercial insurance rose by 7.57 percent, as measured by the S&amp;P Healthcare Economic Commercial Index. Medicare claim costs rose at an annual rate of 2.78 percent, as measured by the S&amp;P Healthcare Economic Medicare Index. This is the lowest annual rate of growth posted for the Medicare Index in its six-year history.<br /><br />"The annual growth rates in healthcare claim costs remain positive, but with declining rates," said David M. Blitzer, chairman of the index committee at Standard &amp; Poor's.<br /><br />"If you look over the last year or so of data, it is apparent that the rates of increase in healthcare costs continue to slow down. While there was some volatility within months, the general trend has been a slowdown across all nine of the indices we publish. Most of the annual growth rates peaked in the late winter/early spring of 2010. Since then, most of these rates have fallen by 2 percentage points or more,&rdquo; Blitzer said.<br /><br />&ldquo;The biggest slowdown has come from the Hospital Medicare Index, where the annual growth rate fell from +8.3 percent in August 2009 to +1.18 percent in March 2011," he said. "On the other hand, we have not seen an equal trend for the Hospital Commercial Index, where the annual growth rate peaked at +9.36 percent in May 2010, and is still reporting a healthy +8.36 percent as of March 2011."<br /><br />Blitzer said this phenomenon could be caused by two factors:<br /><br /><ol><ol> <li>Costs for Medicare patients are being better contained than those covered under commercial insurance plans; and</li> </ol></ol><br /><ol><ol> <li>Hospitals are using more procedures and services covered under commercial plans, contributing to the increase in total costs. "We see a similar differential across the Professional Services Indices, but not as severe," he said.</li> </ol></ol><br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111409/Healthcare-Costs-Continue-To-Rise-But-At-a-Declining-Rate&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:05:00 GMTf1397696-738c-4295-afcd-943feb885714:111409http://www.iatroshealth.com/blog/bid/111410/Medicare-trust-fund-projected-to-run-dry-by-2024#Comments0Medicare trust fund projected to run dry by 2024http://www.iatroshealth.com/blog/bid/111410/Medicare-trust-fund-projected-to-run-dry-by-2024<p>WASHINGTON &ndash; The Medicare Trustees Report has projected that Medicare&rsquo;s Hospital Insurance Fund will run out of money in 2024, five years earlier than the trustees projected in last year's annual report.</p> <br /> <p>President Barack Obama's administration, looking for the silver lining in the report, said that while there is work to be done to ensure the fund&rsquo;s solvency, the HI Trust Fund would have run dry in 2016 without the reforms contained in the Patient Protection and Affordable Care act &ndash; an additional eight years of solvency.</p> <br /> <p>&ldquo;This report shows that without the Affordable Care Act, the outlook for the Hospital Insurance Trust Fund today would be much worse," said Donald Berwick, MD, administrator of the Centers for Medicare &amp; Medicaid Services. &ldquo;CMS is implementing critical reforms to improve care and reduce costs and improve the overall health of Medicare&rsquo;s beneficiaries and the trust fund.&rdquo;</p> <br /> <p>While administration officials focus on maintaining solvency, others point out that it's equally important to preserve the value of the program without shifting some of the cost burden to seniors.</p> <br /> <p>&ldquo;We must remember that preserving Medicare means not only maintaining the solvency of the trust fund, but also maintaining the value of the benefit and the financial and health protections the program provides to the people it serves,&rdquo; said Joe Baker, president of the Medicare Rights Center. &ldquo;Half of people with Medicare live on incomes below $20,000 per year.&rdquo;</p> <br /> <p>According to the report, HI Trust Fund expenditures have exceeded income annually since 2008 and are projected to continue doing so under current law in all future years. The trust fund has relied on interest earnings and asset redemption to meet the deficit. In 2010, Medicare tapped the trust fund for more than $32 billion to make up for the shortfall.</p> <br /> <p>At current rates of spending and cost growth, HI Trust Fund assets are projected to cover annual deficits through 2023, with asset depletion beginning in 2024.</p> <br /> <p>The trustees report noted the five-year change from last year&rsquo;s report is due to the slowdown of the national economy, which caused tax revenues to decline and combined with higher-than-expected costs. The report pointed out that projecting earlier depletion dates from a previous report is not an uncommon occurrence. A seven-year-shorter projection was reported in 2004 due to similar economic conditions.</p> <br /> <p>Not surprisingly, various groups jumped on the announcement to make political points.</p> <br /> <p>J. James Rohack, MD, immediate past president of the American Medical Association, used the Trustees Report to hammer home the need to do away with the current Medicare physician payment formula, called the sustainable growth rate &ndash; or SGR &ndash;&nbsp; in favor of a more lasting payment formula.</p> <br /> <p>&ldquo;Physicians who care for Medicare patients form the foundation of this critical program, and the Trustees confirmed today that they face a steep payment cut of nearly 30 percent on January 1,&rdquo; Rohack said. &ldquo;This cut is the highest ever scheduled under the broken Medicare physician payment system, and it threatens access to care for our nation&rsquo;s seniors, military families, people with disabilities and the baby boomers now entering Medicare. The longer it takes to reform this system, the greater the cost.&rdquo;</p> <br /> <p>The trustees' projection didn't take into account any adjustment to the physician pament formula currently on the books and includes the anticipated payment cut of 29 percent to take effect Jan. 1, 2012.</p> <br /> <p>But Baker noted payment formulas and asset depletion dates aren&rsquo;t at the heart of the problem.</p> <br /> <p>&ldquo;The problem is growing costs in the healthcare sector overall, and shifting costs from one party to another does nothing to address this issue,&rdquo; he said. &ldquo;The ACA achieves savings without cutting benefits or increasing consumer costs, through promoting prevention, paying for quality over quantity, and improving care coordination that can help people with Medicare, including those with multiple chronic conditions, stay healthier. It is solutions like these that we must support to make Medicare stronger.&rdquo;</p> <br /> <p><em>Source: healthcarefinancenews.com</em></p> <br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111410/Medicare-trust-fund-projected-to-run-dry-by-2024&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:04:00 GMTf1397696-738c-4295-afcd-943feb885714:111410http://www.iatroshealth.com/blog/bid/111412/CMS-proposes-policy-and-payment-changes-for-rehab-facilities#Comments0CMS proposes policy and payment changes for rehab facilities http://www.iatroshealth.com/blog/bid/111412/CMS-proposes-policy-and-payment-changes-for-rehab-facilitiesWASHINGTON &ndash; The Centers for Medicare and Medicaid Services has issued a proposed rule that would update Medicare payment policies and rates for inpatient rehabilitation facilities in fiscal year 2012. The rule would increase payment rates under the IRF Prospective Payment System by a projected 1.5 percent &mdash; an estimated $120 million nationwide.<br /><br />According to CMS, the projected update reflects a rebased and revised market basket specific to IRFs, inpatient psychiatric facilities and long-term care hospitals &ndash; currently estimated at 2.8 percent for FY 2012, less a 1.3 percentage point reduction mandated by the Affordable Care Act.<br /><br />The proposed rule, which would apply to more than 1,200 Medicare-participating IRFs, including approximately 200 freestanding IRFs and approximately 1,000 IRF units in acute care hospitals and critical access hospitals, seeks to establish a new quality reporting system authorized by the ACA.<br /><br />"The proposed rule would extend Medicare&rsquo;s ongoing efforts to use its payments to encourage better care for beneficiaries who are treated in inpatient rehabilitation facilities," said CMS Administrator Donald Berwick, MD. "The measures IRFs would report under the proposed rule will pave the way for Medicare to work with IRFs to improve patient safety, prevent patients from picking up new illnesses during a hospitalization and provide well-coordinated person-and-family-centered care."<br /><br />According to Berwick, the proposed quality reporting system is aligned with the goals of the Partnership for Patients, a new public-private partnership that will help improve the quality, safety and affordability of healthcare. Initially, IRFs would submit data on two quality measures &ndash; urinary catheter-associated urinary tract infection and pressure ulcers that are new or have worsened.<br /><br />These proposed measures represent two of the nine conditions identified by the partnership as important places to begin in efforts to reduce harm to a patient, Berwick said. A third measure, currently under development, would address readmissions within 30 days to another inpatient stay, whether in an acute care hospital, rehabilitation facility or other setting, he said.<br /><br />Under the proposed rule, IRFs that do not submit quality data would see their payments reduced by 2 percentage points beginning in fiscal 2014. CMS also plans to establish a process for making the measures data available to the public. As with other data published on the CMS website, IRFs choosing to report quality data would have an opportunity to review the data for accuracy before it becomes public.<br /><br />CMS officials said they will accept comments on the proposed rule until June 21 and will address all comments in a final rule to be issued by August 1.<br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111412/CMS-proposes-policy-and-payment-changes-for-rehab-facilities&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:03:00 GMTf1397696-738c-4295-afcd-943feb885714:111412http://www.iatroshealth.com/blog/bid/111413/Are-You-Prepared-for-HIPAA-5010-Compliance-Florida#Comments0Are You Prepared for HIPAA 5010 Compliance, Florida?http://www.iatroshealth.com/blog/bid/111413/Are-You-Prepared-for-HIPAA-5010-Compliance-FloridaNew research shows that medical groups nationwide are woefully unprepared for <a href="http://www.iatroshealth.com/healthcare-compliance.php">HIPAA 5010 compliance</a>. According to a report by the Medical Group Management Association, many practices have yet to make critical software upgrades or to schedule testing with various health plans. These practices face potential interruption of their claims processing and other essential administrative transactions if they're not up to speed on HIPAA Version 5010 compliance by the January 1, 2012 deadline.<br /><br />Highlights of the report include:<br /><br /> <ul> <ul> <li>Just 22.3 percent of respondents believe their current software will permit them to use Version 5010.</li> </ul> </ul> <br /> <ul> <ul> <li>48.6 percent say their software will require and upgrade.</li> </ul> </ul> <br /> <ul> <ul> <li>5.8 percent expect their software will need to be replaced altogether.</li> </ul> </ul> <br /> <ul> <ul> <li>22.6 percent admitted not knowing what they'll need to do with their software.</li> </ul> </ul> <br /> <ul> <ul> <li>47.7 percent, less than half responding, have received any correspondence from their software vendors concerning HIPAA 5010.</li> </ul> </ul> <br /> <ul> <ul> <li>56.3 percent of respondents have yet to schedule internal testing of Version 5010 compliant software.</li> </ul> </ul> <br /> <ul> <ul> <li>59.8 percent have not yet started their implementation of HIPAA 5010.</li> </ul> </ul> <br /> <ul> <ul> <li>Less than one percent, 0.4 percent of respondents have completed implementation.</li> </ul> </ul> <br /> <ul> <ul> <li>12.1 percent are not confident that their <a href="http://www.iatroshealth.com/medical-practice-management-florida.php">practice management system</a> software vendors will be ready by the HIPAA compliance deadline.</li> </ul> </ul> <br /> <ul> <ul> <li>22.8 percent lack confidence that their major health plans will be ready.</li> </ul> </ul> <br /><br />If any of these factors are true for your practice, you may be facing serious cash flow disruption. To make sure you're fully prepared for HIPAA Compliance, Florida's iATROS Healthcare Solutions can help. Our practice management specialists stay up to the minute on all regulatory compliance issues and can help assure that your practice meets or beats federally mandated deadlines and that your practice doesn't miss a beat. Contact iATROS at 904-241-1160. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111413/Are-You-Prepared-for-HIPAA-5010-Compliance-Florida&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:02:00 GMTf1397696-738c-4295-afcd-943feb885714:111413http://www.iatroshealth.com/blog/bid/111414/Healthcare-Industry-Benchmark-Study-Finds-Customer-Service-a-Priority#Comments0Healthcare Industry Benchmark Study Finds Customer Service a Priority http://www.iatroshealth.com/blog/bid/111414/Healthcare-Industry-Benchmark-Study-Finds-Customer-Service-a-PriorityWINTER PARK, FL &ndash; The Customer Operations Performance Center, a Florida-based customer service and benchmarking company, has released findings from its first Healthcare Industry Benchmark Study.<br /><br />The study, which compares the healthcare industry to multi-industry benchmarks and to COPC High Performing Benchmarks, identifies many opportunities in which healthcare organizations can improve customer satisfaction and reduce expenses.<br /><br />Beginning in January 2011, the COPC healthcare team recruited 20 of large healthcare organizations representing the full range of industry sectors. These organizations provided the baseline results for trending.<br /><br />&ldquo;The healthcare organizations that participated in the first wave of this study seized the opportunity to identify major gaps in their customer experience,&rdquo; said Daren Springer, COPC's director and head of healthcare practice. &ldquo;This study provides a unique insight into healthcare organizations&rsquo; operational performance and offers an opportunity to gain a competitive advantage in the current healthcare transformation occurring today."<br /><br />"Healthcare reform and the consumerism movement require that the healthcare organizations significantly increase their customer focus and perform more like other customer-centric organizations. This requires organizations to benchmark themselves against the best with the best and define and implement best practices to improve their performance,&rdquo; said Springer.<br /><br />&ldquo;Those who participated in this study will be able to use the findings to help improve customer satisfaction/loyalty and reduce costs,&rdquo; said Cliff Moore, chairman and co-founder of COPC.<br /><br />The Healthcare Benchmark Study findings identify key opportunities across healthcare organizations. For example:<br /><br /> <ul> <ul> <li><strong>44 percent track claim leakage </strong>&ndash; Given that the recommended target for claim leakage is 2 percent to 3 percent of total claims expense and the industry is trending at an estimated 13 percent to 15 percent, this represents a significant savings opportunity that the majority of the participants are not tracking and managing.</li> </ul> </ul> <br /> <ul> <ul> <li><strong>6 percent track agent utilization or occupancy</strong> &ndash; This is one-tenth of the average of the companies in COPC&rsquo;s 2010 multi-industry study (about 70 percent) and a key cost driver.</li> </ul> </ul> <br /> <ul> <ul> <li><strong>35 percent monitor social media</strong> &ndash; This is significantly below the 80 percent of companies in COPC&rsquo;s 2010 multi-industry benchmark findings. Given the healthcare industry transition to a retail model, this is a critical area requiring focus.</li> </ul> </ul> <br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111414/Healthcare-Industry-Benchmark-Study-Finds-Customer-Service-a-Priority&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:02:00 GMTf1397696-738c-4295-afcd-943feb885714:111414http://www.iatroshealth.com/blog/bid/111411/CMS-announces-new-ACO-initiatives#Comments0CMS announces new ACO initiativeshttp://www.iatroshealth.com/blog/bid/111411/CMS-announces-new-ACO-initiativesWASHINGTON &ndash; Federal officials have announced three new accountable care organization initiatives that they say could save Medicare $430 million over the next three years.<br /><br />Under the Affordable Care Act, the Centers for Medicare and Medicaid Services announced on May 17 the launch of a new Innovation Center, a pioneer ACO model and new accelerated development learning sessions.<br /><br />CMS Administrator Donald Berwick, MD, said ACOs are key to overhauling the U.S. healthcare system.<br /><br />"Over and over again, we have seen that improving how care is delivered to patients is key to reducing the growth in healthcare spending," he said. "When we improve the coordination of care between providers, reduce duplication of services and avoid medical errors, we can get better outcomes for patients at less cost."<br /><br />According to Berwick, the pioneer model will provide a faster path of development for mature ACOs that have already begun coordinating care for patients and are ready to move forward.<br /><br />The model is designed to work in coordination with private payers to improve care and lower healthcare costs for Medicare beneficiaries.<br /><br />Berwick said the Innovation Center would release a request for applications this week for the pioneer ACO model.<br /><br />Richard Gilfillan, MD, director of the Innovation Center, said the pioneer model is an opportunity for advanced ACOs "to move further and faster into seamless, coordinated care by utilizing alternative payment mechanisms."<br /><br />CMS also announced free training for providers interested in becoming part of an ACO. The sessions will begin in June.<br /><br />Source: Healthcarefinancenews.com <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111411/CMS-announces-new-ACO-initiatives&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:01:00 GMTf1397696-738c-4295-afcd-943feb885714:111411http://www.iatroshealth.com/blog/bid/111415/Healthcare-Continued-Job-Creation-Trend-In-March#Comments0Healthcare Continued Job Creation Trend In Marchhttp://www.iatroshealth.com/blog/bid/111415/Healthcare-Continued-Job-Creation-Trend-In-MarchWASHINGTON &ndash; The U.S. healthcare sector was among the leaders in new job creation nationwide in March, with employment increasing by approximately 36,600 positions.<br /><br />Over the prior 12 months, the healthcare industry has added 283,000 jobs, or an average of 24,000 jobs per month.<br /><br />According to the latest employment report from the Bureau of Labor Statistics, the biggest healthcare job gains were in ambulatory care settings and at hospitals. Approximately 17,600 ambulatory care jobs were added in March, while nursing and hospitals saw gains of 10,200 jobs.<br /><br />Nursing and residential care facilities also added jobs at a healthy clip in March, with a total increase of 8,800 positions.<br /><br /><strong></strong><br /><br />The dominant job growth area in ambulatory care was in physician offices, which added 7,600 jobs. Outpatient care centers added 700 jobs, while home healthcare services created approximately 2,000 jobs.<br /><br />Overall, total non-farm payroll employment increased by 216,000 in March, and the national unemployment rate held steady at 8.8 percent. The number of unemployed decreased by 200,000 to 13.5 million.<br /><br />The labor force was relatively unchanged over the month, and the jobless rate was down by 1 percentage point since November 2010.<br /><br />The number of long-term unemployed (those jobless for 27 or more weeks) increased slightly to 6.1 million. The long-term unemployed currently make up about 45.5 percent of unemployed persons.<br /><br /><em>Source: Healthcarefinancenews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111415/Healthcare-Continued-Job-Creation-Trend-In-March&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:01:00 GMTf1397696-738c-4295-afcd-943feb885714:111415http://www.iatroshealth.com/blog/bid/111416/CMS-executive-outlines-bridge-funding-programs#Comments0CMS executive outlines 'bridge' funding programshttp://www.iatroshealth.com/blog/bid/111416/CMS-executive-outlines-bridge-funding-programsNASHVILLE, TN &ndash; A top executive for the Centers for Medicare and Medicaid Services told healthcare officials in Tennessee this week that the nation is in good shape to implement healthcare reform by 2014.<br /><br />In a March 22 speech to the Nashville Health Care Council, Marilyn Tavenner, CMS' principal deputy administrator and COO, highlighted several programs that provide a &ldquo;bridge&rdquo; to full implementation of healthcare reform in 2014.<br /><br />&ldquo;In the year since passage of the Affordable Care Act, we&rsquo;ve had some ups and downs,&rdquo; she said. &ldquo;But the sky didn&rsquo;t fall and government didn&rsquo;t take over healthcare. And we&rsquo;ve earmarked billions of dollars to help make the transition as smooth as possible.&rdquo;<br /><br />Tavenner cited a number of programs designed to help states, providers and employers, including:<br /><br /> <ul> <ul> <li>New legislation that provides $5 billion to help unions, state and federal government and private employers provide health insurance to employees who retire early.</li> </ul> </ul> <br /> <ul> <ul> <li>$2 billion in training funds to help address the anticipated doctor/nurse shortage, with a goal of bringing 30,000 new primary care providers into the system.</li> </ul> </ul> <br /> <ul> <ul> <li>$2.8 billion to enable states to create their own Primary Care Incentive Programs (PCIPs) or exchanges.</li> </ul> </ul> <br /> <ul> <ul> <li>Federal funding that covers most of the cost of expanded Medicaid in 2014-2019, thus keeping the state share small by design.</li> </ul> </ul> <br /><br />&ldquo;We&rsquo;re also excited about the strides we&rsquo;ve made in preventive care,&rdquo; said Tavenner. &ldquo;This year, we&rsquo;ve eliminated co-pays for preventive screenings &ndash; and soon there will be no co-pays for smoking cessation programs and pneumonia vaccines.&rdquo;<br /><br />Tavenner added that regulations for accountable care organizations will soon be available.<br /><br />&ldquo;CMS has worked closely with the Federal Trade Commission and the Justice Department to reach consensus on the regulations,&rdquo; she said. &ldquo;We&rsquo;re going to thoroughly evaluate ACOs in the next two years to see if the regulations need adjustments.&rdquo;<br /><br />CMS has established an office to help monitor the costs of covering the nearly 10 million Americans eligible for both Medicare and Medicaid. &ldquo;We foresee plenty of opportunities to work with managed care companies on cost-containment,&rdquo; Tavenner said.<br /><br />Tavenner said she is also pleased by the early success of the Insurance Finder section of HHS&rsquo; healthcare.gov website.<br /><br />&ldquo;Insurance Finder has already gotten 1.2 million hits,&rdquo; she said. &ldquo;It&rsquo;s the most visited page on the website.&rdquo;<br /><br /><em>Source: HealthcareFinanceNews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111416/CMS-executive-outlines-bridge-funding-programs&bvt=rss">Jackie KennedyMon, 19 Dec 2011 15:00:00 GMTf1397696-738c-4295-afcd-943feb885714:111416http://www.iatroshealth.com/blog/bid/111417/Meaningful-use-attestation-starts-April-18#Comments0Meaningful-use attestation starts April 18http://www.iatroshealth.com/blog/bid/111417/Meaningful-use-attestation-starts-April-18The window opens April 18 for eligible professionals, hospitals and critical-access facilities to line up and attest that they've met their respective <a href="http://www.modernhealthcare.com/meaningfuluse"><strong><span style="text-decoration: underline;">meaningful-use</span></strong></a> criteria and are eligible to receive Medicare incentive payments for the installation and use of electronic health-record systems under the American Recovery and Reinvestment Act of 2009.<br /><br />Registered providers seeking part of the multibillion-dollar pie of federal EHR incentive payments to be doled out under the Medicare program through 2015 must attest to their meaningful-use status using an online system created by the CMS. <a href="https://www.cms.gov/EHRIncentivePrograms/Downloads/AttestationSneakPeek.pdf"><strong><span style="text-decoration: underline;">A primer (PDF)</span></strong></a> on the attestation process is available at the CMS' website.<br /><br />To meet meaningful-use requirements, physicians and other eligible professionals must report on their achievement in 15 core measures, any five of 10 additional operations measures and six clinical-quality measures. Eligible hospitals and critical-access providers must report on 14 core measures, five of 10 additional measures and 15 clinical-quality measures.<br /><br />During this first year of the Medicare program, both eligible professionals and hospitals must attest that they've met the criteria for 90 consecutive days. Registration opened in January for both eligible professionals and hospitals for the Medicare EHR incentive program.<br /> <div>Read more: <a href="http://www.modernhealthcare.com/article/20110328/NEWS/303289989#ixzz1I5sMoO7N">Meaningful-use attestation starts April 18 - Healthcare business news, research, information and opinions | Modern Healthcare</a> <a href="http://www.modernhealthcare.com/article/20110328/NEWS/303289989#ixzz1I5sMoO7N">http://www.modernhealthcare.com/article/20110328/NEWS/303289989#ixzz1I5sMoO7N</a></div> <br /> <div><!-- END ADVERTISING --><br /><br /></div> <br /> <div></div> <br /> <div><em>Source: Modernhealthcare.com</em></div> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111417/Meaningful-use-attestation-starts-April-18&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:59:00 GMTf1397696-738c-4295-afcd-943feb885714:111417http://www.iatroshealth.com/blog/bid/111418/Patients-say-they-would-pay-more-quickly-with-online-access#Comments0Patients say they would pay more quickly with online accesshttp://www.iatroshealth.com/blog/bid/111418/Patients-say-they-would-pay-more-quickly-with-online-access<p id="Btext1">Patients suggest that if physicians want to improve their collections, they should provide online access.</p> <br />An Intuit Health survey found that patients often are late in paying not because they don't have the money, but because they are confused about their bills. The survey said e-mailing questions and paying online would correct the delay quickly. This would reduce the administrative costs physicians run up by sending multiple mailings to collect one bill, said Warwick Charlton, MD, vice president and chief medical officer for Intuit Health.<br /><br />"Even though there's anxiety about the total costs that they face in health care, the availability of online payment as an option is something that many of them would use," Dr. Charlton said. "And I think that's because it helps their sense of control and visibility and probably ties more directly back to the event" they are paying for.<br /> <h3>70% concerned about bills</h3> <br />The Intuit Health Second Annual Health Care Check-up Survey of 1,000 American adults found that 70% of patients are concerned about managing their health care bills, and two-thirds believe their health care costs will increase. At the same time, 73% said they would use a secure online communication tool that would make it easier to get lab results, request appointments, pay medical bills and communicate with their doctor's office.<br /><br />Forty-five percent of the patients wait more than a month to pay their doctor bills, and half still send paper checks.<br /><br />Part of the problem is that people are confused about their medical bills. For example, one in five patients was unsure whether to pay a physician or insurance company.<br /><br />Sixty-six percent of baby boomers said their costs already increased, and 72% expressed concern about rising costs, compared with 59% of people born after 1965.<br /><br />When compared with younger adults, baby boomers are less demanding of online access. However, a large number of baby boomers are still interested in having e-mail communication with their physicians, Dr. Charlton said.<br /><br />Because people of all ages take care of most other financial transactions online -- banking, travel, retail shopping -- the ability to take care of their medical transactions online is moving from a request to a demand, the survey found.<br /><br />Almost half the survey respondents said they would consider switching to a practice that offered the ability to perform health care tasks online.<br /><br />Offering this function and online scheduling could be important first steps toward a comprehensive online communication tool.<br /><br />"The online dialogue will be started," Dr. Charlton said. Then "it won't seem so foreign and strange" to add other Web-based functions such as lab results and personal health record access, he said.<br /><br /><em>Source: admednews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111418/Patients-say-they-would-pay-more-quickly-with-online-access&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:59:00 GMTf1397696-738c-4295-afcd-943feb885714:111418http://www.iatroshealth.com/blog/bid/111419/Three-Legal-Issues-That-Could-Affect-Your-Florida-Medical-Billing#Comments0Three Legal Issues That Could Affect Your Florida Medical Billinghttp://www.iatroshealth.com/blog/bid/111419/Three-Legal-Issues-That-Could-Affect-Your-Florida-Medical-BillingWatershed changes in the medical industry mean potential legal issues for your Florida medical billing. The federally mandated switch to electronic health records and the implementation of the Patient Protection and Affordable Care Act present multiple challenges that must be addressed with utmost care, as the legal and financial ramifications can be significant. To make sure your Florida medical billing practices stand up to the intensifying scrutiny, iATROS Healthcare Solutions recommends focusing on three main potential pitfalls:<br /><br /><br /><ol><ol> <li><strong>HIPAA and Data Breaches: </strong>Protection of electronic health records (EHRs) is critical as providers implement, learn and tweak their chosen EHR program. The learning curve itself makes practices vulnerable to hackers, as physicians and staff become accustomed to the new programs and are bound to make mistakes in the process. Stolen laptops are the most common type of data breach. Laptop thefts account for 24 percent of reported breaches, with desktop computers involved in 16 percent and mobile devices such as smart phones involved in another 14 percent, according to the U.S. Department of Health and Human Services. A data breach of any sort is expensive, incurring both hefty fines and requiring patient and media notifications - a draw on your time and human resources.</li> </ol></ol><br /><ol><ol> <li><strong>Recovery Audit Contractors:</strong> RACs are private companies that audit providers for overpayments and get a share of what they find. Right now, they're working primarily with Medicare payments, but soon will spread to Medicaid and Medicare Advantage payments. Some have levied criticisms against RACs that fail to use CMS payment criteria in evaluating claims, so be sure that your claim filings will stand the CMS test. Also, know that you can appeal an RAC decision, but appeals are expensive and time consuming.</li> </ol></ol><br /><ol><ol> <li><strong>Medical Malpractice and Tort Reform:</strong> In his State of the Union address in January, President Obama said he would consider proposals designed to eliminate frivolous medical malpractice lawsuits. That statement followed the introduction of a tort reform bill that would cap noneconomic (pain and suffering) damages at $250,000 - similar to multiple versions that have been introduced by House Republicans and failed in the Senate since 2002. An AMA report showed that medical liability premiums in the U.S. grew by upwards of 950 percent and proponents of tort reform say those skyrocketing costs are an unnecessary expenditure in an already struggling industry. In any case, nearly every state requires physicians to have liability insurance and even in exempt states, it's typically required for hospital privileges.</li> </ol></ol> <p><br /><br />To assure that every aspect of your Florida medical billing and coding stands up to legal scrutiny, contact iATROS Healthcare Solutions at 904-296-1160 or complete our simple online form for a free performance analysis.</p> <p>&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 328px; height: 51px; display: block; border-width: 0px;" id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111419/Three-Legal-Issues-That-Could-Affect-Your-Florida-Medical-Billing&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:58:00 GMTf1397696-738c-4295-afcd-943feb885714:111419http://www.iatroshealth.com/blog/bid/111421/Repeal-of-ACA-s-1099-tax-reporting-requirement-stalled-in-Congress#Comments0Repeal of ACA's 1099 tax-reporting requirement stalled in Congresshttp://www.iatroshealth.com/blog/bid/111421/Repeal-of-ACA-s-1099-tax-reporting-requirement-stalled-in-CongressWASHINGTON &ndash; There is one small part of the Affordable Care Act that both Republicans and Democrats seem to agree on: A desire to repeal the provision that requires small businesses, including physicians, to file an IRS 1099 form for each vendor purchase of $600 or more.<br /><br />A bill repealing the 1099 provision has passed both the House and the Senate this year, with more than three-quarters of Congress showing support. In his State of the Union speech on January 25, President Barack Obama said the provision was a mistake and should be repealed. "We can start right now by correcting a flaw in the legislation that has placed an unnecessary bookkeeping burden on small businesses," he said.<br /><br />Only one problem remains: The price tag.<br /><br />A repeal of the IRS 1099 provision carries with it $19 billion in lost tax revenues. On Capitol Hill, where budget battles are molten and Congress struggling with fiscal year 2012 budget differences, that could put a damper on things.<br /><br />The Senate version of the bill, introduced by Sen. Debbie Stabenow (D-Mich.), passed on February 2. "Rather than focusing on issues that divide us, this is an issue that we can all come together on," Stabenow said. "If left unchecked, 40 million small businesses would see their IRS 1099 paperwork increase 2,000 percent."<br /><br />Passage of Rep. Dan Lungren's (R-Calif.) House version came a month later.<br /><br />There's no shortage of support for doing away with the provision. The American Medical Association has been joined by the U.S. Chamber of Commerce, National Association of Manufacturers, American Farm Bureau, National Association of Realtors and other organizations in supporting the repeal.<br /><br />"It is estimated that paperwork already takes up as much as a third of a physician&rsquo;s workday &ndash; time that could be better spent with patients &ndash; and this provision would only increase that burden," said AMA President Cecil Wilson, MD.<br /><br />On the House floor on March 3, Ways and Means Committee Chairman David Camp (R-Mich.) summed up the frustration: "Some have even gone so far to say there have been 1,099 votes to repeal 1099s."<br /><br /><em>Source: Healthcare Finance News</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111421/Repeal-of-ACA-s-1099-tax-reporting-requirement-stalled-in-Congress&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:57:00 GMTf1397696-738c-4295-afcd-943feb885714:111421http://www.iatroshealth.com/blog/bid/111422/Private-Employers-Paying-For-Better-Health-Choices#Comments0Private Employers Paying For Better Health Choiceshttp://www.iatroshealth.com/blog/bid/111422/Private-Employers-Paying-For-Better-Health-ChoicesIn an interesting parallel to the federal government&rsquo;s efforts, private employers are also offering cash incentives to employees who make healthier lifestyle choices.<br /><br />HHS set-aside $100 million for the Affordable Care Act funding, through which states can create innovative incentive programs for Medicaid beneficiaries.<br /><br />Today, private employers, too, are giving workers perks in exchange for quitting smoking, losing weight and managing their diabetes symptoms. In fact, a growing number of employers (62 percent) offered health incentive programs in 2010 than in 2009 (57 percent), and they spent 65 percent more on those programs, according to a new report from Fidelity Investments and the National Business Group on Health. Employers averaged $430 per employee in 2010 compared to only $260 in 2009.<br /><br />The incentives included cash, gift cards and financial contributions to health savings accounts. There were even a few punitive actions, including cases in which 12 percent of employers reduced their contribution to an employee&rsquo;s health plan if the employee refused to participate in wellness efforts.<br /><br />Interesting note: More than 50 percent of employers who offered health incentives extended them to family members and dependents as well, according to the report. And they spent almost as much as for the employees themselves--an average of $420 for family members.<br /><br />California already has tried incentive programs in its Medicaid program, with some success. For example, the program gives amusement park tickets to children who receive their wellness checks on time, the Orange County Register reports.<br /><br />Source: FierceHealthcare.com <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111422/Private-Employers-Paying-For-Better-Health-Choices&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:56:00 GMTf1397696-738c-4295-afcd-943feb885714:111422http://www.iatroshealth.com/blog/bid/111423/Physicians-to-get-relief-from-Medicare-lab-paperwork-rule#Comments0Physicians to get relief from Medicare lab paperwork rulehttp://www.iatroshealth.com/blog/bid/111423/Physicians-to-get-relief-from-Medicare-lab-paperwork-rule<p id="Btext1">Washington - Responding to pressure from the American Medical Association and others, the Centers for Medicare &amp; Medicaid Services has indicated that it will rescind a new Medicare rule requiring physicians to provide their signatures on requisitions for laboratory tests. Doctors had warned that the rule would have created paperwork headaches for medical professionals ordering and fulfilling lab test requests, ultimately having an adverse impact on patient care.</p> <p><br />The signature policy has been on the books since Jan. 1, but it was never enforced by the Medicare agency. CMS finalized the rule in its 2011 physician fee schedule in November 2010. However, citing concerns about lack of awareness of the change in the health care industry, the agency delayed enforcement of the policy until April 1.<br /><br /><!--start_subsbox--> <!--subsbox--> <!--end_subsbox-->Lawmakers soon became involved, requesting an additional nine-month enforcement delay. Reps. Michael Burgess, MD (R, Texas) and Bill Pascrell Jr. (D, N.J.) wrote a Feb. 10 letter to the agency stating, "We worry about how the rule could affect Medicare beneficiaries where such lab services are necessary for a physician to make critical decisions that affect patients' health and well-being, often under significant time constraints, and urge CMS to consider these situations as they examine this policy." The letter was signed by 87 other lawmakers. A group of 34 senators sent a similar letter to CMS on Feb. 11.<br /><br />But the AMA, along with several other members of organized medicine, called for the agency to abolish the signature rule permanently.<br /><br />"We clearly communicated to CMS that the added administrative hassles this rule would impose on physicians were burdensome and unnecessary," said AMA President Cecil B. Wilson, MD. "CMS' decision to reverse this policy will allow physicians to spend less time on paperwork and more time on patient care. This decision is an important step as the administration works to ease regulatory burdens for businesses, including physician practices."<br /><br />CMS spokeswoman Ellen Griffith would not comment on how the agency would go about rescinding the rule. "All I can confirm is that the agency is taking another look at the policy and considering next steps," she said.</p> <h3>Not a new concept</h3> <br />The lab signature policy had been in development for several years. CMS proposed the rule in 2009, but it chose not to finalize it because of concerns raised during a public comment period. In 2010, agency officials had enough confidence that they had ironed out those details that they decided to include a signature requirement in the 2011 fee schedule.<br /><br />The rule would not create an extra burden for physicians, CMS had said, because in most instances a physician already is annotating the patient's medical record with either a signature or an order, as well as with any paperwork needed to identify the lab test. The agency also noted that a signature in ink would not be required for similar requisitions made over the phone or through an electronic medical record system.<br /><br />In the final fee schedule rule, CMS further defended its decision by stating that the policy would make it easier for lab technicians to know whether a test was appropriately requested. Also, "potential compliance problems would be minimized for laboratories during the course of a subsequent Medicare audit because a signature would be consistently required."<br /><br />But physicians argued that the signature requirement would create an additional barrier between them and their patients. The policy could interfere with a physician's ability to practice medicine professionally and efficiently, said Jeff Terry, MD, a urologist in Mobile, Ala. He said physicians can't be in front of patients to sign requisitions all of the time.<br /><br />For instance, Dr. Terry said, a scenario might exist where a physician performing surgery in the operating room receives an urgent call for another patient. The doctor already is aware of the second patient's problem, so he wants the patient to get an x-ray immediately, then follow up with the physician in the office later. The physician's nurse could provide the patient with the requisition needed to obtain the x-ray, expediting the process in a way that benefits both patient and physician, he said. This handoff would not be possible if a physician signature requirement were in place.<br /><br />"Patients with kidney stones don't want to wait another day for me to sign the paper before they can do a test," he said.<br /><br />Before the most recent rule change, CMS had been very clear that doctor sign-offs weren't required, said JoAnne Glisson, senior vice president of the American Clinical Laboratory Assn. in Washington, D.C. Consequently, almost all requisitions arrive at labs without signatures.<br /><br />The new policy had left labs facing a choice between two unpleasant options if they wanted to be paid by Medicare for all the services they provide, said Richard Daly, CEO of Laboratory Partners, a large full-service lab company based in Cincinnati that runs about 5.5 million tests a year. "One would be to not provide the test -- or provide the test and chase the physician or facility for a signature," he said. "Neither was a great solution."<br /><br />Glisson said senior CMS officials informed the lab association that they were going to rescind the policy. She said the agency would need to issue an interim final rule to undo the requirement before April 1, but the new document had not been released at this article's deadline.<br /><br /><em>Source: amednews.com</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111423/Physicians-to-get-relief-from-Medicare-lab-paperwork-rule&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:54:00 GMTf1397696-738c-4295-afcd-943feb885714:111423http://www.iatroshealth.com/blog/bid/111424/Florida-Medical-Billing-and-Medicare-Audits-Intensify#Comments0Florida Medical Billing and Medicare Audits Intensifyhttp://www.iatroshealth.com/blog/bid/111424/Florida-Medical-Billing-and-Medicare-Audits-Intensify<p>Your Florida medical billing just got tougher. Reports show that <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php" target="_self">Medicare billing </a>audits are intensifying. Auditors who once focused primarily on documentation today are digging deeper, questioning physicians' diagnoses and rejecting claims when they disagree with a diagnosis or procedure.<br /><br />The trend is apparent in the rejections of two recent claims. In one, the auditor refused a physician's aspiration pneumonia diagnosis, citing a lack of specific imaging evidence. In another, the RAC (recovery audit contractor) argued that a patient's medical records did not support acute renal failure as the secondary diagnosis.<br /><br />Medicare billing auditors traditionally focused on basics such as assuring that medical charts contained proper documentation such as physician orders, service delivery dates and signatures, Kevin Cornish, national director of Navigant Consulting's healthcare dispute, compliance and investigation practice told reporters. "Now it's 'what was the diagnosis, what was the history, what tests were run, what decisions were made in terms of the procedures performed, and was it consistent with Medicare requirements?'"<br /><br />Many healthcare providers argue that RACs are stepping out of professional and legal bounds. For instance, numerous claims have been denied because the submitting physician did not base the diagnosis on clinical guidelines even though use of those guidelines is not required by Medicare. In one case, an RAC wrongly denied a claim by applying Correct Coding Initiative (CCI) edits before they had taken effect. And many hospitals say their valuable time, financial and human resources are being wasted with audits that don't meet CMS (Centers for Medicare Services) guidelines.<br /><br />To assure your Florida medical billing and Medicare billing can stand up to auditing, contact <a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions</a>. Our staff of highly experienced Florida medical billing and <a href="http://www.iatroshealth.com/medical-coding-florida.php" target="_self">coding </a>specialists stays up-to-the-minute on industry changes, including the thousands of new diagnosis and procedure codes brought by ICD-10. Reach us via phone at 877-900-6763 or sign up online for a free performance analysis.</p> <p>&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 328px; height: 51px; display: block; border-width: 0px;" id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111424/Florida-Medical-Billing-and-Medicare-Audits-Intensify&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:53:00 GMTf1397696-738c-4295-afcd-943feb885714:111424http://www.iatroshealth.com/blog/bid/111425/Rand-study-looks-at-how-to-improve-quality-measures-for-new-payment-models#Comments0Rand study looks at how to improve quality measures for new payment modelshttp://www.iatroshealth.com/blog/bid/111425/Rand-study-looks-at-how-to-improve-quality-measures-for-new-payment-models<p>BOSTON &ndash; New efforts are needed to develop and refine quality-of-care and other performance measures that can assure new payment models will improve medical care without harming patients, according to a new RAND Corporation study.</p> <br /> <p>While some current quality measurement tools may be useful to new performance-based payment models, significant work is needed to design and test methods, which can be applied to measuring the quality of care provided under innovative payment reforms, according to the report.</p> <br /> <p><strong></strong>"Insurers and purchasers of healthcare in the United States are on the verge of potentially revolutionary changes in the approaches used to pay for healthcare," said Eric Schneider, the study's lead author and a senior natural scientist at RAND, a nonprofit research organization. "A significant investment is needed to develop new performance measures that can assure high quality care as the United States experiments with these new payment models."</p> <br /> <p>The RAND report, sponsored by the National Quality Forum, studied 90 payment reform programs and identified 11 general payment reform models that reward providers for delivering better-quality, cost-conscious care or pay health care providers a fixed amount to coordinate treatment of an illness such as diabetes.</p> <br /> <p>Researchers say the 11 payment models vary widely in how they alter current payment methods, the patients and services affected, and the number of clinical providers that might be subject to the new payment arrangements.</p> <br /> <p>To date, payment reform models have focused on hospitals, outpatient medical practices and physicians, but future performance-based payment reform will also include other types of providers such as long-term care settings and surgery centers.</p> <br /> <p><strong></strong>The researchers identified five priority areas for further development and refinement of healthcare quality measures that could be applicable to many of the 11 payment reform models:</p> <br /><br /> <ul> <ul> <li>Health outcome measures that can be used to assess the health status of populations, including patients' quality of life and safety outcomes, such as avoiding harms that can be caused by healthcare.</li> </ul> </ul> <br /> <ul> <ul> <li>Quality measures that can be used to examine the way care is coordinated among health providers, such as when a patient is transitioned from a hospital to outpatient care or a nursing home.</li> </ul> </ul> <br /> <ul> <ul> <li>Programs that can be used to assess the participation of patients and their caregivers in their medical care.</li> </ul> </ul> <br /> <ul> <ul> <li>Measures that can be used to assess the structure of health systems, particularly those built to respond to the new payment models. Items to be assessed should include the quality of care management and the use and functionality of electronic health records.</li> </ul> </ul> <br /><br /> <p>Researchers also say that effort is necessary to assure that payment reforms do not increase disparities in healthcare. Measures for this purpose would monitor access to care and detect whether providers are turning away high-risk or medically-complicated patients.</p> <br /> <p>Since at least the 1980s, the traditional fee-for-service model of healthcare payment has been challenged by reforms that alter payment methods in order to limit costs. Critics say that the persistent use of fee-for-service &ndash; where health providers are rewarded only when they provide more care &ndash; encourages unnecessary healthcare spending without enhancing quality or efficiency.</p> <br /> <p>The Patient Protection and Affordable Care Act of 2010 has given new impetus to payment reforms that can achieve both cost containment and improvements in healthcare quality. Most of the new approaches are expected to tame costs by reversing incentives to deliver more care. Instead they create incentives to providers and patients to weigh the costs of their medical choices. But some worry that if providers are at financial risk, these payment models may have mixed consequences for quality. Quality measurement should be used to assure that the financial incentives produce high quality cost-conscious care.</p> <br /> <p><em>Source: Healthcare Finance News</em></p> <br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111425/Rand-study-looks-at-how-to-improve-quality-measures-for-new-payment-models&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:53:00 GMTf1397696-738c-4295-afcd-943feb885714:111425http://www.iatroshealth.com/blog/bid/111426/Obama-s-FY12-Budget-Includes-Money-For-Medicare-Doctor-Payments#Comments0Obama's FY12 Budget Includes Money For Medicare Doctor Paymentshttp://www.iatroshealth.com/blog/bid/111426/Obama-s-FY12-Budget-Includes-Money-For-Medicare-Doctor-PaymentsWASHINGTON &ndash; President Barack Obama has released a fiscal year 2012 budget proposal that includes funding to stabilize Medicare physician payments.<br /><br />According to Health and Human Services Secretary Kathleen Sebelius, the Obama administration worked in December with Congress to offset the cost of legislation preventing an imminent decrease in physician payments due to the Medicare Sustainable Growth Rate (SGR) formula.<br /><br />Dec. 15, Obama signed H.R. 4994, the Medicare and Medicaid Extenders Act of 2010 into law that will delay a 25 percent Medicare physician pay cut until Dec. 31 of this year. Some political experts and many stakeholders are speculative Congress will be able to solve the problem this year.<br /><br />&ldquo;The budget goes further and proposes to continue the current level of payment, and offset the increase above current law for the next two years with specific savings,&rdquo; Sebelius told members of the Senate Finance Committee. &ldquo;Beyond the next two years, I am determined to work with you to put in place a long-term plan to reform physician payment rates in a fiscally responsible way, and to craft a reimbursement system that gives physicians incentives to improve quality and efficiency, while providing predictable payments for care furnished to Medicare beneficiaries.&rdquo;<br /><br />Obama&rsquo;s $3.7 trillion plan includes $891.6 billion for HHS.<br /><br />&ldquo;For every program we invest in, we know we need to cut somewhere else,&rdquo; Sebelius said. &ldquo;So in developing this budget, we took a magnifying glass to every program in our department and made tough choices. When we found waste, we cut it. When we found duplication, we eliminated it. When programs weren&rsquo;t working well enough, we reorganized and streamlined them to put a new focus on results. When they weren&rsquo;t working at all, we ended them. In some cases, we cut programs we wouldn&rsquo;t in better fiscal times.&rdquo;<br /><br />Sen. Charles Grassley (R-Iowa), senior member of the Senate Budget Committee and the Finance Committee, wasn&rsquo;t pleased with the President&rsquo;s proposal.<br /><br />&ldquo;The President said families have to live within their budgets, but his proposal makes a mockery of that statement,&rdquo; he said. &ldquo;Over 10 years, the debt balloons from $14 trillion today to more than $26 trillion. On any measure of debt, his budget makes things worse, not better.&rdquo;<br /><br />Rich Umbdenstock, president and CEO of the American Hospital Association, said the AHA is pleased that the President&rsquo;s budget doesn&rsquo;t include any new reductions in payments for hospital services to Medicare beneficiaries, but it&rsquo;s &ldquo;deeply disappointed&rdquo; that the budget reduces Medicaid.<br /><br />&ldquo;(A)t a time when hospitals have already been asked to absorb big cuts at the state level and state budgets are already stretched, it is unwise to ask states to continue to do more with less,&rdquo; he said. &ldquo;In addition, we are also disappointed to see elimination of funding for the children&rsquo;s graduate medical education program at a time when there is a need for an expanded physician workforce.&rdquo;<br /><em><br />Source: Healthcare Finance New</em>s <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111426/Obama-s-FY12-Budget-Includes-Money-For-Medicare-Doctor-Payments&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:52:00 GMTf1397696-738c-4295-afcd-943feb885714:111426http://www.iatroshealth.com/blog/bid/111427/Senate-repeals-IRS-1099-physician-reporting-requirements#Comments0Senate repeals IRS 1099 physician reporting requirementshttp://www.iatroshealth.com/blog/bid/111427/Senate-repeals-IRS-1099-physician-reporting-requirementsWASHINGTON &ndash; The Senate has passed legislation that would repeal a provision of the Affordable Care Act that requires small businesses, including physicians, to file an IRS form 1099 for each vendor purchase of $600 or more.<br /><br />The provision, introduced by Sen. Debbie Stabenow (D-Mich.), was passed the Senate on February 2 with bipartisan support. Stabenow is now urging the House to pass its version of the provision, which also has wide support.<br /><br />"Rather than focusing on issues that divide us, this is an issue that we can all come together on," she said.<br /><br />"If left unchecked, 40 million small businesses would see their IRS 1099 paperwork increase 2000 percent," she added.<br /><br />The American Medical Association has been pushing for elimination of the 1099 requirement.<br /><br />"The AMA applauds the Senate&rsquo;s vote in support of the Stabenow amendment to repeal the unnecessary and burdensome IRS 1099 reporting requirement that was included as part of the health reform law," said AMA President Cecil Wilson, MD. "It is estimated that paperwork already takes up as much as a third of a physician&rsquo;s workday &ndash; time that could be better spent with patients &ndash; and this provision would only increase that burden."<br /><br />"As the nation&rsquo;s largest physician organization, the AMA will continue working during the implementation phase of the health reform law to ensure the best outcomes for patients and physicians by advocating for improvements including expanded medical liability reforms and major changes in the IPAB framework," Wilson said.<br /><br />In his State of the Union Address on January 25, President Barack Obama gave the nod for eliminating the 1099 provision found in the healthcare reform law.<br /><br />"If you have ideas about how to improve this law by making care better or more affordable, I am eager to work with you," he told Congress. "We can start right now by correcting a flaw in the legislation that has placed an unnecessary bookkeeping burden on small businesses."<br /><br /><strong></strong><em>Source: Healthcare Finance News</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111427/Senate-repeals-IRS-1099-physician-reporting-requirements&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:52:00 GMTf1397696-738c-4295-afcd-943feb885714:111427http://www.iatroshealth.com/blog/bid/111428/Florida-lawsuit-ruling-brings-mixed-reactions#Comments0Florida lawsuit ruling brings mixed reactionshttp://www.iatroshealth.com/blog/bid/111428/Florida-lawsuit-ruling-brings-mixed-reactionsCritics of the Patient Protection and Affordable Care Act hailed a Florida judge's decision to strike the law as a step toward protecting citizens' freedom, while supporters of the ACA said the decision was nothing short of &ldquo;judicial activism.&rdquo;<br /><br />U.S. District Judge Roger Vinson in Pensacola struck down the entire reform law on Monday, saying its mandate for individual Americans to purchase qualifying health insurance plans was unconstitutional and yet so central that nothing else in the 900-page law could stand without it. It was the fourth federal judicial ruling on the law's constitutional merits, and the second to find the mandate illegal.<br /><br />Karen Harned, executive director of the Small Business Legal Center of the National Federation of Independent Business, which was one of the plaintiffs, said in a written statement that the mandate conflicts with the right of small-business owners to operate free from unnecessary government intervention. &ldquo;The individual mandate &hellip; undermines this core principle and gives the federal government entirely too much power,&rdquo; Harned said.<br /><br />Ron Pollack, executive director of Families USA, which filed a friend-of-the-court brief defending the reform law, said in a statement that Vinson's opinion was &ldquo;radical judicial activism run amok.&rdquo;<br /><br />&ldquo;We are confident, as this and other cases are decided on appeal, that the Affordable Care Act will be upheld in its entirety,&rdquo; Pollack said.<br /><br /><em>Source: ModernHealthcare.com</em><em></em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111428/Florida-lawsuit-ruling-brings-mixed-reactions&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:51:00 GMTf1397696-738c-4295-afcd-943feb885714:111428http://www.iatroshealth.com/blog/bid/111429/With-iATROS-EMR-Consulting-Florida-Providers-Keep-Medical-Liability-Insurance-Premiums-Low#Comments0With iATROS EMR Consulting, Florida Providers Keep Medical Liability Insurance Premiums Low http://www.iatroshealth.com/blog/bid/111429/With-iATROS-EMR-Consulting-Florida-Providers-Keep-Medical-Liability-Insurance-Premiums-LowAccording to a recent <a href="http://www.conning.com/viewpublications-article.aspx?id=5187" target="_self">study</a>, adoption of electronic medical records (EMR) may cause yet another increase in medical malpractice insurance premiums. With the right <a href="http://www.iatroshealth.com/emr-consulting-florida.php" target="_self">EMR consulting</a>, Florida providers can keep their insurance costs at bay.<br /><br />Researchers with Hartford, Conn.-based Conning Research and Consulting concluded that the mandated switch to EMR, along with the increasing roles of nurse practitioners and physician reimbursements that reward lower-cost treatment options, will boost chances of error, particularly in the initial EMR adoption phase. This will drive up medical liability claims and costs for defending them, and those costs will get passed along to healthcare providers in the form of higher medical liability insurance premiums.<br /><br />The numbers are daunting. Researchers estimate that more than 90 hospitals and medical practices have yet to implement EMR systems that meet federal meaningful use standards and ObamaCare will bring more than 30 million new insureds by 2014. As providers and their staff members learn new EMR technology, coding data errors and software operability failure are bound to occur, particularly during testing and early adoption periods. And as patients gain easier access to their EMRs, they may discover lapses in treatment protocols embedded in their records. All of these mean potential claims and medical liability insurance cost boosts.<br /><br /><a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions</a> can help. With EMR consulting, Florida clients can be assured that their transition to electronic medical records will be seamless. Our staff of medical coding, medical billing and practice management specialists can help you choose the best EMR system (more than 300 are on the market today) for your practice and walk you through the implementation process to help you avoid system failures and common errors. We also offer <a href="http://www.iatroshealth.com/medical-coding-florida.php" target="_self">medical coding</a>, <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php" target="_self">medical billing</a> and <a href="http://www.iatroshealth.com/medical-practice-management-florida.php" target="_self">practice management services</a> that allow you to focus on caring for your patients while we care for your business.<br /><br />If you'd like to talk with a specialist in EMR consulting, Florida-based iATROS Healthcare Solutions can be reached at 904-296-1160 or via our online "Contact our Specialist" feature. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111429/With-iATROS-EMR-Consulting-Florida-Providers-Keep-Medical-Liability-Insurance-Premiums-Low&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:50:00 GMTf1397696-738c-4295-afcd-943feb885714:111429http://www.iatroshealth.com/blog/bid/111430/Tips-to-Boost-your-Florida-Medical-Billing-Success#Comments0Tips to Boost your Florida Medical Billing Successhttp://www.iatroshealth.com/blog/bid/111430/Tips-to-Boost-your-Florida-Medical-Billing-SuccessFlorida medical billing statistics show that on average, more than 20% of a physician's net revenues go uncollected; 30% of insurance claims are rejected during the first submission; and of those, 50% are never resubmitted.<a href="http://www.iatroshealth.com/" target="_self"> iATROS Health Care Solutions</a> offers tips to help assure your medical firm collects full payment for your valuable services more often.<br /><br /><ol><ol> <li><strong>Track your claims from point A to payor: </strong> Each electronic claim for payment that you submit goes first to your EDI (Electronic Data Interchange) company, then to the payor. However, if your EDI does not have a contract with a particular payor, the claim may first go to a number of trading partners, increasing the time it takes to reach the payor and the chance of error. Both can mean big delays in your getting paid. To help minimize delays, make phone calls to your EDI and each trading partner to assure that your claim is being processed correctly and forwarded quickly all along the way.</li> </ol></ol><br /><ol><ol> <li><strong>Don't neglect the operative note section in your Florida medical billing: </strong>A medical service never documented never happened, as far as a payor is concerned. Studies show that many simpler procedures performed often are skipped in the operative note, although they can mean additional reimbursement. Incomplete or unclear operative notes that result in missed payments most commonly involve bilateral or multiple procedures; identification of surgical sites or specific areas treated; detailed implant information; ancillary procedures performed; any complications or deviations from normal expectations, including a procedure that takes more time than is typical; and postoperative pain management details.</li> </ol></ol><br /><ol><ol> <li><strong>Develop a collection policy for self-pay patients and stick to it: </strong>A great rule of thumb is to issue statements to the patient on the day the services were rendered and at 30 and 60 days if payment remains outstanding. If no results, patients should go into pre-collection, then bad debt collection procedures at 90-120 days and should be notified quickly.</li> </ol></ol><br /><ol><ol> <li><strong>Claim rejected? Resubmit!: </strong>Statistic showing that 30% of insurance claims are rejected on the first try and 50% of them are never resubmitted means a lot of money left on the table, or delayed indefinitely. Often this happens because of a simple mistake like a wrong digit in a social security number that can easily be fixed. Make sure that your Florida medical billing staff immediately review rejected claims for mistakes or omissions and resubmit quickly.</li> </ol></ol><br /><ol><ol> <li><strong>Audit your Florida medical billing procedures and staff:</strong> Make sure that someone is overseeing and regularly spot-checking your billing staff's work. Also assign an employee to regularly check insurance companies' explanation of benefits reports for any changes in a patient's policy or an insurer's offerings. This can help you confirm whether a frequent problem is an external or internal issue and keep your billing staff on their toes.</li> </ol></ol><br /><br />iATROS Health Care Solutions offers numerous services to improve your Florida medical billing success, from simply augmenting your staff day-to-day procedures or taking over your <a href="http://www.iatroshealth.com/medical-coding-florida.php" target="_self">medical coding</a>, <a href="http://www.iatroshealth.com/patient-billing-and-collections.php" target="_self">patient billing</a> or <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php" target="_self">insurance company billing,</a> follow up and collections for you. Call 904-296-1160 or <a href="http://www.iatroshealth.com/contact.php" target="_self">reach us online</a> for a free performance analysis. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111430/Tips-to-Boost-your-Florida-Medical-Billing-Success&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:49:00 GMTf1397696-738c-4295-afcd-943feb885714:111430http://www.iatroshealth.com/blog/bid/111431/Keep-it-simple#Comments0Keep it simplehttp://www.iatroshealth.com/blog/bid/111431/Keep-it-simpleThe cost of inefficient healthcare claims processes, payment, and reconciliation is estimated to be as much as $210 billion, eating up 10% to 14% of physician practice revenue, according to the American Medical Association (AMA).<br /><br />A recent study by a team of researchers at Massachusetts General Hospital illuminates the frustration of the current medical billing system.<br /><br />After analyzing the billing system of a physician's group affiliated with a large urban academic teaching hospital, the researchers discovered that 12.6% of claims are initially rejected. With considerable staff time and effort, 81% of these claims eventually are paid.<br /> <table id="inlineAd" align="left"> <tbody> <tr> <td>&nbsp;</td> </tr> </tbody> </table> <br />They also found that standardizing the medical billing system&mdash;using a single set of payment rules for multiple payers, a single claim form, and standard submission rules&mdash;saved significant staff time and could save U.S. physicians about $7 billion annually.<br /><br />Administrative simplification provisions in the Patient Protection and Affordable Care Act seek to create uniformity of standards for several types of electronic health information transactions and mandate the creation of specific operating rules. Currently, claims can be submitted 400 different ways.<br /><br />The secretary of the U.S. Department of Health and Human Services has until January 1, 2012, to solicit input on electronic standardization of enrolling healthcare providers and transparency and consistency in claims processing.<br /><br /><strong>COSTLY PROCESSES</strong><br /><br />"Each health insurer uses a different set of guidelines for processing and paying medical claims," says AMA President Cecil B. Wilson, MD. "This variability requires physicians to maintain a costly claims management system for each insurer, placing a substantial administrative burden on physicians that adds a huge, unnecessary cost to our healthcare system."<br /><br />The American Academy of Family Physicians (AAFP) also sees administrative simplification as "imperative" to the future of healthcare. The AAFP estimates that simplifying administrative tasks could save the healthcare system $300 billion annually.<br /><br />The group advocates several measures to simplify administrative processes, including electronic health records, eligibility verification and benefits, health identification card standards, credentialing, real-time claims adjudication, healthcare contracting, electronic payments and statements, prior authorizations, and e-prescribing.<br /><br />AAFP President Roland A. Goertz, MD, MBA, FAAFP, says the organization also supports a redesign of healthcare processes to provide a blended payment methodology, wherein physicians receive incentives based on how care is coordinated and transitioned.<br /><br />"There is a lack of incentives built into payment systems to utilize all the modern tools to improve the process of care," Goertz says.<br /><br /><strong>STUDYING THE PROBLEM</strong><br /><br />There is no shortage of information available about how administrative complexities bog down the healthcare system.<br /><br />The AAFP is part of a public/private partnership with the American Health Information Management Association and the Medical Group Management Association (MGMA) that founded the Healthcare Administrative Simplification Coalition (HASC), which is committed to reducing the administrative costs and complexity of healthcare. The HASC released a report&mdash;"Bringing Better Value: Recommendations to Address the Costs and Causes of Administrative Complexity in the Nation's Healthcare System"&mdash;that estimates that reducing administrative costs by just 10% could save as much as $500 billion over 10 years.<br /> <table id="inlineAd" align="left"> <tbody> <tr> <td>&nbsp;</td> </tr> </tbody> </table> <br />As much as one-fourth of U.S. healthcare spending goes to administrative functions, according to the HASC, which outlined several points for a voluntary coordinated nationwide approach to key administrative processes, including:<br /><br /> <ul> <ul> <li>a universal credentialing form to eliminate repetitious paperwork;</li> </ul> </ul> <br /> <ul> <ul> <li>adoption of an industry-wide standard for interchangeable electronic data in determining and verifying patient insurance coverage;</li> </ul> </ul> <br /> <ul> <ul> <li>standardizing healthcare patient identification cards; and</li> </ul> </ul> <br /> <ul> <ul> <li>improving coordination of prior authorization processes for radiology and pharmacy services.</li> </ul> </ul> <br /><br />The AMA's 2010 National Health Insurer Report Card found that the health insurance industry has about an 80% accuracy rate for processing and paying claims, but $777.6 million in unnecessary administrative costs could be saved if the industry improves claims processing accuracy by as little as 1%. Bumping that accuracy rating up to 100% would save up to $15.5 billion annually.<br /><br />The AMA advocates automated, real-time health plan transactions, along with a reduction in manual processes throughout the physician's claims management revenue cycle, increased health insurer claim-process transparency, and reduced ambiguity.<br /><br />"The AMA is working to ensure that the administrative simplification regulations in the new health reform law simplify the claims process through the adoption of consistent standards," Wilson says. "Hundreds of billions of dollars in cost savings for patients and physicians can be achieved through regulations that support a meaningful health plan identifier and a uniform set of operating rules."<br /><br />Whittling down the processes of more than 1,000 different insurers and agents into one set of standards will be difficult because of the number of entities involved, says William F. Jessee, MD, FACMPE, FACPM, president and chief executive officer of the MGMA.<br /><br />With no final rules in place to date, health plans are reluctant to offer electronic claim attachment options, vendors have not produced supporting software products, and providers cannot move forward.<br /><br />The benefits of adopting a single set of electronic standards, according to the MGMA, include eliminating lost paper attachments, accelerating the claim adjudication process, reducing follow-up time and eliminating the cost of paper and stamps. The MGMA estimates a potential $9.4 billion in savings over 10 years, just for electronic claim attachment.<br /><br />"I think it's just human nature; everyone would rather get up and do the same thing they did yesterday," says Jessee. "Trying to get an industry as large as the healthcare industry to all agree on the particular change is complicated. There's everything from fear that someone will accuse us of antitrust violations to having to change a computer system."<br /><br />The question, Jessee adds, is whether everyone can get past the fears and work together.<br /><br />"I'm hopeful everybody will bite the bullet," he says. "We spend 30 cents out of every healthcare dollar in the United States on administrative costs. Most developed nations spend 5% to 8%. Part of our healthcare cost problem is that administrative costs are so convoluted and expensive, and a lot of that has to do with standardization."<br /><br />There is a lot of money to be saved, but getting to the savings requires getting past the inertia of current business practices, he adds.<br /> <table id="inlineAd" align="left"> <tbody> <tr> <td>&nbsp;</td> </tr> </tbody> </table> <br />The Health Insurance Portability and Accountability Act (HIPAA) of 1996 first addressed administrative simplification by providing a basic level of specifications. A lack of detailed operating rules led to significant variations among payers, however. Providers now find themselves dealing with significant rework or workaround processes since the patchwork of systems cannot communicate with each other.<br /><br />"HIPAA has provided the healthcare system with a solid starting point for administrative standards; however, improvements are needed to increase uniformity and simplify the claims process," Wilson says.<br /><br />The administrative simplification provisions included in the healthcare reform legislation are designed to standardize transactions and operating rules to eliminate these issues.<br /><br />"If the rules work as intended, they should make it possible to determine an individual's eligibility and financial responsibility for special healthcare services in real time, that is, prior to or at the point of care," says John Garner, CEBS, CLU, principal of California-based Garner Consulting.<br /><br />In the meantime, physicians can look at being creative and innovative in their own offices&mdash;specifically by adopting health information technology, Goertz says. Making routine functions automatic will dramatically reduce costs by removing redundancy and moving the focus from paperwork to patients, he adds.<br /><br />The AMA similarly encourages both physicians and health insurers to make routine functions automatic through the HIPAA electronic standard transactions to dramatically reduce unnecessary costs, says Wilson.<br /><br />"One thing needed in the future is the creative, innovative application of technology to the process of how we do care," says Goertz. "We've just touched on the surface of how that will impact care in the future."<br /><br /><em>Source: American Medical Association</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111431/Keep-it-simple&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:48:00 GMTf1397696-738c-4295-afcd-943feb885714:111431http://www.iatroshealth.com/blog/bid/111432/Survey-41-percent-of-mid-sized-practices-are-struggling#Comments0Survey: 41 percent of mid-sized practices are strugglinghttp://www.iatroshealth.com/blog/bid/111432/Survey-41-percent-of-mid-sized-practices-are-strugglingSAN FRANCISCO &ndash; Nearly one in three doctors cite practice management costs and administrative burdens as a chief concern for their practice, according to a new survey.<br /><br />The survey was conducted in December by Practice Fusion, a San Francisco-based EHR provider, and MDLinx. It collected responses from a national sample of 100 physicians, the majority of which were primary care providers with fewer than six providers.<br /><br />Officials say the "2011 State of the Small Practice" survey highlights the challenges faced by private practices nationwide in an environment of economic downturn, technology mandates and healthcare reform.<br /><br />"Small primary care medical practices are the backbone of the U.S. healthcare system," said Ryan Howard, CEO of Practice Fusion. "These are family doctors on the front lines; they're passionate about caring for their patients and our survey indicates that they're struggling."<br /><br />According to the survey, 41 percent of doctors report that their practice is doing worse this year than compared to last year; 26 percent reported their practice is doing better, and 31 percent reported no change.<br /><br />The survey indicates that insurance reimbursement delays and payments are a big concern for doctors, with 26 percent citing it as one of their chief complaints, followed by patient volume and satisfaction (11 percent). Decreases in revenue coupled with lower patient volumes are making it more difficult for doctors to keep up with the costs of running a practice, said officials.<br /><br />Despite the financial pressures, the survey found that 69 percent of doctors report being satisfied or extremely satisfied with their career.<br /><br />Physicians cited advancements in medicine (22 percent), patient quality (19 percent) and improvement in the healthcare workforce (15 percent) as contributing to improved satisfaction in their jobs.<br /><br /><em>Source: Healthcare Finance News</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111432/Survey-41-percent-of-mid-sized-practices-are-struggling&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:48:00 GMTf1397696-738c-4295-afcd-943feb885714:111432http://www.iatroshealth.com/blog/bid/111433/CMS-launches-first-phase-of-Physician-Compare-website#Comments0CMS launches first phase of Physician Compare websitehttp://www.iatroshealth.com/blog/bid/111433/CMS-launches-first-phase-of-Physician-Compare-websiteWASHINGTON &ndash; The Centers for Medicare &amp; Medicaid Services has launched the first phase of its Physician Compare website, which provides online tools aimed at helping Medicare beneficiaries and other consumers choose doctors in their communities.<br /><br />The new resource expands and updates CMS&rsquo; Healthcare Provider Directory, which has been in operation for more than a decade.<br /><br />&ldquo;The new Physician Compare tool begins to fill an important gap in our online tools by providing more information about physicians and other healthcare workers,&rdquo; said Donald Berwick, MD, CMS' administrator. &ldquo;This helps to pave the way for consumers to have similar information about their physicians as they have for nursing homes, home health agencies and health and drug plans.&rdquo;<br /><br />The website is a requirement of last year&rsquo;s health reform law and houses information about healthcare workers enrolled in the Medicare program. It includes information on doctors of medicine, osteopathy, optometry, podiatry and chiropractics as well as on healthcare providers who provide routine care for Medicare beneficiaries, including nurse practitioners, clinical psychologists, dietitians, physical therapists, physician assistants and occupational therapists.<br /><br />While the website includes basic information about physician practices &ndash; including addresses and where the doctors received their degrees and completed residency &ndash; it also shows whether the doctors reported data to CMS through the Physician Quality Reporting System, formerly known as the Physician Quality Reporting Initiative (PQRI). The PQRI is a voluntary program that allows physicians to earn rewards by reporting data and specific quality measures related to providing care for Medicare beneficiaries. In 2009, more than 200,000 healthcare providers reported data to the PQRI.<br /><br />The second phase for the website, to be unveiled later this year, will provide information on whether healthcare providers participated in a voluntary program with CMS to prescribe medications electronically. Further enhancements are planned in coming years to include information on quality of care and patient experiences with individual healthcare providers.<br /><br />CMS has worked with healthcare providers in developing Physician Compare and will continue to seek feedback from the industry through public events, as well as through updates to the Physician Fee Schedule.<br /><br /><em>Source: Healthcare Finance News</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111433/CMS-launches-first-phase-of-Physician-Compare-website&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:47:00 GMTf1397696-738c-4295-afcd-943feb885714:111433http://www.iatroshealth.com/blog/bid/111434/New-Medicare-Rules-Governing-Equipment-Vendors-Affects-Medical-Billing-Miami-Providers#Comments0New Medicare Rules Governing Equipment Vendors Affects Medical Billing, Miami Providers http://www.iatroshealth.com/blog/bid/111434/New-Medicare-Rules-Governing-Equipment-Vendors-Affects-Medical-Billing-Miami-Providers<p>Beginning January 1, new Medicare rules are in effect when it comes to medically-necessary equipment and <a href="http://www.iatroshealth.com/medical-billing-miami.php" target="_self">medical billing</a>. Miami and the surrounding South Florida area may be hardest hit because of the area's high Medicare activity.<br /><br />The new Medicare rules (in the works since 2003 and temporarily enacted in 2008) allow reimbursements for certain equipment purchased only from approved vendors. Among the affected items are walkers, motorized scooters, mattresses, hospital beds, feeding-tube supplies, mail-order supplies, oxygen equipment and respiratory devices.<br /><br />"Over the next 10 years, our actuaries estimate it will save $17 billion for the Medicare Part B trust fund and $11 billion for our beneficiaries," Jonathan Blum, deputy administrator of the Centers for Medicare and Medicaid Services told reporters earlier this month. "There is tremendous evidence that the program pays too much for these items and supplies."<br /><br />The program may sound familiar. It actually as enacted in 2008, but shut down by Congress just two weeks later after an outcry from vendors and many seniors. The new rules, in effect as of January 1, 2011, require more stringent bidding requirements and thorough vendor screening processes.<br /><br />These changes are sure to affect your medical billing, Miami. Hospitals and doctors' offices now will have to ensure that the equipment they purchase and the vendors from which those purchases are made are Medicare-approved. It's one more layer of change in an industry already undergoing monumental shifts in quite literally every facet of Medicare and medical billing. Miami providers are under pressure as it is, so they count on companies like iATROS Health Care Solutions to help.<br /><br /><a href="http://www.iatroshealth.com/" target="_self">iATROS Health Care Solutions</a> is a Florida-based company specializing in medical billing (insurance and patient) and coding, EMR consulting and compliance, and medical practice management facets including patient scheduling and verification of patient benefits. Our staff of highly experienced medical billing specialists keep up to the minute on all industry changes and can help assure that you and your practice get the money you have earned caring for patients. To learn how we can help with all your Miami medical billing needs, contact iATROS at (877) 900-6763 or through our online form.</p> <p>&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 156px; height: 47px; display: block; border-width: 0px;" id="hs-cta-wrapper-bd12355c-a0f3-4f0f-89e9-21e73f89c630"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630" id="hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630"> <a href="http://www.iatroshealth.com/contact-us" data-mce-href="http://www.iatroshealth.com/contact-us"><img id="hs-cta-img-bd12355c-a0f3-4f0f-89e9-21e73f89c630" src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" alt="contact-us" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=bd12355c-a0f3-4f0f-89e9-21e73f89c630"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111434/New-Medicare-Rules-Governing-Equipment-Vendors-Affects-Medical-Billing-Miami-Providers&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:46:00 GMTf1397696-738c-4295-afcd-943feb885714:111434http://www.iatroshealth.com/blog/bid/111435/MGMA-s-outlook-Still-waiting-on-reform#Comments0MGMA's outlook: Still waiting on reformhttp://www.iatroshealth.com/blog/bid/111435/MGMA-s-outlook-Still-waiting-on-reformNEW ORLEANS &ndash; Healthcare reform is a hot topic at this years&rsquo; Medical Group Management Association Annual Conference in New Orleans. Everyone is playing the waiting game, but much speculation has been heard during educational sessions.<br /><br />A handful of presenters are targeting the SGR rate problem that Congress has yet to fix.<br /><br />&ldquo;If reform is based upon the current SGR rate, it&rsquo;ll be standing on a house of sand with no foundation &ndash; no chance of survival,&rdquo; said Patrick F. Smith Jr., senior vice president of government affairs for the MGMA and a session presenter.<br /><br />Mention of the SGR rate also echoed at a Monday morning panel discussion led by MGMA President and CEO Bill Jessee. Congress is not expected to fix the rates until the lame duck session later in the year.<br /><br />During 2010, healthcare providers have seen many decisions and regulations, mainly involving payment reform. Pre-existing conditions, lifetime limits and child-dependent coverage have been taken care of. Small business tax credit and imaging regulations have been handled as well.<br /><br />Anders M. Gilberg, MGA, vice presiden of public and private economic affairs for the MGMA and a presenter at AC10, said 2011 should yield some standards for electronic transaction, primary care and other incentives, as well structuring of the Center for Medicare Innovation and PQRI measures.<br /><br />He said there are three payment models to watch:<br /><br /> <ul> <ul> <li>Accountable care organizations</li> </ul> </ul> <br /> <ul> <ul> <li>Bundling of payments</li> </ul> </ul> <br /> <ul> <ul> <li>Value-based payment modifiers</li> </ul> </ul> <br /><br />Attendees are waiting for answers, too. One asked at the end of a session, &ldquo;When payments are bundled, who gets the money? &ldquo;We don&rsquo;t know yet,&rdquo; said Smith.<br /><br />Many sessions focused on general reform objectives &ndash; how to control spending, improve access, create incentives and enhance quality.<br /><br />An eight-state pediatric ACO pilot with Medicaid is expected after the initial ACO rule is released, according to Gilberg, but that has yet to be determined.<br /><br />Gilberg also suggested that medical practices prepare and test for the transition to HIPAA 5010 and ICD-10.<br /><br /><em><br /></em><br /><br /><em>Source: Healthcare Finance News</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111435/MGMA-s-outlook-Still-waiting-on-reform&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:45:00 GMTf1397696-738c-4295-afcd-943feb885714:111435http://www.iatroshealth.com/blog/bid/111437/One-year-Medicare-payment-cut-reprieve-to-be-signed-into-law#Comments0One-year Medicare payment cut reprieve to be signed into lawhttp://www.iatroshealth.com/blog/bid/111437/One-year-Medicare-payment-cut-reprieve-to-be-signed-into-lawToday, the U.S. House of Representatives passed H.R. 4994, the "Medicare and Medicaid Extenders Act of 2010," which would stabilize Medicare physician payments at current rates for 12 months&mdash;through the end of 2011&mdash;and stop the 25 percent cut that was originally scheduled to take effect on Jan. 1. Because the U.S. Senate passed the same piece of legislation by unanimous consent yesterday, Dec. 8, the bill will now be sent to the White House for President Obama to sign into law.<br /><br />In addition to providing a 12-month reprieve from the Medicare physician payment cuts being produced by the sustainable growth rate (SGR) formula, the bill extends a number of other payment policies through 2011 that were originally set to expire at the end of this year, including:<br /><br />&bull; The "floor" on geographic adjustments made for the physician work component of the Medicare payment schedule.<br /><br />&bull; The 5 percent payment increase for certain Medicare mental health services.<br /><br />&bull; An exceptions process for the cap on Medicare outpatient therapy services.<br /><br />&bull; Payments for the technical component for certain pathology services.<br /><br />Medicine was supported in this bipartisan effort by aggressive grassroots pressure from AARP, which included more than 100,000 contacts by seniors to congressional offices, as well as paid radio and print advertising, direct mail and tele-town hall meetings.<br /><br />"Stopping the steep 25 percent Medicare cut for one year was vital to preserve seniors' access to physician care in 2011," AMA President Cecil B. Wilson, MD, said. "The AMA will be working closely with congressional leadership in the new year to develop a long-term solution to this perennial Medicare problem for seniors and their physicians."<br /><br />Source: America Medical Association <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111437/One-year-Medicare-payment-cut-reprieve-to-be-signed-into-law&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:44:00 GMTf1397696-738c-4295-afcd-943feb885714:111437http://www.iatroshealth.com/blog/bid/111436/Survey-Medical-practice-managers-struggling-with-operating-costs#Comments0Survey: Medical practice managers struggling with operating costshttp://www.iatroshealth.com/blog/bid/111436/Survey-Medical-practice-managers-struggling-with-operating-costsENGLEWOOD, CO &ndash; Medical practice managers cite &ldquo;dealing with rising operating costs&rdquo; as their biggest daily challenge in 2010, according to a new Medical Group Management Association survey.<br /><br />For a third year, medical practice professionals sounded off about their biggest daily challenges, as well as their struggles to safeguard their practices' financial solvency despite a failing economy, in the MGMA&rsquo;s 2010 &ldquo;Medical Practice Today: What Members Have to Say&rdquo; survey.<br /><br />According to the research, the top three challenges of running a group practice are:<br /><br /><ol><ol> <li>Dealing with rising operating costs;</li> </ol></ol><br /><ol><ol> <li>Managing finances with the uncertainty of Medicare reimbursement rates; and</li> </ol></ol><br /><ol><ol> <li>Selecting and implementing a new electronic health record system</li> </ol></ol><br /><br />&ldquo;It is not surprising that 'maintaining finances with the uncertainty of Medicare reimbursement rates' jumped to the No. 2 spot this year due to the continued Congressional irresponsibility in not permanently addressing the flawed sustainable growth rate (SGR) formula,&rdquo; said William F. Jessee, MD, president and CEO of the MGMA.<br /><br />Medicare reimbursement rate uncertainty had ranked fifth in both 2008 and 2009.<br /><br />An organizational governance issue MGMA introduced to the list this year, &ldquo;managing teamwork and group dynamics among physicians,&rdquo; debuted at No. 8. &ldquo;Implementing a patient-centered medical home model of care&rdquo; made the biggest leap from last year&rsquo;s list (from No. 22 to No. 12).<br /><br />&ldquo;Practices are clearly balancing the very serious issue of keeping their practices afloat amid unprecedented financial uncertainty with the more delicate practice management issues such as managing group dynamics and overseeing their organizations&rsquo; strategic direction,&rdquo; Jessee said. &ldquo;It&rsquo;s a testament to the profession of medical practice management that they must find a way to survive and move forward despite the dynamic and challenging environment in which they practice.&rdquo;<br /><br />The MGMA found that when compared with independent medical practices, hospitals and health system respondents were more likely to find &ldquo;challenging&rdquo; these issues:<br /><br /> <ul> <ul> <li>Modifying physician compensation methodology;</li> <li>Recruiting physicians</li> <li>Dealing with rising operating costs; and</li> <li>Implementing a patient-centered medical home model of care</li> </ul> </ul> <br /><br />However, hospitals and health system respondents were less likely than independent medical practices to be challenged by &ldquo;maintaining physician compensation levels&rdquo; and &ldquo;negotiating contracts with payers.&rdquo;<br /><br />For a second year, the MGMA also asked study participants how the recession is affecting their medical groups and how they are responding. Respondents indicated that improved billing collections and/or denial management process was at the top of the list.<br /><br />Source: Healthcare Finance News <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111436/Survey-Medical-practice-managers-struggling-with-operating-costs&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:43:00 GMTf1397696-738c-4295-afcd-943feb885714:111436http://www.iatroshealth.com/blog/bid/111438/Congress-agrees-to-short-term-postponement-to-doctor-Medicare-payment#Comments0Congress agrees to short-term postponement to doctor Medicare paymenthttp://www.iatroshealth.com/blog/bid/111438/Congress-agrees-to-short-term-postponement-to-doctor-Medicare-paymentWASHINGTON (AP) &mdash; Congress agreed Monday to a one-month delay in <a href="http://www.latimes.com/topic/health/government-health-care/medicare-HEPRG00002.topic" id="HEPRG00002" title="Medicare">Medicare</a> payment cuts to doctors, giving a short-term reprieve to a looming crisis over treatment of the nation's elderly.<br /><br />The House, in approving by voice vote the bill passed by the Senate earlier this month, postponed a 23 percent cut in doctors' pay scheduled to take effect Dec. 1. That gives lawmakers a month to come up with a longer-term plan to overhaul a system that in recent years has bedeviled Congress, angered doctors and jeopardized health care for 46 million elderly and disabled.<br /><br />"This bill is a stopgap measure to make sure that seniors and military families can continue to see their doctors during December while we work on the solution for the next year," said Rep. <a href="http://www.latimes.com/topic/politics/frank-jr-pallone-PEPLT005036.topic" id="PEPLT005036" title="Frank Jr Pallone">Frank Pallone</a>, D-N.J., chairman of the Energy and Commerce health subcommittee.<br /><br />Health care payment formulas for military service members and veterans are tied to Medicare.<br /><br /><a href="http://www.latimes.com/topic/politics/government/barack-obama-PEPLT007408.topic" id="PEPLT007408" title="Barack Obama">President Barack Obama</a> is urging Congress "to now pass a one-year extension to ensure seniors maintain access to the doctor they know and trust over the coming year," the <a href="http://www.latimes.com/topic/politics/government/executive-branch/white-house-PLCUL000110.topic" id="PLCUL000110" title="White House">White House</a> said in a statement.<br /><br />The payment cuts are the result of a 1990s budget-balancing law that attempted, with little success, to keep Medicare spending in line. With medical groups estimating that as many as two-thirds of doctors would stop taking new Medicare patients if the cuts go into effect, Congress has had to periodically step in to stop the automatic cuts.<br /><br />Last summer, when Congress missed the deadline for an extension, Medicare officials had to hold off processing claims to avoid paying the lower rates.<br /><br /><a href="http://www.latimes.com/topic/politics/government/u.s.-senate-committee-on-finance-ORGOV0000134152.topic" id="ORGOV0000134152" title="U.S. Senate Committee on Finance">Senate Finance Committee</a> Chairman <a href="http://www.latimes.com/topic/politics/max-baucus-PEPLT000333.topic" id="PEPLT000333" title="Max Baucus">Max Baucus</a>, D-Mont., and the panel's top Republican, <a href="http://www.latimes.com/topic/politics/government/charles-grassley-PEPLT002489.topic" id="PEPLT002489" title="Charles Grassley">Charles Grassley</a> of Iowa, say they are working on a 12-month postponement that would give them time to devise a new system for paying doctors. It is estimated that repeal of the current budget formula would cost $300 billion over 10 years that would have to be made up with other spending cuts or added to the deficit.<br /><br />The one-month postponement passed Monday will cost $1 billion over 10 years, to be paid for by changes in Medicare reimbursement for outpatient therapy services.<br /><br />Doctors will face a payment cut of almost 25 percent on Jan. 1 if Congress doesn't act on another postponement.<br /><br /><a href="http://www.latimes.com/topic/health/drugs-medicines/american-medical-association-ORCIG000016.topic" id="ORCIG000016" title="American Medical Association">American Medical Association</a> president Dr. Cecil B. Wilson applauded the short-term delay while noting that the first baby boomers will turn 65 next year and begin relying on Medicare.<br /><br />"Congress is responsible for ensuring that the baby boomers can see a doctor through Medicare by enacting long-term reform next year of the broken Medicare physician payment system," Wilson said.<br /><br />Source: Los Angeles Times <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111438/Congress-agrees-to-short-term-postponement-to-doctor-Medicare-payment&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:42:00 GMTf1397696-738c-4295-afcd-943feb885714:111438http://www.iatroshealth.com/blog/bid/111439/Credit-Card-Technology-Adapted-to-Fight-Fraud-in-Medicare-Medical-Billing-Florida-is-Major-Target#Comments0Credit Card Technology Adapted to Fight Fraud in Medicare Medical Billing - Florida is Major Targethttp://www.iatroshealth.com/blog/bid/111439/Credit-Card-Technology-Adapted-to-Fight-Fraud-in-Medicare-Medical-Billing-Florida-is-Major-TargetSigned into law in June, the new Small Business Lending Act includes an anti-fraud provision that requires the Centers for Medicare and Medicaid Services to boost efforts to prevent fraudulent medical billing. Florida's top-rank for Medicare fraud makes it a primary target. Among the mandates is that CMS nix its long-held policy of approving claims without first verifying them.<br /><br />"CMS uses an outdated [medical] billing system which I understand actually helps facilitate over $60 million in Medicare fraud annually," says Alan Weinstock, a Medicare Supplement Insurance Agent.<br /><br />The law implements a new Medicare medical billing software system that features a predictive modeling component similar to that used in the credit card industry. The analytical technology is designed to identify potentially fraudulent medical bills and expected to save the government upwards of $20 billion a year if implemented and used correctly. Medicare billing contractors will be required to use this new technology for billing hospitalization and outpatient services, which make up the lion's share of Medicare's spending.<br /><br />CMS will launch a competitive bidding process by January, then choose and implement the technology in the 10 states with the highest Medicare fraud rates by July. The U.S. Department of Health and Human Services will submit a report to Congress after the first year of implementation, detailing the actual savings on Medicare fraud. If the report is a positive one, the money saved likely will be used to implement the technology in 10 additional states.<br /><br />When it comes to Medicare medical billing, Florida has been a target of criticism for its high fraud rate. Federal agents have made several high profile busts, primarily in South Florida, over the past year - a factor that may have prompted U.S. Senator George LeMieux (R-FL) to coauthor the Small Business Lending Act and write the Medicare anti-fraud initiative. Of course, eliminating Medicare and medical billing fraud ultimately is in everyone's best interest. So, the new software will make it all the more critical that claims are submitted accurately to avoid rejection. At <a href="http://www.iatroshealth.com/" target="_self">iATROS Health Care Solutions</a>, we specialize in Florida medical insurance billing and follow up. Statistics show that 30% of medical insurance claims are rejected upon the first submission and half of those never get resubmitted. iATROS' streamlined process aims for a minimum 97% of its clients' insurance claims to be accepted on the first submission.<br /><br />To make sure that your Florida medical billing, including Medicare billing, <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php" target="_self">private insurance company billing</a> and <a href="http://www.iatroshealth.com/patient-billing-and-collections.php" target="_self">patient billing</a> is accurate and thorough enough for quick approval and payment processing, contact iATROS Health Care Solutions. We specialize in the tough <a href="http://www.iatroshealth.com/locations-we-serve.php" target="_self">Florida</a> market (primarily Jacksonville, Orlando, Tampa and Miami) but service clients nationwide. To speak with a medical billing specialist, contact us at 904-296-1160 or via our online <a href="http://www.iatroshealth.com/contact.php" target="_self">email form</a>. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111439/Credit-Card-Technology-Adapted-to-Fight-Fraud-in-Medicare-Medical-Billing-Florida-is-Major-Target&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:42:00 GMTf1397696-738c-4295-afcd-943feb885714:111439http://www.iatroshealth.com/blog/bid/111440/SGR-update-Senate-approves-a-31-day-patch-House-to-act-next#Comments0SGR update - Senate approves a 31-day patch; House to act next http://www.iatroshealth.com/blog/bid/111440/SGR-update-Senate-approves-a-31-day-patch-House-to-act-nextThis evening the Senate approved by unanimous consent a bill that will provide a 31-day payment patch to the Medicare sustainable growth rate (SGR) formula. The bill will freeze current rates for services provided through Dec. 31, and temporarily avert a 23 percent cut to physician payments that was slated to take effect on Dec. 1.<br /><br />The House of Representatives has adjourned for the week. The representatives are anticipated to vote on the bill upon their return.<br /><br />While the 31-day fix, if approved, is a step in the right direction, it is only a temporary patch. Physicians still face a 25 percent cut on January 1, 2011. MGMA continues to call for an additional 12-month fix to give lawmakers time to find a permanent solution. Additional member grassroots advocacy during December is necessary to halt the 25 percent cut on Jan.1. We will continue to keep you apprised as we receive further updates.<br /><br /><em>Source: Washington Connexion</em> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111440/SGR-update-Senate-approves-a-31-day-patch-House-to-act-next&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:41:00 GMTf1397696-738c-4295-afcd-943feb885714:111440http://www.iatroshealth.com/blog/bid/111442/How-HIPAA-s-Version-5010-and-D-0-will-Improve-Your-Florida-Medical-Billing-Coding#Comments1How HIPAA's Version 5010 and D.0 will Improve Your Florida Medical Billing & Codinghttp://www.iatroshealth.com/blog/bid/111442/How-HIPAA-s-Version-5010-and-D-0-will-Improve-Your-Florida-Medical-Billing-CodingThe new HIPAA-required Version 5010 and the National Council for Prescription Drug Programs (NCPDP) Version 5.0 promise significant improvements to current Florida medical billing and coding practices. The revised set of HIPAA transactions updates standards for claims, eligibility, referral authorizations and more. In fact, nearly ever standard has been updated from the current Version 4010/4010A standards. And NCPDP offers more thorough patient eligibility and responsibility factors.<br /><br />Currently, over 99 percent of Medicare Part A claims and over 96 percent of Medicare Part B claims transactions are submitted and received electronically. The current versions of the standards (the Accredited Standards Committee X12 Version 4010/4010A1 for health care transactions and the NCPDP Version 5.1 for pharmacy transactions) used in these health care transactions lack certain required functionality. Therefore, adoption of Version 5010 by covered entities (health plans, health care clearinghouses, and certain health care providers) is mandated by January 1, 2012. EMR/EHR transactions submitted after that date using any other version will not be HIPAA compliant and will be rejected. Level I compliance, meaning that a covered entity has designed, built and internally tested an EMR/HER system and can demonstrably create and receive compliant transactions, is mandated by December 31, 2010.<br /><br />Among the improvements that Version 5010 and Version D.0 will afford Florida medical billing and coding standards are:<br /><br /> <ul> <ul> <li>Standardized business information related to the healthcare transaction;</li> </ul> </ul> <br /> <ul> <ul> <li>Use of Technical Reports Type 3 (TR3) guidelines that represent data more consistently and clearly;</li> </ul> </ul> <br /> <ul> <ul> <li>Accommodation of reporting of clinical data including ICD-10-CM diagnosis codes and ICD-10-PCS procedure codes;</li> </ul> </ul> <br /> <ul> <ul> <li>Easy distinction between principal diagnosis, admitting diagnosis, external cause of injury and patient reason for visit codes;</li> </ul> </ul> <br /> <ul> <ul> <li>Monitoring of certain illness mortality rates, outcomes for specific treatment options, some hospital length of stays and clinical reasons for care;</li> </ul> </ul> <br /> <ul> <ul> <li>Handling of unaddressed business needs such as an indicator on institutional claims for present-on-admission conditions;</li> </ul> </ul> <br /> <ul> <ul> <li>New data elements and rejection codes to facilitate Medicare Part D and coordination of benefits claims processing;</li> </ul> </ul> <br /> <ul> <ul> <li>More complete eligibility information for Medicare Part D and other insurance coverage;</li> </ul> </ul> <br /> <ul> <ul> <li>Improved process for identifying patient responsibility, benefits stages and coverage gaps on secondary claims;</li> </ul> </ul> <br /> <ul> <ul> <li>Facilitation of billing of multiple ingredients in processing claims for compounded drugs.</li> </ul> </ul> <br /><br />Is your healthcare firm ready for the EMR transition deadlines? <a href="http://www.iatroshealth.com/" target="_self">iATROS Health Care Solutions</a> can help you choose the right EMR system for your Florida medical billing and coding processes including <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php" target="_self">insurance billing and follow up</a>, <a href="http://www.iatroshealth.com/patient-billing-and-collections.php" target="_self">patient billing and collection</a> and management of <a href="http://www.iatroshealth.com/healthcare-compliance.php" target="_self">healthcare compliance </a>issues. Call 904-296-1160 to speak with a Florida medical billing and coding specialist today. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111442/How-HIPAA-s-Version-5010-and-D-0-will-Improve-Your-Florida-Medical-Billing-Coding&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:40:00 GMTf1397696-738c-4295-afcd-943feb885714:111442http://www.iatroshealth.com/blog/bid/111443/EHR-Meaningful-Use-Update#Comments0EHR & Meaningful Use Update http://www.iatroshealth.com/blog/bid/111443/EHR-Meaningful-Use-UpdateThe Office of the National Coordinator for Health Information Technology (ONC) named the Chicago-based Certification Commission for Health Information Technology (CCHIT) and The Drummond Group, Inc. of Austin, TX as the first technology review bodies authorized to test and certify EMR (electronic medical record) software and systems for compliance with the standards and certification criteria issued by the U.S. Department of Health and Human Services (HHS) earlier this year.&nbsp; HHS/ONC-certified EMR software users are eligible for financial incentives and higher Medicare/Medicaid reimbursements.<br /><br />The announcement means that EMR software vendors now can have their products certified as meeting the HHS&rsquo; &ldquo;meaningful use&rdquo; criteria. HHS/ONC certified EMR software must pass 45 tests covering critical issues such as encryption, access management and reporting. For healthcare providers, using HHS/ONC certified EMR software not only helps ensure compliance, it may help boost your practice&rsquo;s revenues as well.<br /><br />CCHIT Certification is good for two years, and several companies have had their solutions certified at one stage or another since 2006.&nbsp; However, in order to qualify for &ldquo;meaningful use&rdquo; reimbursement, those solutions must receive 2011 CCHIT Certification or a comparable certification from the Drummond Group.&nbsp; As of August 20<sup>, </sup>2010, only 32 EMR products have achieved 2011 CCHIT Certification.<br /><br />EMR software certification is part of a broad initiative undertaken by President Obama and Congress under the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA) of 2009. The HITECH Act provides for upwards of $27 billion in incentives to help health care providers recoup costs of transitioning from paper-based medical records to EMRs. Individual physicians and other eligible healthcare professionals can receive up to $44,000 through Medicare and almost $64,000 through Medicaid. Hospitals can receive millions of dollars.<br /><br />To qualify, healthcare providers must implement and demonstrate meaningful use of HHS/ONC-certified EMR software systems as defined by the Centers for Medicare and Medicaid Services in July.&nbsp; Physicians must also accept Medicare and must have at least $24,000.00 in total Medicare allowable charges per year.<br /><br /><em><span style="text-decoration: underline;">About the author:</span></em><em> Mr. Quinn works with a variety of healthcare organizations throughout Florida and nationwide to assess their individual, financial, operational and strategic challenges and to develop tailored solutions designed to streamline administrative, billing and coding functions, free up resources to focus on core competencies and boost revenue. </em><br /><br />Scott C. Quinn | Iatros Healthcare Solutions<br /><br />(904) 296-1160, option 1 | <a href="../../">www.iatroshealth.com</a> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111443/EHR-Meaningful-Use-Update&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:40:00 GMTf1397696-738c-4295-afcd-943feb885714:111443http://www.iatroshealth.com/blog/bid/111444/Official-EMR-Software-Credentialing-Bodies-Chosen#Comments0Official EMR Software Credentialing Bodies Chosenhttp://www.iatroshealth.com/blog/bid/111444/Official-EMR-Software-Credentialing-Bodies-ChosenThe Office of the National Coordinator for Health Information Technology (ONC) named the Chicago-based Certification Commission for Health Information Technology and The Drummond Group, Inc. of Austin, TX as the first technology review bodies authorized to test and certify EMR (electronic medical record) software and systems for compliance with the standards and certification criteria issued by the U.S. Department of Health and Human Services (HHS) earlier this year.<br /><br />The announcement means that EMR software vendors now can have their products certified as meeting the HHS' "meaningful use" criteria. HHS/ONC certified EMR software must pass 45 tests covering critical issues such as encryption, access management and reporting. For healthcare providers, using HHS/ONC certified EMR software not only helps ensure compliance, it may help boost your practice's revenues as well.<br /><br />EMR software certification is part of a broad initiative undertaken by President Obama and Congress under the Health Information Technology for Economic and Clinical Health (HITECH) Act, part of the American Recovery and Reinvestment Act (ARRA) of 2009. The HITECH Act provides for upwards of $27 billion in incentives to help health care providers recoup costs of transitioning from paper-based medical records to EMRs. Individual physicians and other eligible healthcare professionals can receive up to $44,000 through Medicare and almost $64,000 through Medicaid. Hospitals can receive millions of dollars. To qualify, healthcare providers must implement and demonstrate meaningful use of HHS/ONC-certified EMR software systems as defined by the Centers for Medicare and Medicaid Services in July.<br /><br />In addition, only users of HHS/ONC-certified EMR software and systems will be eligible for increased Medicare and Medicaid reimbursements beginning in 2011, as outlined by the 2008 ARRA.<br /><br /><a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions</a> can help ensure that the EMR software you choose is not only HHS/ONC-certified, but is the right choice for your medical practice's unique needs. EMR systems are not one-size-fits-all and the number of software options on the market is growing constantly. Choosing a system that meets all of your varied needs and supports full compliance with Federal law can be overwhelming. iATROS' expert EMR consultants can help make your practice's transition seamless and ultimately profitable. Contact an iATROS Healthcare Solutions EMR specialist at 904-296-1160 or via our online email form today. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111444/Official-EMR-Software-Credentialing-Bodies-Chosen&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:39:00 GMTf1397696-738c-4295-afcd-943feb885714:111444http://www.iatroshealth.com/blog/bid/111446/Let-iATROS-Healthcare-Solutions-Protect-Your-Practice-from-Florida-Medical-Billing-Medicare-Fraud-Allegations#Comments0Let iATROS Healthcare Solutions Protect Your Practice from Florida Medical Billing/Medicare Fraud Allegationshttp://www.iatroshealth.com/blog/bid/111446/Let-iATROS-Healthcare-Solutions-Protect-Your-Practice-from-Florida-Medical-Billing-Medicare-Fraud-AllegationsFlorida medical billing and Medicare fraud has dominated headlines recently. Just last month, U.S. Attorney General Eric Holder and Secretary of Health and Human Services Kathleen Sibelius announced that 94 people had been charged with defrauding Medicaid. Of them, 24 defendants in Miami alone were charged with allegedly participating in the submission of false Medicare claims amounting to $103 million. In the vast majority of cases, Medicare payment errors are simple mistakes rather than a healthcare provider's deliberate attempt to defraud the system. But when an allegation - founded or unfounded - is levied, the damage to a physician's or provider's professional reputation can be irreparably damaged.<br /><br />At <a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions</a>, we know that most physicians, providers and suppliers who serve Medicare patients are committed to providing top-quality care and billing the program accurately and fairly. But just keeping up with the ever-changing Florida medical billing codes, policies and requirements can be a daunting task, especially with major healthcare reform on its way. When you trust iATROS with your Florida medical billing, we'll make sure that every detail is rock-solid. If an honest mistake is made, we'll find and correct it.<br /><br />We can handle both <a href="http://www.iatroshealth.com/patient-billing-and-collections.php" target="_self">patient billing</a> and <a href="http://www.iatroshealth.com/insurance-billing-and-follow-up.php" target="_self">insurance company billing </a>as well as <a href="http://www.iatroshealth.com/patient-verification-of-benefits.php" target="_self">verification</a> of patient benefits, <a href="http://www.iatroshealth.com/medical-coding-florida.php" target="_self">medical coding</a> and <a href="http://www.iatroshealth.com/healthcare-compliance.php" target="_self">healthcare compliance</a> issues. Via streamlined processes and attention to detail, iATROS aims for a minimum 97% of insurance claims to be accepted on the first submission. Based on specialty, we collect 90% - 95% of claim value within 120 days. We also specialize in the effective, compassionate collection of fees due from your self-pay patients who may be experiencing financial difficulties. To find out how your practice can boost cash flow and remain infallible when it comes to regulatory compliance and auditing, <a href="http://www.iatroshealth.com/contact.php" target="_self">contact</a> iATROS Healthcare Solutions today. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111446/Let-iATROS-Healthcare-Solutions-Protect-Your-Practice-from-Florida-Medical-Billing-Medicare-Fraud-Allegations&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:38:00 GMTf1397696-738c-4295-afcd-943feb885714:111446http://www.iatroshealth.com/blog/bid/111447/The-iATROS-Billing-and-Collections-Team-Raises-the-Bar-With-Collection-Efforts#Comments0The iATROS Billing and Collections Team Raises the Bar With Collection Effortshttp://www.iatroshealth.com/blog/bid/111447/The-iATROS-Billing-and-Collections-Team-Raises-the-Bar-With-Collection-EffortsEarlier this year one of our new clients had only been collecting 80 % of their total AR within 120 days, as of month end July 2010, six months after joining iATROS, our billing and collections team is capturing 98.47 % of revenue within 120 days. iATROS Healthcare Solutions strives to collect the maximum amount of revenue for each of our clients and we feel that the efforts of our billing and collections team reflects our company&rsquo;s goals. iATROS is continually raising the bar to provide a more effective billing and collections effort for our clients.<br /><br />For more information about iATROS Healthcare Solutions, please contact us at squinn@iatroshealth.com or via phone at (904) 296-1600. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111447/The-iATROS-Billing-and-Collections-Team-Raises-the-Bar-With-Collection-Efforts&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:37:00 GMTf1397696-738c-4295-afcd-943feb885714:111447http://www.iatroshealth.com/blog/bid/111448/PECOS-Enrollment-Deadline-July-6-2010#Comments0PECOS Enrollment Deadline, July 6, 2010http://www.iatroshealth.com/blog/bid/111448/PECOS-Enrollment-Deadline-July-6-2010The Centers for Medicare &amp; Medicaid Services (CMS) have implemented an on-line system whereby provider and supplier organizations who are eligible to enroll in the Medicare program may use the Internet to submit enrollment applications, view enrollment information, update enrollment information, voluntarily terminate from the Medicare program, and track the status of an application submitted via the Internet. The system is called Internet-based Provider Enrollment, Chain and Ownership System (PECOS).<br /><br />CMS has announced that the PECOS enrollment deadline for ordering and referring providers will be moved up by six months from January 3, 2011 to July 6, 2010. The implementation of the PECOS system stands to cause potential claim denials for any and all providers who perform services for Medicare beneficiaries. If you and your associates have not revalidated your Medicare enrollment record since November 2003 there is a high probability that you and your referring partners Medicare claims will begin rejecting effective July 6, 2010. Please be aware that revalidating your group and providers Medicare enrollment record is just one step in the perplexing PECOS enrollment process. <br /><br />Understanding that the implementation of the PECOS system can be confusing and overwhelming, iATROS Healthcare Solutions is offering assistance to simplify the PECOS enrollment process. If you would like additional information, please contact us.<br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111448/PECOS-Enrollment-Deadline-July-6-2010&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:37:00 GMTf1397696-738c-4295-afcd-943feb885714:111448http://www.iatroshealth.com/blog/bid/111441/Preparing-Your-Florida-Medical-Billing-and-Administrative-Staff-for-the-EMR-Transition#Comments0Preparing Your Florida Medical Billing and Administrative Staff for the EMR Transitionhttp://www.iatroshealth.com/blog/bid/111441/Preparing-Your-Florida-Medical-Billing-and-Administrative-Staff-for-the-EMR-TransitionWith the federally mandated EMR transition deadline approaching,<a href="http://www.iatroshealth.com/" target="_self"> Florida medical billing</a> and medical office staff members face a multitude of changes in the way they've done their jobs for years, even decades. Despite the breakneck pace in which medicine itself changes, the business end of practicing medicine has remained constant for many pencil-and-paper holdouts. That's why the first thing you'll have to change isn't a process - is the minds of your staff who handle patient scheduling, insurance verification, billing and payment collections every day. <a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions </a>offers tips on preparing your Florida medical billing and administrative staff for EMR.<br /><br /> <ul> <ul> <li><strong>Start at the top:</strong> Begin with your top-tier staff members, especially physicians and administrators. They are the ones to whom the rest of your staff looks to for guidance, so their buy-in of the EMR programs and processes that you choose will help ease the transition for everyone. Of course, these likely are the staff members who have been in the industry for the longest and may prove to be the ones most resistant to such a monumental change.&nbsp; However, they also are the ones who best understand all the nuances of your practice's day-to-day operations, so be open to their suggestions. Also, having someone with the tech-savvy to answer questions and explain all the whys and wherefores of the transition will help tremendously.</li> </ul> </ul> <br /> <ul> <ul> <li><strong>Train your super-users: </strong>Leaders of employee groups should be trained first and take ownership of the project elements that most affect their particular departments. Because they have closer connections and better credibility with subordinates than do physicians and upper management, they are crucial to gaining acceptance from and training lower level employees. Encourage them to assign projects to their group members too, so that employees at all levels will feel they contributed to the outcome.</li> </ul> </ul> <br /> <ul> <ul> <li><strong>Start as early as possible:</strong> The EMR deadline will be here before you know it and there may be a huge learning curve. Once you've chosen your EMR software and processes, arm your employees with all the necessary information and begin training in time to allow for a gradual transition - particularly if you currently operate on a pen-and-paper system. Take into consideration those who will be learning how to operate a computer for the first time. They will need to begin with more basic training and advance to more complex systems, while others may be able to begin training at a higher level.</li> </ul> </ul> <br /> <ul> <ul> <li><strong>Be optimistic, but not naive: </strong>You can bet that problems will occur. Issues you and your staff never thought of are sure to arise during your EMR transition and can cause a ripple effect throughout your entire organization. Expect them. And allow flexibility for managing them, including time, as some issues can push back your system go-live date and cause you to miss the federally-mandated deadline.</li> </ul> </ul> <br /> <ul> <ul> <li><strong>Know that help is available.</strong><a href="http://www.iatroshealth.com/" target="_self"> iATROS Healthcare Solutions </a>specializes in Florida medical billing, practice management and EMR transition. The Jacksonville-based company can help you right from the beginning by analyzing your medical practice from top to bottom, then making recommendations for the best EMR system fit. We then can walk you through your EMR transition and/or handle your Florida medical billing for you. Call 904-296-1160 and speak with a Florida medical billing and EMR consultant today.</li> </ul> </ul> <br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111441/Preparing-Your-Florida-Medical-Billing-and-Administrative-Staff-for-the-EMR-Transition&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:36:00 GMTf1397696-738c-4295-afcd-943feb885714:111441http://www.iatroshealth.com/blog/bid/111449/Strategic-Consulting-Setting-up-an-Endoscopy-Surgery-Center#Comments1Strategic Consulting: Setting up an Endoscopy/Surgery Centerhttp://www.iatroshealth.com/blog/bid/111449/Strategic-Consulting-Setting-up-an-Endoscopy-Surgery-CenterThere are multiple facets that must be managed when setting up an endoscopy center.&nbsp; Not to mention, a variety of regulatory compliance issues, state legal issues, and credentialing issues which must be addressed.&nbsp; The team at iATROS Healthcare Solutions can help you navigate these challenges.<br /><br />Our areas of focus include:<br /><br /> <ul> <ul> <li>JACO &amp; CMS Accreditation</li> </ul> </ul> <br /> <ul> <ul> <li>Regulatory Concerns</li> </ul> </ul> <br /> <ul> <ul> <li>Certificate of Need Requirements</li> </ul> </ul> <br /> <ul> <ul> <li>Size &amp; Staffing Requirements</li> </ul> </ul> <br /> <ul> <ul> <li>Vendor Relationships</li> </ul> </ul> <br /> <ul> <ul> <li>OSHA Compliance</li> </ul> </ul> <br /> <ul> <ul> <li>Cleaning Requirements</li> </ul> </ul> <br /> <ul> <ul> <li>Scheduling Best Practices</li> </ul> </ul> <br /> <ul> <ul> <li>Facility Ratios (# rooms, # pre-op beds, # recovery)</li> </ul> </ul> <br /> <ul> <ul> <li>Billing, Coding, and Collections</li> </ul> </ul> <p><br /><br /><strong><em>Why iATROS Healthcare Solutions?</em></strong><br /><br />Our team of consultants, collectively, has over 75 years experience working in and with gastroenterology and endoscopy centers.&nbsp; Our team includes a variety of health care professionals who&rsquo;ve navigated the legal and professional challenges associated with setting up new sources of revenue, including endoscopy centers and new lines of ancillary services. Contact us today to get answers to your questions about setting up an Endoscopy/Surgery Center.</p> <p style="text-align: center;">&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 156px; height: 47px; display: block; border-width: 0px;" id="hs-cta-wrapper-bd12355c-a0f3-4f0f-89e9-21e73f89c630"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630" id="hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630"> <a href="http://www.iatroshealth.com/contact-us" data-mce-href="http://www.iatroshealth.com/contact-us"><img id="hs-cta-img-bd12355c-a0f3-4f0f-89e9-21e73f89c630" src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" alt="contact-us" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/557be653-18ef-41d8-9b32-e825cd92d396-1332336151193/contact-us.png?v=1332336151.48" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=bd12355c-a0f3-4f0f-89e9-21e73f89c630"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-bd12355c-a0f3-4f0f-89e9-21e73f89c630").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111449/Strategic-Consulting-Setting-up-an-Endoscopy-Surgery-Center&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:35:00 GMTf1397696-738c-4295-afcd-943feb885714:111449http://www.iatroshealth.com/blog/bid/111445/21st-Century-Medical-Billing-with-EMR-Consulting-by-Florida-s-iATROS-Healthcare-Solutions#Comments021st Century Medical Billing with EMR Consulting by Florida's iATROS Healthcare Solutionshttp://www.iatroshealth.com/blog/bid/111445/21st-Century-Medical-Billing-with-EMR-Consulting-by-Florida-s-iATROS-Healthcare-SolutionsIf you've been putting off transitioning your medical billing system electronic medical records, <a href="http://www.iatroshealth.com/" target="_self">iATROS Healthcare Solutions</a> offers EMR consulting in Florida. And you can rest assured we're on top of things when it comes to helping you land your share of the federal government's $27 billion in economic stimulus incentives available to hospitals and doctors to implement electronic medical records.<br />The federal government recently finalized its "meaningful use" regulations that doctors and hospitals must follow to earn incentives for their transitions from paper records to EMR. Consultants in Florida, a state with one of the nation's highest Medicare enrollments by percentage, say the EMR move will help significantly cut healthcare costs, reduce paperwork, improve outcomes and empower patients, as well as help reduce chances of medical billing and Medicare fraud, which ultimately costs the entire industry and population.<br /><br />Yet despite the long term benefits of EMR, only two in ten doctors and one in ten hospitals have made the EMR transition either in full or in part. The result is patients still spending too much time filling out the same forms over and over again, plus physicians spending too much time writing down patients' medical histories, tracking down x-rays and other diagnostic reports, and unnecessarily repeating expensive tests. Why? Primarily because many health care providers, particularly those with smaller practices, worry that the initial costs will be too expensive and that the process will be too difficult and time consuming, robbing their patients and their practices of needed attention.<br /><br />Under the American Recovery and Reinvestment Act, individual providers who make the EMR transition can earn bonus payment of up to $44,000 in Medicare and nearly $64,000 in Medicaid. Hospitals stand to earn bonus payments in the millions. All of this, however, rests on your taking all the right steps and choosing the most efficient and effective EMR system for your practice - not an easy task considering that more than 300 EMR systems exist on the market today. With its team of highly specialized EMR consultants, Florida-based iATROS Healthcare Solutions can help you narrow the list of systems that will work for your practice based on financial costs, technology requirements, inter-operability, customization needs and more. We'll then perform a side-by-side cost and benefit analysis to help you make the right choice for your needs.<br /><br />Our Florida-based EMR consultants keep up to the minute on all industry and governmental issues that affect Florida medical building. To get started on your EMR transition, call 904-296-1160 or contact us via our online <a href="http://www.iatroshealth.com/contact.php" target="_self">email</a> form today. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111445/21st-Century-Medical-Billing-with-EMR-Consulting-by-Florida-s-iATROS-Healthcare-Solutions&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:34:00 GMTf1397696-738c-4295-afcd-943feb885714:111445http://www.iatroshealth.com/blog/bid/111450/On-average-physicians-leave-over-20-of-their-net-revenues-uncollected#Comments0On average, physicians leave over 20% of their net revenues uncollectedhttp://www.iatroshealth.com/blog/bid/111450/On-average-physicians-leave-over-20-of-their-net-revenues-uncollectedOn average, physicians leave over 20% of their net revenues uncollected...<br /><br />Lack of time, oversight, institutional controls, or knowledge of complex payer rules are often the root of the problem.&nbsp; Complacency may also be a crippling factor.<br /><br />As a physician, its critical to "check under the hood" from time to time.&nbsp; You wouldn't drive your car for 3 years without servicing it, so why continue to run your practice the same as you have for the last 3 years.&nbsp; Regardless if you process your claims in-house or currently outsource, why not get a free check-up from time to time to ensure things are running optimally?<br /><br />For most practices, up to 30% of claims may be rejected on the first submission to the insurance company.&nbsp; What's startling is that 50% of those claims are never resubmitted!?!<br /><br />If you don't have the time, thorough understanding, or energy to evaluate your practice, consult with iATROS Healthcare Solutions.&nbsp; We'll provide a free revenue cycle "check-up" to help you answer:<br /> <h2><strong><em>Can it be better?&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; How much better?&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp;&nbsp; Better at what cost?</em><em> </em></strong></h2> <p><br />For more information click the free analysis button below or contact us directly at (877) 900-6763.</p> <p>&nbsp;</p> <p><span class="hs-cta-wrapper" style="margin-right: auto; margin-left: auto; width: 328px; height: 51px; display: block; border-width: 0px;" id="hs-cta-wrapper-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <!--HubSpot Call-to-Action Code --> <span class="hs-cta-node hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" id="hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0"> <a href="http://www.iatroshealth.com/performance-analysis/#form" data-mce-href="http://www.iatroshealth.com/performance-analysis/#form"><img id="hs-cta-img-f0a5d769-fbe1-4dbf-b787-73e042aa56a0" src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" alt="get-your-free-practice-analysis" class="hs-cta-img" style="border-width:0px" mce_noresize="1" data-mce-src="//d1n2i0nchws850.cloudfront.net/portals/141935/22d18773-861b-4403-9416-2ee76f5cded8-1332348814094/get-your-free-practice-analysis.png?v=1332348814.35" data-mce-style="border-width: 0px;"></a> </span><script type="text/javascript"> (function(){ var hsjs = document.createElement("script"); hsjs.type = "text/javascript"; hsjs.async = true; hsjs.src = "//cta-service.cms.hubspot.com/cta-service/loader.js?placement_guid=f0a5d769-fbe1-4dbf-b787-73e042aa56a0"; (document.getElementsByTagName("head")[0]||document.getElementsByTagName("body")[0]).appendChild(hsjs); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="hidden"}, 1); setTimeout(function() {document.getElementById("hs-cta-f0a5d769-fbe1-4dbf-b787-73e042aa56a0").style.visibility="visible"}, 2000); })(); </script><!-- HubSpot Call-to-Action Code --> <!-- hs-cta-wrapper --></span></p> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111450/On-average-physicians-leave-over-20-of-their-net-revenues-uncollected&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:33:00 GMTf1397696-738c-4295-afcd-943feb885714:111450http://www.iatroshealth.com/blog/bid/111451/Today-s-Healthcare#Comments0Today's Healthcarehttp://www.iatroshealth.com/blog/bid/111451/Today-s-HealthcarePhysicians today are enduring the most turbulent state of healthcare in recorded history. Medicare cuts, Healthcare reform, Increase patient responsibility, ICD-10, HIPAA, Electronic Health Record conversion, Red Flag Rules, etc. are all weighing on productivity and profitability. Physicians spend more time on adminstrative details rather than on what's most important - their patient's experience.<br /><br />Case in point- according to MGMA, from 2001 to 2005, Median Compensation grew 12.9% while Productivity grew 20.4%. In other words, physicians are working harder for less.<br /><br />The current state of healthcare requires physicians to run lean as ever. Operating as one did 10 years ago puts physicians at risk in terms of strategic performance, competition, and compliance.<br /><br />Founded by healthcare finance professionals, iATROS was created to address these challenges. We provide expert guidance to providers, easing the pain of running a practice in today's challenging market, allowing physicians to focus on maximizing the patient's experience. From billing/collections to practice management, iATROS is your partner.<br /><br /><strong>Contact us today at (904) 296-1160 for a free analysis of your revenue cycle and information regarding our variety of healthcare solutions.</strong> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111451/Today-s-Healthcare&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:33:00 GMTf1397696-738c-4295-afcd-943feb885714:111451http://www.iatroshealth.com/blog/bid/111452/Welcome-to-the-new-iATROS-Health-Website#Comments0Welcome to the new iATROS Health Websitehttp://www.iatroshealth.com/blog/bid/111452/Welcome-to-the-new-iATROS-Health-WebsiteiATROS Healthcare Solutions is proud to announce the launch of our new website, <a href="http://www.iatroshealth.com">www.iatroshealth.com</a>. Full of helpful information about our services, this website will also become a key tool in relaying up-to-date information on the changes taking place in the healthcare industry.<br /><br />We're here for YOU - whether for your medical billing, practice management, or any of our other services, send us a message with topics you'd like to discuss. We look forward to serving your needs in the healthcare industry. <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111452/Welcome-to-the-new-iATROS-Health-Website&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:32:00 GMTf1397696-738c-4295-afcd-943feb885714:111452http://www.iatroshealth.com/blog/bid/111453/iATROS-booth-1-at-Florida-MGMA-s-Annual-Conference#Comments0iATROS booth #1 at Florida MGMA's Annual Conferencehttp://www.iatroshealth.com/blog/bid/111453/iATROS-booth-1-at-Florida-MGMA-s-Annual-ConferenceiATROS Healthcare Solutions will be exhibiting at the 2010 Florida MGMA Annual Conference, April 19 - 21, 2010 at the Caribe Royale Resort in Orlando, Florida.&nbsp; Please stop by booth #1 to learn more 1st hand about our Revenue Cycle Management solutions as well as our Strategic Consulting solutions.<br /><br /><br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111453/iATROS-booth-1-at-Florida-MGMA-s-Annual-Conference&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:31:00 GMTf1397696-738c-4295-afcd-943feb885714:111453http://www.iatroshealth.com/blog/bid/111454/iATROS-Healthcare-Solutions-FICPA-show-in-Orlando#Comments0iATROS Healthcare Solutions & FICPA show in Orlandohttp://www.iatroshealth.com/blog/bid/111454/iATROS-Healthcare-Solutions-FICPA-show-in-OrlandoiATROS Healthcare Solutions will be exhibiting their solutions designed to optimize medical practice revenues at the Florida Institute of CPA's Healthcare Industry Conference on April 21 - April 22 at the Caribe Royale Convention Center in Orlando, Fl.<br /><br /><a href="http://www.ficpa.org/fs_ficpa/publicfiles/cpe/brochures/2010/HCC2010.pdf" target="_blank">Conference Brochure</a><br /><br /><br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111454/iATROS-Healthcare-Solutions-FICPA-show-in-Orlando&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:29:00 GMTf1397696-738c-4295-afcd-943feb885714:111454http://www.iatroshealth.com/blog/bid/111455/iATROS-Healthcare-Solutions-exhibiting-at-DDW-2010-in-New-Orleans#Comments0iATROS Healthcare Solutions exhibiting at DDW 2010 in New Orleanshttp://www.iatroshealth.com/blog/bid/111455/iATROS-Healthcare-Solutions-exhibiting-at-DDW-2010-in-New-OrleansiATROS Healthcare Solutions will be exhibiting their revenue cycle management and strategic consulting solutions at Digestive Disease Week in New Orleans, May 2 - May 5, 2010.&nbsp; DDW is the world's largest gathering of physicians and researchers in the fields of gastroenterology, hepatology, endoscopy, and gastrointestinal surgery.&nbsp; Please visit iATROS Healthcare Solutions at <strong>booth #49</strong>.<br /><br /><br /> <img src="http://track.hubspot.com/__ptq.gif?a=141935&k=14&bu=http://www.iatroshealth.com/blog/&r=http://www.iatroshealth.com/blog/bid/111455/iATROS-Healthcare-Solutions-exhibiting-at-DDW-2010-in-New-Orleans&bvt=rss">Jackie KennedyMon, 19 Dec 2011 14:27:00 GMTf1397696-738c-4295-afcd-943feb885714:111455