The Affordable Care Act

By Steve Adams, MCS, CPC, CPC-H, CPC-I, PCS, FCS, COA The Affordable Care Act (ACA) added a section to the Social Security Act which specifies that the Secretary shall identify potentially “misvalued codes” by examining multiple codes that are frequently billed in conjunction with furnishing a single service. To correct what Medicare deems “misvalued codes,” they are expanding...

Need a New Employee? Ask Yourself These...

By Mary Pat Whaley, FACMPE, CPC Adding an employee to any business takes some serious consideration. Regardless of whether you are replacing someone who left the company or you are adding an entirely new position, adding an employee is a serious commitment. At the point that you are ready to make an offer to a candidate, you have already invested labor and resources. In healthcare, most...

TEN TIPS ON MEANINGFUL USE STAGE 2 FINAL...

By Margie Satinsky, MA, MBA BACKGROUND: Meaningful Use is already part of the everyday vernacular of most medical practices. Enacted as part of the 2009 American Recovery and Reinvestment Act (ARRA), the program allows Eligible Providers (EPs) who purchase a certified EHR system and use it to collect and use information in a certain way to apply for either a Medicare or Medicaid...

Transitional Care Management

by Steve Adams, CPC CMS has approved the reimbursement for transitional care management (TCM) services – codes 99495 and 99496. In simple language – CMS is trying to reduce hospital readmissions and ensure better outcomes for patients being discharged from an inpatient setting to an outpatient setting. They think they can do this if patients are contacted by telephone by a...

HIPAA Audits – what to expect for 2013

by Brian L Tuttle, CHP, CPHIT, CBRA, CHA, CISSP, CCNA  According to Leon Rodriguez (director of the Health and Human Services), covered entities (which means you) have a mountain of work to do in the area of HIPAA compliance.  In addition Mr Rodriguez states that the HIPAA audits are to resume and ramp up over 2013 with strong funding and renewed vigor.  Uh oh…   So in what areas...

CPT coding changes for 2013

by Steve Adams, CPC, CPC-H, CPC-I There are more than 700 changes this year to CPT.  In this article I’ll address the changes that I think will have the biggest impact on your practice.  However, don’t forget to check Appendix B in the back of your CPT code book for a full listing of all the coding changes since I’m not addressing all 700 in this article. Evaluation and...

FINAL OMNIBUS HIPAA PRIVACY AND SECURITY...

By Margie Satinsky, MA, MBA This article summarizes the highlights of the Final Omnibus HIPAA Privacy and Security Rule announced by the Department of Health and Human Services (DHHS) on January 17, 2013 and published in the Federal Register on January 25, 2013. The Rule modifies HIPAA Privacy, Security, and Enforcement Rules, implements statutory amendments under the HITECH Act of...

Face Up to the Reality of the ACO

By Marjorie Satinsky, MA, MBA ACOs: The Underlying Concept To briefly review…Accountable Care Organizations (ACOs) are provider-based organizations that assume the responsibility for meeting the healthcare needs of a defined population. They coordinate the treatment of patients across the continuum of care, and there’s an opportunity for participating providers to share financial...

CMS Contractors and OIG Work Plan

This information is provided by Steve Adams, Senior Management Consultant, InGuge Healthcare Solutions. As the new year is here I thought it would be helpful to share a link that gives access to the CMS Compliance Contractor list.  These are all the different agencies that can request information and conduct audits on services billed. Click on the link below and a map will show up –...

OSHA – a four letter word

By Brian L Tuttle, CHP, CPHIT, CHA, CISSP, CCNA   In this article I am going to talk about OSHA and the top 10 fines that were levied against medical practices for 2011.  I know, I know, this subject matter can be more boring than listening to Al Gore and Charlie Brown’s teacher discuss the finer points of theU.S.tax code but this information can help prevent nasty fines for your...