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THE FINAL COUNTDOWN! Jun 27, 2012 -
By now, you should have received a letter from our office advising you whether you may be required to file for an e-prescribing exemption. As we advised in our eStatus in April, CMS will begin assessing penalties on providers who fail to e-prescribe during the first 6 months of 2012.....
Reminder: Only a few Days Left to File for e-Prescribing Exemption
Jun 14, 2012 - By now, you should have received a letter from our office advising you whether you may be required to file for an e-prescribing exemption. As we advised in our eStatus in April, CMS will begin assessing penalties on providers who fail to e-prescribe during the first 6 months of 2012. The deadline to file for an exemption is June 30. ARM cannot file your request for exemption; it must be filed by the individual provider.....
Critical Medicare Revalidation in Progress
Apr 06, 2012 - Medicare continues to execute the revalidation process according to CMS guidelines implemented in March 2011. Providers who have not completed a revalidation since March of 2011 will be required to do so between now and March 23, 2015.....
CMS Agrees to Request for 5010 Enforcement Delay
Mar 15, 2012 - In response to industry concerns, the Centers for Medicare & Medicaid Services (CMS) announced it will extend its current discretionary enforcement delay of the HIPAA Version 5010 transaction standards through June 30.
2012 Anesthesia Update
Jan 03, 2012 - With the start of the new year, here are a few reminders and updates for all anesthesia providers....
2012 Pain Management Update
Jan 03, 2012 - With the start of the new year, following are a few reminders and updates important for every pain management provider to keep in mind.
Critical Medicare Revalidation in Progress
Oct 10, 2011 - Medicare has started the revalidation process according to the new CMS guidelines implemented earlier this year. Providers who have not completed a revalidation within the last 6 months
ePrescribing Deadline Approaching Sep 10, 2011 -
Eligible professionals (like anesthesiologists) worried about being hit by a penalty for non-participation with the Medicare e-prescribing program, take note: you may qualify for one of the new exemptions created by CMS.
OIG Warns of Documentation Pitfalls in EHR Use May 25, 2011 -
The Office of Inspector General warned you and your peers on May 18 about some features of electronic health records (EHRs) that could endanger your business and lead to False Claims Act violations......
MGMA Releases Analysis of Proposed ACO Rules Apr 25, 2011 -
With all the conversation about ACO's and how they may impact so many aspects of medical practice, the Medical Group Managers Association (MGMA) asked the law firm of Powers, Pyles, Sutter and Verville, P.C. to prepare an analysis of the proposed ACO rules. This analysis is essential reading for anyone interested in this subject.
This article provides a brief summary of their analysis.
Maximize Reimbursement with Better Documentation Apr 05, 2011 - It is very important that anesthesia providers document all procedures in detail to maximize their reimbursement. Better Documentation = Better Reimbursement.
Some procedures, when performed with additional services or conditions, can yield from 1 to 5 additional base units.
2011 Michigan CMS Conversion Factors
Nov 19, 2010 - Unless the lame-duck Congress once again extends the hold on applying the SGR, physicians across the country will soon face a major reduction in Medicare payments. The initial cut of approximately 22%
Oct 06, 2010 - Introducing our quality data capture app for iPad.
Senate Reaches Medicare Physician Payment Deal Jun 21, 2010 -
On Friday, the Senate passed legislation via a unanimous consent agreement blocking the 21.3 percent cut to Medicare physician payments until Nov 30. The House of Representatives must also vote on the matter and is expected to do so this week. If this bill becomes law, medical practices will receive a 2.2 percent increase to Medicare physician payment for claims with dates of service of from June 1 through Nov. 30.
Changes to Medicare Reactivation Effective Date
Jun 17, 2010 - Currently, a provider’s Medicare billing number (Provider Transaction Access Number or PTAN) will be deactivated after twelve months of inactivity. If a provider does not bill for any services with a specific group for 12 months, Medicare will terminate their affiliation with that group. In order to reactivate a provider with a group, a reactivation application must be submitted to Medicare. Recently, CMS made changes to their policy regarding the effective dates of these reactivations. Previously, we were able to reactivate a provider’s group affiliation retroactively. This is not longer the case. According to the WPS Medicare Part B website:
Clarifying Post-Op Pain Documentation Mar 22, 2010 -
Several clients have recently asked us to clarify the documentation requirements for post-op pain. Since there seems to be some confusion in this area, we thought it would be appropriate to refresh everyone’s understanding.
In order to be reimbursed for postoperative pain management services the following must be documented in the patient’s medical record/chart by the anesthesia provider:
Important Information for CRNA’s Credentialed with BCBSM Mar 03, 2010 - Over the past year, Blue Cross Blue Shield of Michigan has implemented new guidelines for enrolling and updating provider information for CRNAs. These new guidelines mandate that CRNAs utilize the Universal Provider Datasourse (UPD) at the Council for Affordable Quality Healthcare (CAQH) website (https://upd.caqh.org/oas) to maintain their personal demographic information. Medicare E&M Coding Has Changed Feb 12, 2010 -
Per the Medicare Claims Processing Manual [Pub 100-4, Chapter 12, Section 30.6.1 (B)] the selection of the level of evaluation and management service is based upon the content of the service. There are now new codes to represent this interpretation.
ASA Analysis of New Anesthesia Interpretive Guidelines for Hospitals Feb 12, 2010 -
On December 11, 2009, CMS issued final revisions to the hospital interpretive guidelines that pertain to anesthesia services. While ASA is concerned that these changes may not have followed provisions in the Administrative Procedures Act and will address this issue as well as other concerns in regards to the revisions with CMS, it is important that you understand the key changes and implications.
2010 Coding Update & Documentation Review Jan 08, 2010 -
As we work through the year it is all too easy to forget some of the basic things we know about documentation. This can be particularly costly when failing to document one or two items can have a significant impact on your reimbursement. We have put together a short “refresher” to help remind you of some of those procedures where a word or two more on your anesthesia record can yield big improvements to your bottom line.
2010 PQRI Update Jan 08, 2010 -
In addition to adding an anesthesia measure (#193: Perioperative Temperature Management), CMS has introduced the concept of clusters and groups. Professional coders will know which way to code them however there are some considerations that may impact which measures you choose to report.
Health Care News Roundup Sep 10, 2009 -
Aetna: No Payment for ‘Never Events’ and Certain Other Medical Errors
Joint Commission Alert: Effective Leadership Critical to Preventing Medical Errors
Hospital Financial Metrics Improving: Industry Report
- HHS Issues Rule Requiring Notification of Health Information Breaches
Overview of RAC Program Jun 26, 2009 -
We asked The Health Law Partners (www.thehlp.com) to provide an overview of the RAC Program for our clients. Following is their summary:
Per Section 302 of the Tax Relief and Health Care Act of 2006, CMS’ Recovery Audit Contractor (RAC) Program was made permanent and was expanded nationwide. This program was recently rolled out and will mean a significant increase in Medicare auditing activity for health care providers.
Update on Red Flag Rule
Jun 26, 2009 - As many of you may have heard, the Federal Trade Commission once again delayed enforcement of its identity theft prevention regulations (commonly referred to as the Red Flags Rule) until August 1, 2009. Anesthesia Revenue Management has implemented an internal policy addressing this topic for your protection. We are providing this informational update to assist you in your own compliance efforts on this topic.
CMS DELAYS RECOVERY AUDIT CONTRACTOR (RAC) MEDICAL NECESSITY REVIEWS Jun 22, 2009 - From The Health Law Partners - According to its most-recently published “Expansion Schedule,” the Centers for Medicare and Medicaid Services (CMS) planned to expand the Recovery Audit Contractor (RAC) program to 23 states by March 1, 2009, and the remaining states by August 1, 2009 or later. RAC automated reviews soon will begin, but medical necessity reviews have been delayed. Senate HELP Committee Releases Health Reform Bill Jun 11, 2009 -
The Senate Health, Education, Labor and Pensions (HELP) Committee has released a comprehensive health reform bill: the “Affordable Health Choices Act.” Committee leadership has indicated that they will begin marking up the bill next Tuesday, June 16.
FTC Grants 3 Month Delay of Enforcement of Jun 11, 2009 -
From the FTC Website: ?The Federal Trade Commission will delay enforcement of the new ?Red Flags Rule? until August 1, 2009, to give creditors and financial institutions more time to develop and implement written identity theft prevention programs.
Satisfaction Survey Results for Select States Feb 05, 2009 -
The Medical Group Management Association (MGMA) surveyed provider groups in all 50 states to determine their level of satisfaction with the 5 major carriers in their state plus Medicare.
2009 PQRI Educational Resources
Feb 05, 2009 - The Centers for Medicare & Medicaid Services (CMS) has announced several updates to its information database for 2009.
CMS Conference Call To Explain 2009 PQRI
Jan 08, 2009 - The Centers for Medicare & Medicaid Services (CMS) announced it will host a national provider conference call on the 2009 Physician Quality Reporting Initiative (PQRI).
Anesthesia Conversion Factor to Jump 5% in 2009
Nov 03, 2008 - The American Society of Anesthesiologists reports that beginning January 1, 2009, the national unadjusted Medicare anesthesia conversion factor (CF) will increase 5% from $19.
House Votes to Suspend Medicare Cuts
Jun 25, 2008 - The U.S. House of Representatives yesterday passed H.R. 6331, a bill that halts the 10.6% Medicare payment cut scheduled for implementation on July 1.
Some Physician Practices Facing NPI Deactivation
Jun 23, 2008 - The Centers for Medicare and Medicaid Services (CMS) has sent letters to health care entities whose legal business names (LBN) in the National Plan and Provider Enumeration System (NPPES) do not match those on file with the Internal Revenue Service (IRS).
Looking Ahead in 2008
Jan 04, 2008 - CPT Code Changes, Pain code modifiers changes and Medicare Conditions of Participation updates are a few of the things Anesthesiologists and practice managers can look forward to in 2008.
Aetna to Deny Use of Propofol in Colonoscopies
Jan 03, 2008 - Despite its increased use in Colonoscopy screening, Aetna, one of the nations largest private health plan managers, has classified Propofol (Diprivan) as "medically unnecessary.