Skip to site content
Search


Practice Management

Menu

Data Before Drama

March 2024  |  Elizabeth Woodcock, MBA, FACMPE, CPC

How many times have you heard sentiments from colleagues, administrators, employees – and perhaps yourself – describing your practice? When it comes to the business of a medical practice, we often rely on anecdotal evidence to manage: If appointment lead times are rising or patients are being tur...

Patient Payment Plans: Seven Tips for Success

February 2024  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Payment plans permit the patient to pay off the amount they owe for a service over a period, instead of requiring a lump sum payment. Offering payment plans to patients benefits your practice – and your patients; however, execution is key. Consider these tactics for success: Put the ball in the patie...

Getting Paid for Relationships

January 2024  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Physicians have long expressed frustration at the lack of payment associated with the preparation time required to learn about a patient, develop insight about a patient, and nurture a relationship with the patient, all with an eye to being able to provide the highest quality care. While it may not be suffici...

Medicare Reimbursement in 2024 Announced

November 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On November 2, the Centers for Medicare & Medicaid Services (CMS) released the final rule for the Medical Physician Fee Schedule (PFS). The PFS conversion factor for 2024 is $32.74, a 3.4% decrease from the 2023 conversion factor of $33.89. The overall payment rate will be reduced by 1.25% based on requir...

Scheduling Techniques for Success

October 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As I was chatting with a busy pediatrician about her priorities for managing her successful practice, I realized how often she mentioned the word, “schedule.” Perhaps it’s not a surprise, as the schedule defines the delivery of the practice’s most important asset – in this case, ...

Is Your Practice Prepared for a Disaster?

October 2023

SVMIC recently held a disaster preparedness “tabletop” drill where it tested the company’s Business Continuity Plan, an exercise we wholeheartedly recommend for all our members and practices. Disaster preparedness is a topic that often falls through the proverbial cracks because it is time-...

Scores Available for Medicare's Quality Payment Program

September 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The federal government recently released the scores for the Quality Payment Program. Feedback about your performance as reported for 2022 is provided - along with your 2024 payment adjustment. Audits are available by request; these targeted reviews must be requested by October 9, 2023, at 8:00 pm EST. The pe...

Patient Messages: Pathway to Payment

September 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Once documented and clipped neatly to the patient’s chart, messages today primarily arrive in an electronic format. Like the days of paper, electronic messages represent a record of the patient’s request. They are inherently accompanied by the record, accessible with just a few keystrokes. The adv...

2024 Medicare Proposed Rule Reveals Insight

August 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On July 13th, the Centers for Medicare & Medicaid Services (CMS) issued the calendar year (CY) 2024 Physician Fee Schedule (PFS) proposed rule. The ruling is just a proposal, but history demonstrates that it closely aligns with the final policy for the coming year. Therefore, it’s worthwhile to eval...

Leveraging Your Fixed Costs

July 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Much like airplanes, medical practices carry a multitude of fixed expenses. When a plane takes off, the airline must pay for the pilots, flight attendants, mechanics, and gas, regardless of whether every seat is taken – or just a handful. The nature of bearing these fixed costs makes selling a ticket fo...

Effective June, 27, 2023 - New Employee Workplace Posters “Know Your Rights: Workplace Discrimination Is Illegal”

July 2023  |  Sheri Smith, FACMPE

Due to new rights granted under the Pregnant Workers Fairness Act (PWFA) and the Providing Urgent Maternal Protections for Nursing Mothers Act (PUMP Act), employers must display a new version of workplace posters.  The U.S. Department of Labor (DOL) recently released two new posters with additional info...

New Medicare ABN Required Effective Now

July 2023  |  Jackie Boswell, FACMPE

Medicare provides certain rights and protections to their beneficiaries related to financial liability and appeals.  An Advanced Beneficiary Notice (ABN) is required to transfer potential financial liabilities to Medicare patients in certain instances to allow them to make informed decisions about their ...

Alarming Trend: Sharp Increase in Commercial Insurer Claims Denials

June 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Anecdotal evidence about increasing claim denials has been on the medical practice airwaves for months. Whether purposeful or not, commercial health insurers are denying claims at alarmingly high rates. A newly published analysis of claims data revealed that commercial insurers denied a remarka...

Supervision Requirements for Diagnostic Tests

May 2023  |  Jackie Boswell, FACMPE

On March 16, 2023, Medicare issued MLN Matters - MM13094 which clarified language related to the January 1, 2021 rule that expanded the list of providers who can supervise diagnostic tests to include Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Certified Nurse-Midwives (CNMs), Certified Regis...

Staffing Strategies that Work

May 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Despite looming predictions about the economy, employment rates have still not stabilized in the health care industry. Medical practices remain challenged by staffing shortages – and high turnover rates. There is no end in sight, so it pays to brush up on recruitment and retention tactics to ensure you&...

Gratitude or Grift: The Perils of Physician Gifts to Patients and Referral Sources (Part 2 of 2)

April 2023  |  Mark A. Ison, J.D.

Note: If you missed Part 1 of this article in the March 2023 Sentinel, please click here to read it. Ethical Obligations Codes of professional ethics typically address (and prohibit) the payment or receipt of kickbacks, but also may address the separate and sensitive issue of whether a provider may accept ...

APP Supervision and Diagnostic Tests: Clarification from CMS

April 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

If your medical practice offers imaging services, a recent clarification from the Centers for Medicare & Medicaid Services (CMS) requires attention. The March 16 2023 memo entitled: “Supervision Requirements for Diagnostic Tests: Manual Update” outlines the circumstances for which advanced pra...

The Hazards of Using Foreign Medical Scribes

April 2023  |  Stephen A. Dickens, JD, FACMPE

Scribes have long been employed in medical practices as a tool to increase the productivity of physicians and practitioners by lessening the demand on their time for documentation in an electronic health record (EHR). A well trained and competent scribe does exactly that. Given the staffing challenges of rece...

Convenience: Delivering on Patient Experience

March 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

CVS and Oak Street. Amazon and One Medical. Walgreens and Village Medical. Dollar General and DocGo On-Demand. The list could go on and on. Brought on by the allure of the size and stability of the health care market, retailers are partnering, acquiring, or infusing cash into health care start-up companies. W...

Farewell to the Public Health Emergency

March 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The federal government’s declaration of a “public health emergency (PHE)” on January 27 2020 is finally coming to an end. On May 11, 2023, the PHE concludes – following a lengthy three-year period combatting COVID-19. While there may be no end in sight to the disease that caused the wo...

Gratitude or Gift: The Perils of Physician Gifts to Patients and Referral Sources (Part 1 of 2)

March 2023  |  Mark A. Ison, J.D.

“In some industries, it is acceptable to reward those who refer business to you. However, in the Federal health care programs, paying for referrals is a crime.”  U.S. Dept. of Health & Human Services Office of the Inspector General, A Roadmap for New Physicians: Avoiding Medicare and Medi...

Coding: Opportunities to Improve Your Bottom Line

February 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

My daughter recently had out-of-network medical services, so I requested a copy of the superbill. Without so much as glancing at it, I submitted it to my health insurance company for processing towards our deductible. A few weeks later, I received a letter denying the services. Confused, I looked through the ...

Status of 2023 Medicare Payment Rate

January 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On December 29, 2022, the President signed the “Consolidated Appropriations Act, 2023” into law, sparing physicians the 4.5% payment cut to Medicare announced just weeks prior. While the decline wasn’t as bad as projected, it was far from reversed. The section, “Extension of Support fo...

QPP Application for Exemption Extended

January 2023  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The deadline to submit your 2022 Quality Payment Program data is March 3, 2023, at 8 pm EST. If you are required to participate in the Quality Payment Program (QPP) based on your volume of Medicare payments or patients, submit your data for 2022. For medical practices that do not have sufficient data to subm...

Newly Revised Risk Reduction Resource for Your Practice

November 2022  |  Robin Buter, BSN, RN, LNCC

Are your current office systems and processes protecting you from a lawsuit or leaving you vulnerable? Even well-established processes can break down when circumstances in your office change, such as opening an additional practice site, EHR modifications, and staff turnover.  National and internal data s...

Public Health Emergency Extended Once Again – but End is Near

November 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Despite declaring the pandemic was “over,” the federal government extended the public health emergency (PHE) for another 90 days last month. The PHE, which now expires on January 11, 2023, has been in place since early 2020. Now in its third year, it’s difficult to remember what flexibilitie...

2023 Coding Changes: Around the Corner

October 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Each year, the authors of the Current Procedural Terminology (CPT) Manual make changes to the code set. Some years usher in a multitude of changes; others bring few alterations to the table. The 393 changes to the 2023 CPT codes are of importance because they translate your services into billable transactions...

Patient Self-Service: Perk or Expectation?

September 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

When is the last time you walked into a bank? Automated teller machines put banking transactions in the hands of customers years ago. Airport kiosks, gas pumps, ridesharing, self- check-out lanes, and bill payment have joined the self-service trend. Most Americans love the convenience, transparency, and flexi...

(Crazy) Good Ideas for Employee Retention

August 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

All bets are off for ideas to keep employees on staff. Consider the hotel chain in Germany that is paying for employee tattoos. Body ink may not be appropriate for your medical practice, but consider these 15 crazy good ideas that other practices have successfully deployed: Host “Open Door” mee...

Leveraging Human Behavior Insights to Benefit Your Practice

July 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Behavioral science is a growing field of science, rooted in economics as a means of understanding decision-making. People do not always make rational decisions that align with the beliefs of economists. Indeed, traditional economists had historically opined that all human determinations are made based on pric...

Keep It Flowing

June 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Simply getting through the day has been an incredible achievement over the past two years for anyone working in a medical practice. Off-the-charts staff turnover, heightened patient expectations, and the infusion of new technological tools have added to the operational pressures. Now patients are flooding in,...

New Guidelines for Insurance Payments Benefit Physicians

May 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

VCC may sound like new college basketball conference, but it’s actually a term that could be adversely affecting your practice’s revenue without your knowledge. Moreover, there’s now something you can do about it. First, let’s define the term. The acronym, VCC, stands for “virtu...

New Federal Law Extends Telemedicine Reimbursement

April 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Performing telemedicine in your practice is an operational challenge, but those challenges pale in comparison with the unknowns about its reimbursement in the long run. Prior to the COVID-19 pandemic, telemedicine was not on the radar for most medical practices, but today it’s standard industry practice...

Key Performance Indicators: Spotlight on Revenue Cycle Management

March 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The tumultuous environment of the past couple of years has certainly introduced vulnerability into your practice’s revenue cycle. Reimbursement success emanates from a myriad of factors, but it can be tracked by a handful of standard indicators. Take the opportunity to measure three key performance indi...

Managing Missed Appointments

March 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Appointment no-shows can be incredibly frustrating, but the chief negative impact is on your bottom line. Like all practices, yours carries a tremendous amount of fixed expenses. That is, you are paying for your space, employees, insurance, technology, and many other costs, regardless of how many patients you...

Five Key Trends for 2022

February 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

2022 is off to a roaring start, and it pays to be mindful of the external pressures on your practice. Start with this checklist of key trends to consider regarding your medical practice. Keep abreast regarding the dynamic nature of your market. Change abounds in the healthcare delivery system, driven by the ...

The No Surprises Act: What You Need to Know Now

February 2022  |  Jackie Boswell, FACMPE

Surprise medical bills are a major concern for patients.  Visits to the emergency room, and services provided by physicians who are not in the patient’s insurance network, have caused patients to incur thousands, and sometimes hundreds of thousands of dollars in medical debt. The No Surprises Act, ...

Medicare Reimbursement Forecast for 2022

January 2022  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Released on November 2, 2021, the final Medicare Physician Fee Schedule (PFS) revealed few surprises, given the foreshadowing of the previously issued proposed rule. However, it’s still a hard pill to swallow. While the changes are issued by the Centers for Medicare & Medicaid Services (CMS), the im...

Breaking News: PHE Renewal

October 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On October 15, 2021, the Secretary of Health & Human Services renewed the Public Health Emergency (PHE). This move represents the seventh time the PHE was renewed since its declaration on January 27, 2020.  The importance for medical practices is that the regulatory relaxations for telemedicine relat...

Your Digital Front Door

October 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Open the (Digital) Door It will be many years before we determine the long-lasting impacts of the pandemic on medical practices, but there is one effect that is already crystal clear – patients’ expectations for a digital front door to their physicians. The migration to a digital interface for yo...

Monitoring Your Revenue Cycle

September 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Ensuring the health of your revenue cycle is like self-care for your medical practice – essential to prioritize so that you can serve your community for many years to come. It’s a great idea to do a full physical on your revenue cycle every three to five years, but monthly monitoring helps keep gu...

Proposed Medicare Payment Rate Drops for 2022

August 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The federal government’s proposal for the Medicare Physician Fee Schedule in 2022 features an alarming payment cut of 3.75%. This is a result of the conversion factor shifting from its current rate of $34.89 to a proposed $33.58 based on the budget neutrality required by law. This news was certainly not...

Personnel Management During a Labor Shortage

July 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Labor shortages are creating havoc for many businesses in the United States, and medical practices are not immune. Although there may be some relief when the federal government’s bonus checks end this fall, the problem will not come to a screeching halt. Indeed, experts believe that the growth of the am...

Breaking News: COVID-19 Public Health Emergency Extended for 90 Days

July 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On July 19, 2021, Xavier Becerra renewed the Public Health Emergency for 90 days starting July 20. The move by the Secretary of Health & Human Services signals the federal government's intention to extend regulatory relaxations associated with telemedicine delivery and reimbursement into the fall. The Bid...

Hold Harmless: MIPS Cost Category

June 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On May 20, 2021, the Centers for Medicare & Medicaid Services announced that the hotly debated cost category will be reweighted to 0% for 2020, effectively eliminating it from scoring as part of the Merit-based Incentive Payment System (MIPS). Advocates for physicians – including the American Medica...

Sequestration Holiday Extended

May 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Centers for Medicare & Medicaid Services (CMS) put a temporary hold on Medicare claims in March. The pause in processing resulted from pending legislation to extend the removal of the 2% sequestration cut to Medicare reimbursement. On April 13, Congress voted to continue the sequestration relief throu...

Open Notes Mandate Starts Now

April 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

In May 2020, the Office of the National Coordinator for Health Information Technology (ONC) published the 21st Century Cures Act: Interoperability, Information Blocking, and the ONC Health IT Certification Program Final Rule, which is designed to provide patients and providers secure access to health informat...

Getting Paid for Vaccine Administration

April 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Centers for Medicare & Medicaid Services more than doubled the reimbursement for COVID vaccines as of March 15, 2021; the payment rate is now approximately $40 per dose. For up-to-date information on payment rates for Medicare, see COVID-19 Vaccines and Monoclonal Antibodies | CMS . If your practice i...

MIPS Penalty Exemption Applied to All Clinicians

March 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On February 25, 2021, the Centers for Medicare & Medicaid Services (CMS) declared that a hardship exception would retroactively apply to all eligible clinicians for the 2020 performance year of the Quality Payment Program (QPP). The announcement, which came just weeks after the deadline for the exemption ...

The Evolution of ‘Incident to’ Billing

February 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

‘Incident to’ billing has been a challenging topic since its creation by Medicare. The rules – which allow advanced practice providers to be reimbursed at the full physician rate by Medicare when seeing patients in an office and directly supervised by a physician – are complex and, arg...

2021 Changes to RVUs: Ripple Effects

February 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

By now, physicians have transitioned into the new rules to code evaluation and management (E/M) encounters in the office.*[1] What may not be recognized, however, is the changes to the relative value units associated with the codes. In addition to the shift in coding guidance, the American Medical Association...

Law Changes Improve 2021 Reimbursements

January 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On December 27, President Trump signed the fourth major COVID-19 emergency funding bills into law, providing approximately $900 billion in funding. The bipartisan agreement offers several key provisions critical to medical practices in 2021. Here is a summary of the law’s impact on medical practice reim...

February 1 Deadline for QPP Hardship

January 2021  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Quality Payment Program imposes a 9% reduction to Medicare payments across the board for physicians who do not participate in the federal government’s initiative. There’s one easy method to avoid the penalty in 2022, if you did not keep track of your 2020 data – or your efforts weren&rsq...

QPP Exemption Application Open

November 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As the end of the year draws near, it is an opportune time to consider your participation in the Quality Payment Program (QPP). Launched by the Medicare Access to Care and CHIP Reauthorization Act (MACRA) in 2015, the QPP exacts mandatory participation from physicians and other eligible clinicians who meet ce...

Contactless Registration Tips

October  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Many practices have moved to a contactless registration process. As the term infers, the process is completed without physical interaction with the patient. Patients are seeking safe environments, and the touch-free process can offer significant benefits for your practice. Consider these strategies to achieve...

A New Vantage® Feature: Vantage Discussions

October  |   Meghan Clark

There’s no question that 2020 has forced many of us to forego our usual routines and adopt innovative, new ways of doing things – both personally and professionally. One change that many are struggling to get accustomed to is the absence of live events and the opportunity to interact face-to-face ...

Rebooting Your Leadership Team: A Virtual Interactive Series

September  |  Stephen A. Dickens, JD, FACMPE

As we look to 2021, it is time to begin assessing operations and developing plans for the new year. While the current environment brings new challenges and uncertainties, some things remain constant. One is the need for leadership and direction within an organization. Successful practices have a defined missi...

New CPT® Code for COVID-19 Expenses

September  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On September 8, the American Medical Association announced the addition of CPT® 99072 with the express purpose to account for the supplies and clinical staff time required for medical practices to mitigate COVID-19 transmission. Acknowledging the practice expenses related to patient safety during the pand...

SVMIC Announces Practice Management Refresher Series

August 2020  |  Stephen A. Dickens, JD, FACMPE

There seems to be no shortage of webinars these days as everyone works through the ramifications of COVID-19. While there are important considerations depending on the impact to the practice and its response, there are still many non-COVID related challenges in running a medical practice. Managers must stay c...

The Government's COVID-19 Financial Assistance: Impact on Billing

August 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Provider Relief Fund (PRF) provided $175 billion in payments made through the Coronavirus Aid, Relief and Economic Secure (CARES) Act, as well as the Paycheck Protection Program (PPP). These funds may not require repayment, however, there are terms and conditions with which recipients must comply.[1] Thes...

COVID-19 Financial Relief: What Providers Should Know About Required Certifications, Attestations, and Terms and Conditions

July 2020  |  Ian Hennessey, J.D.

Since the onset of the COVID-19 pandemic in the United States, the federal government has implemented several waves of unprecedented financial stimulus to shore up the economy. For healthcare providers, the primary sources of federal assistance to date have come by way of two programs: (1) the Paycheck Protec...

Bostock v Clayton County, Georgia: What the U.S. Supreme Court Decision on LBGT Employee Rights Means For Your Practice

July 2020  |  Scott Hickman, J.D.

On June 15, 2020, the United States Supreme Court issued its opinion on a trio of consolidated cases regarding discrimination against LBGT employees in the workplace. In Bostock v. Clayton County, Georgia, the Court held in a 6-3 decision that Title VII, the federal law that generally prohibits discrimination...

Re-opening Your Practice in the Midst of COVID-19

June 2020  |  Shelly Weatherly, JD

As state and local authorities permit your practice to reopen, it is imperative that you implement processes that ensure the safety and health of your employees and patients.   Our new checklist is provided in furtherance of our commitment to support you during this uncertain time. There is no one-s...

Key Considerations for Telemedicine

May 2020  |  Julie Loomis, RN, JD

1) Contact the Medical Board in every state where you plan to treat patients. Generally, states require full licensure to treat residents and may also have requirements for telemedicine encounters. During the COVID-19 pandemic, most states have relaxed licensing requirements as well as telemedicine regul...

Utilizing Telemedicine in Your Practice During the Pandemic and Beyond

May 2020  |  Justin Joy, JD, CIPP

Telemedicine use has skyrocketed during the COVID-19 health crisis: Is it here to stay? Prior to the COVID-19 pandemic, the vast majority of patients were unfamiliar with telemedicine,[1] and relatively few medical practices offered any form of virtual care. According to a J.D. Power report released in late ...

SVMIC Actions and Resources to Assist with Coronavirus Impact

May 2020  |  Judy Musgrove

SVMIC has proactively developed several financial programs to help with the impact of the COVID-19 pandemic on practices. The company has also developed an extensive network of resources to help policyholders and staff respond in the most rapid and efficient manner to the changes necessitated by the current s...

Quality Payment Program Deadline Looming - and Change is Afoot

March 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

8:00 p.m. EST on March 31, 2020 is the final deadline for submitting your 2019 performance data for the Quality Payment Program (QPP). Many physicians participate in the QPP through the Merit-based Incentive Payment System (MIPS) track, which requires reporting on Quality, Promoting Interoperability, and Impr...

Use LEARN When Patients Complain

March 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As perceptions of value becomes ever-more important to your medical practice, now is a good time to review how you and your staff handle patient concerns and complaints about scheduling, billing, and other administrative functions. There may well be little that you can do to resolve some complaints, but a wel...

Don’t Let Surprise Billing Surprise Your Practice

February 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

President Trump’s 2020 State of the Union speech addressed an important topic currently being debated on Capitol Hill. Patients, he espoused, should never be "blindsided" by medical bills. Tackling surprise billing, which occurs when an insured patient receives care from an out-of-network provider at an...

Body Language Makes a Difference

January 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

When you think about improving your patient experience scores, you might be quick to focus on your office décor or new equipment without pausing to think about the little things that can add up to a big deal in the minds of a patient. An interaction that garners high patient experience scores may be mu...

2020 Quality Payment Program Update

January 2020  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Recently, the Centers for Medicare & Medicaid Service (CMS) revealed that the tool provided to look up participation status for the Quality Payment Program (QPP) was flawed. To ensure your participation status is correct for the current reporting year, please visit this link: &nbs...

Primary Care First: Applications Now Being Accepted

November 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Primary care physicians in Arkansas, Tennessee, Virginia, and 23 other states are invited to apply for Primary Care First, the latest payment model by the Centers for Medicare & Medicaid Services (CMS). Applications are accepted from practices that meet certain basic criteria, like having an electronic he...

Physician Fee Schedule Final Rule

November 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

What’s Ahead for 2020? On November 1, the Centers for Medicare & Medicaid Services (CMS) released the highly anticipated Final Rule for the 2020 Physician Fee Schedule (PFS). Although the PFS is specific to Medicare reimbursement, CMS’ dictums have significant influence over all insurers. Per...

Managing the Quality of Patients' Wait

October 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Patients now wait 24 days to see a specialist, up 30 percent since 2014, according to a survey of specialists in the 15 largest U.S. metro areas.[1] As patients wait longer just to get open appointments to see their physicians, making them linger another 30-plus minutes in the reception area on the day of the...

CMS Final Rule - Omnibus Burden Reduction

October 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On September 26, the Centers for Medicare & Medicaid Services released a Final Rule titled "Omnibus Burden Reduction." While the rule focuses on processes within health care facilities, a multitude of these changes will impact physicians practicing there. To highlight a few areas, CMS ruled: 1. Portable ...

Effective and Efficient Recruiting for Your Practice

September 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Hiring is a constant in a medical practice. According to the Medical Group Management Association, the employee turnover rate for surgical practices is 33 percent, 25 percent, and 30 percent for reception, nursing, and billing/collections staff, respectively. Although the rate varies by position, there is no ...

Is It Time for Your Practice to Conduct a Mystery Patient Survey

September 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

While secret shoppers have long been a method of gleaning customer feedback in the retail world, the notion of using an anonymous “mystery patient” in a medical practice is certainly less common. However, since secret shoppers provide an opportunity for an objective, customer-focused evaluation, t...

Patients Want More Out of the Data You Collect About Them

August 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Patients are seeking to interface the data you collect about them in your practice with their mobile health tracking device – a Fitbit, Apple Watch, or the like. If your practice is fielding these patient requests, you may be questioning your liability related to this information transfer. On April 18, ...

2020 Proposals for Medicare Released

August 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The federal government recently issued important Medicare proposals for 2020. While you can certainly take a deep dive into the 1,704-page document if time permits, we compiled this article to highlight key proposals that may impact you. The Quality Payment Program – in which many physicians participat...

Is a Medicare Appeal Worthwhile?

July 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

If you are dissatisfied with a denial of payment by your Medicare contractor, you can appeal the decision. The Centers for Medicare & Medicaid Services (CMS) recently announced attempts to streamline the process by no longer requiring signatures, thus enabling documents to be submitted in a more efficient...

MIPS Audits Begin

July 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

In June, the Centers for Medicare & Medicaid Services (CMS) announced the commencement of audits for the Merit-based Incentive Payment System (MIPS). The contract was awarded to Guidehouse, formerly known as the US Public Sector of PricewaterhouseCoopers. Guidehouse is transmitting notifications of audits...

MIPS Scores Are In

July 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

If you participated in the Merit-based Incentive Payment System (MIPS) in 2018, you can now view your results. The Centers for Medicare & Medicaid Services (CMS) released the performance feedback, final scores, and payment adjustments for 2018 MIPS program participants. CMS reports that 98% of practices w...

Turn the Daily Grind into a Successful and Satisfying Future

June 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Managing a medical practice is an experience that can’t be meaningfully compared to anything else. Daily operations often border on chaotic: Effective deployment of people, space and supplies is essential to success, but it can also be overwhelming. Most importantly, your patients’ lives depend on...

Buzz Word Alert: SDOH

June 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Even if you aren’t already familiar with the acronym SDOH, you have likely encountered the notion of “social determinants of health.” The term is splashed all over the health care media as it relates to value-based reimbursement. It’s a fancy term for a topic that your practice has bee...

Billing for Chronic Care Management

June 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Chronic Care Management (CCM) Services offer an opportunity to be paid for services you perform outside of the face-to-face patient encounter. Billing for CCM services may seem daunting, but the Centers for Medicare & Medicaid Services (CMS) offers extensive guidance about reimbursement protocols for Medi...

Medical Practice Services Announces Advanced Practice Seminar

June 2019  |  Stephen A. Dickens, JD, FACMPE

The healthcare landscape is rapidly changing!  These changes can be overwhelming to say the least. Do you know there are groups that are not only embracing change but are doing so successfully? Do you want to lead your group by successfully navigating these changes, but you are not sure where to start? J...

Take a Gemba Walk

May 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Gemba is a Japanese term meaning “the real place.” In medical practices across the country, administrators are taking the walks to the “real places” in their practices – the front office, the exam rooms, the business office, and throughout the halls of their practices. Administra...

Finding - and Resolving - Problems in the Billing Office

May 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As a business, there’s a lot of money at stake in a medical practice. When mistakes occur in the billing office, it is easy for you to get frustrated. If you’re consistently spending time handling the aftermath of blunders, then it is time to shift your focus from problem resolution to problem pre...

Spring Cleaning: Seven Strategies for Your Practice

April 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The spring offers a chance to shake off the winter blues – and get started on an improvement initiative for your practice. Make a commitment to focus on one area in your practice. Select a task, create a workgroup, pledge to meet once or twice a month, maintain a written agenda, and document an action p...

Transparency Revealed: How to Make Payments More Transparent to Patients

April 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Medical practices and price transparency haven’t exactly gone hand in hand in the past. With complex reimbursement systems and the real need to focus on other tasks, practices have not always been up front with patients when it comes to revealing the payment due until long after the service is rendered....

Don't Say "Sorry"

March 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

When your practice is running late, it is easy to greet the next patient with an “I’m sorry” instead of making a more meaningful connection. Although acknowledging the time and the patient’s frustration is a noble intention, a basic “I’m sorry” can actually start your...

Quality Payment Program: 2019 Adjustments

March 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Medicare remittances began arriving for 2019 services in mid-January. Unless an exemption applies, physicians and other eligible clinicians will see a bonus – or penalty – attached to each service. The claim adjustment reason code (CARC) for a positive payment adjustment is CO144; the negative adj...

Federal HR Changes May Impact Your Practice

March 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Overtime is common in medical practices, so it is important to understand the regulations associated with it. On March 7, the Department of Labor (DOL) announced an overtime update that could impact your practice. The DOL’s proposal raises the salary threshold for exempt employees from $23,660 to $35,30...

Tips for Successful Collection Calls: Business Critical in the Era of High Deductibles

February 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As patient financial responsibility grows, it’s business critical to have an effective process to collect outstanding debt. It’s an opportune time to review your entire collection workflow, to include making collection calls. These steps are aimed to boost your success rate, while preserving patie...

Handling an Upset Patient

February 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Physicians, nurses, support staff and anyone else in a practice have all witnessed this scenario too many times: a patient gets frustrated and takes his or her anger, confusion, or worry out on you. How you handle an upset patient can quickly determine the difference between a successful or disastrous outcome...

Hiring the Best Candidate

January 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

A single bad hire can cost you more than $50,000 according to a CareerBuilder survey. If you have a position open, take the opportunity to hire right – the first time. Consider these proven techniques to get the best candidate for your practice. Listen. While it’s difficult to schedule multiple r...

Seven Percent on the Line for Practices in 2019 for 2021 Payments

January 2019  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The federal government's Quality Payment Program (QPP) is now in its third year, although 2019 is the initial annum for the program's payment adjustments. For those of you who achieved perfect performance in 2017, your current Medicare remittances should reflect a 1.88% boost; a decline of 4% is the reality f...

Changes to Evaluation & Management Coding to Have Major Impact of Government's New Ruling

November 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On November 1, the Centers for Medicare & Medicaid Services (CMS) released the Final Policy, Payment, and Quality Provisions Changes to the Medicare Physician Fee Schedule for Calendar Year 2019. This highly anticipated, hefty 2,378-page federal ruling outlines key reimbursement changes for 2019 – a...

Eight Simple, Inexpensive Tips to Improve Patient Flow

October 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Automation can create opportunities to enhance patient flow, but sometimes it’s the little things that make the day run better for you and your patients. None of these tips require any fancy equipment, and most can be done for a few dollars – or no expense at all. Let’s review eight simple i...

Applications for QPP Exception Due Soon

October 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The financial impact of the Quality Payment Program will soon be felt. On January 1, 2019, the reimbursement for Medicare will be shifted based on your performance in 2017. Although it's too late to avoid the 2019 penalty of 4%, you have until December 31, 2018, to possibly dodge the 2020 sanction, or at leas...

HIPAA Myths and Misconceptions

October 2018

Trying to comply with HIPAA can be a challenge for healthcare providers, especially when there is so much confusion about specific aspects of the Rules. On almost a daily basis, policyholders contact SVMIC for assistance with HIPAA-related issues. In fielding those calls and emails, some commonalities have be...

Some Physicians Receive Alterations to 2017 QPP Scores

September 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Centers for Medicare & Medicaid Services (CMS) updated the 2017 Quality Payment Program (QPP) performance scores for some participants. Released in mid-September, the updated feedback will impact Medicare payments in 2019. The scores were changed based on the CMS’ review of several program varia...

It's Due Time: Patient Self-Scheduling

September 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Blame OpenTable®, Uber®, or ATMs, but the world of self-service is knocking on physicians’ door as patients desire self-service tools. Patient self-scheduling solutions need not encumber your practice; in fact, they can be an excellent way to reduce a burden on your already-overworked administra...

Government Releases Medicare Proposed Rule for 2019

August 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Choosing the appropriate level of an evaluation and management (E/M) codes is a daily occurrence for providers, but it’s no easy task. The “correct” code for an E/M is dictated by two guiding principles – the 1995 and the 1997 Documentation Guidelines; providers must select one or the ...

Tips to Prevent Denied Claims

July 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Denied claims cost your practice both time and money. Employees spend precious hours researching and processing denials, only to find that payers are unresponsive or unwilling to overturn their decision. Given the complexity of our reimbursement system, denied claims will always exist. However, there are cert...

2017 Scores Released: Merit-based Incentive Payment Plan

July 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

In July, the Centers for Medicare & Medicaid Services (CMS) issued the scores for the first year of the Quality Payment Program (QPP). Your 2017 Merit-based Incentive Payment System (MIPS) scores and performance feedback reports can be retrieved from the Quality Payment Program’s website. These scor...

Avoid the Overtime Blues in Your Practice

June 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Perhaps no one in your practice deliberately abuses overtime. Then again, if you make overtime pay available to employees on a regular basis, who could blame them for grabbing the opportunity? Not only can overtime cost you money, but it may also bring legal liabilities if you fail to manage it with care. It...

Physician Compensation Plans

June 2018  |  Michael Cash, MHSA, FACMPE

Physician compensation in a private solo practice is simple: The physician receives any profits after expenses are paid as compensation. The physician generally takes a monthly draw and has periodic bonus distributions. When two or more physicians join the practice, the compensation variables change. Open com...

Quality Payment Program Update

June 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Physicians who bill more than $90,000 in total allowed Medicare Part B charges need to ensure successful participation in the Quality Payment Program (QPP). Two pathways are available: submitting data for the Merit-based Incentive Payment System (MIPS) or joining an Advanced Alternative Payment Model (APM). T...

Self-scheduling: Attracting the Coming Wave of Patients

May 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The generations known as “Baby Boomers” and “Gen Xers” constitute the majority of your patients today; however, it’s necessary for you to be thinking about the coming wave of Millennials and Gen Zers. While addressing the needs of the new generations may concern you, the automat...

Tiering: Levels of Copayments

April 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Tiering is a concept that has moved from the pharmacy to the medical practice. For years, payers have tiered medications into categories. Certain medications cost the consumer more, while others are available at lower costs. This strategy has steered patients – and ordering physicians – to generic...

Budget Act Extends GPCI Floor

April 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Bipartisan Budget Act of 2018 featured an extension of the physician work geographic price cost index (GPCI) floor. As the work GPCI is a component of the Medicare payment formula, this declaration positively impacts physician reimbursement. On March 20, the Centers for Medicare & Medicaid Services (C...

Managing the Challenges of Technology

March 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Electronic health record (EHR) systems are installed in most practices, yet they remain the source of daily headaches. Having worked in practice management for many years, my philosophy is that the systems were built by technology experts, not those familiar with the workflow of a physician’s office. Wh...

Managing Your Schedule is Vital to a Successful Practice

March 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Of the many ways that a manager can contribute to a practice’s success, the ability to manage the physicians’ time is the most important. The time of your physicians, advanced practice providers and other billable providers is, ultimately, your practice’s most valuable asset. In addition to ...

What Kind of "Manager" Does Your Practice Need?

March 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Don’t start looking for someone to run your office until you know what the person in this position must do. While many of the qualities needed in a successful manager are universal — solution-oriented, delegator, motivator, etc. — more depend on your office’s unique needs. It might se...

Government Shutdown Averted

February 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Bipartisan Budget Act of 2018 was expected to focus on immigration, however, healthcare was the prevailing theme of the law that was passed on February 9, 2018. Highlights for medical practices include: The elimination of the Independent Payment Advisory Board (IPAB), a group of 15 stakeholders who wer...

Get the Reimbursement You Deserve

February 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

How much do you know - and truly understand - about your allowables? This is the term for the discounted price to which you agree as a participating provider for an insurance company. This price is not what the payer reimburses you, but rather the rate you agree to accept as payment in full based on the patie...

Should You Use a Chaperone?

January 2018  |  Stephen A. Dickens, JD, FACMPE

Given the recent flood of high-profile sexual misconduct claims in the news, SVMIC has received an increased number of questions surrounding the topic of chaperones in an exam room. While there are no legal requirements to do so, the goal should be to make the patient feel comfortable while also protecting th...

The QPP Portal is Open: Submit Your 2017 Data

January 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Centers for Medicare & Medicaid Services (CMS) opened the reporting portal for the Quality Payment Program (QPP) on January 2. The deadline to submit your 2017 performance data is March 31, 2018. The portal provides one-stop shopping, allowing users to enter performance scores for all three categories...

The MIPS Cost Category: New for 2018

January 2018  |  Elizabeth Woodcock, MBA, FACMPE, CPC

In 2018, the federal government began to assess the cost of caring for Medicare beneficiaries under the Merit-based Incentive Payment System (MIPS). One of four components of the MIPS composite performance score – the cost category – counts as 10% of the overall score in 2018. While it m...

How Much Is Your Practice Really Worth?

November 2017  |  Michael Cash, MHSA, FACMPE

At some point, every practice undergoes physician transitions as physicians join, retire, merge and separate from groups. Advanced planning and communication can help facilitate the process. When physicians wait until the last minute, options are limited and decisions tend to be reactive to the market conditi...

Medicare Physician Fee Schedule 2018 Overview

November 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Within just hours of the release of the Final Rule concerning the 2018 revisions to the Quality Payment Program (QPP) on November 2, the Centers for Medicare & Medicaid Services (CMS) published the ruling that governs the Medicare Physician Fee Schedule (PFS) for the coming year. Although overshadowed by ...

CMS Unveils Numerous Changes to Quality Payment Program (QPP)

November 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The number of clinicians required to heed Medicare’s Quality Payment Program (QPP) next year and beyond got smaller, thanks to new language in the program’s final rule for 2018. In issuing the rule on November 2, 2017, the Centers for Medicare & Medicaid Services (CMS) effectively raised the b...

Billing Medicare for Preventive Services

October 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Can I bill Medicare for Depression Screening? What is the CPT® code for Medicare’s Initial Preventive Physical Exam? How many smoking cessation sessions will Medicare cover for my patient? Do all males qualify for Prostate Cancer Screening? Which counseling services can I provide via telehealth?...

Charting Your Success in Employee Disciplinary Actions - Best Practices for Managing Staff Performance

October 2017

No doubt employee discipline can be one of the most challenging aspects of human resource management. Perhaps this is due to the term “discipline” and the negative connotation associated with the details of disciplinary actions.  Much of the stress related to managing staff disciplinary actio...

Hardship Application - ACI Category

October 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

You can apply for a hardship exemption for the “Advancing Care Information” (ACI) category of the Quality Payment Program’s Merit-based Incentive Payment System. ACI counts for 25% of the composite performance score for eligible clinicians (ECs) in the government’s new payment program....

Know in Advance What a Patient Wants You to Do When They Can't Tell You

October 2017  |  Justin Joy, JD, CIPP

As the patient population ages, the likelihood of encountering a patient unable to make decisions regarding his or her care will increase. Unexpected and emergency situations however can obviously affect a patient at any age, rendering the patient unable to make care decisions for themselves. Whether treatin...

2018 Penalties: PQRS and VBPM Informal Review Available Through December 1

October 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

On September 18, 2017, the Centers for Medicare & Medicaid Services (CMS) released the feedback reports for the Physician Quality Reporting System (PQRS) and the Value-based Payment Modifier (VBPM or VM). Both programs concluded at the conclusion of 2016, however, the impact on reimbursement continues thr...

Commercial Payers Changing the Rules for APP Billing

September 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The reimbursement of services provided by advanced practice providers is a complex issue. Guidelines may vary based on the type of APP, and the rules surrounding APPs are impacted by federal and state regulations, facility-imposed standards of care, and billing requirements. The latter may include payer-speci...

New Medicare Cards with New Numbers: 3 Changes You May Need to Make

September 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. CMS will begin mailing new Medicare cards with a new Medicare number (currently called the Medicare Claim Number on cards) to your patients in April 2018. You m...

Overpayments

September 2017  |  Laura Watkins, FACMPE, CPC

When was the last time your credit balance report was reviewed and worked thoroughly? Working the report on a regular basis is an essential step in the revenue cycle. Understandably, many practices focus on the collection of insurance and patient payments portion of the revenue cycle. Overpayments are often ...

Meeting Management

August 2017

One of the unfortunate necessities of managing any organization is the need to have meetings. As medical practice consultants, we work with practices on governance and management issues. Few practices handle their meetings well. Problems range from no regular meetings to meeting too frequently, meetings witho...

Minding Your Information Through Document Retention Policies

August 2017  |  Justin Joy, JD, CIPP

The information contained in your practice’s documents and records is one of the most valuable assets to your organization. Without this information, your practice cannot treat patients, receive compensation, or otherwise operate. With the fundamental transformation of documents from paper to digital fo...

Hardship Application Open for MIPS' Advancing Care Information

August 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

“Extreme and uncontrollable” circumstances provide a way out of a key component of the Merit-based Incentive Payment System (MIPS) of the Quality Payment Program (QPP). The QPP Hardship Exception Application for the MIPS program year 2017 just opened on August 2, with circumstances such ...

Kentucky Surgeons: July 1, 2017, Start of Government Research Study

August 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Several years ago, the Centers for Medicare & Medicaid Services (CMS) proposed a dismantling of the coding system for surgeries. Congress stepped in to block the change, but allowed CMS to study the non-surgical activity that occurs during global periods. That research study began on July 1, 2017, encompa...

MACRA 2.0 Proposed

July 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Proposed updates to the Medicare Quality Payment Program (QPP) for calendar year 2018 would provide many physicians and other providers welcome relief from several regulatory burdens imposed by the Medicare Access to Care and CHIP Reauthorization Act (MACRA). The updates also would give tens of thousands clin...

The New Reality of Patient Financial Responsibility

July 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As insurers and employers are now offering health plans with higher deductibles and copayments, collecting at the point of contact is more important than ever to ensure a successful practice. While many medical practices struggle with this, it doesn’t need to be as difficult or intimidating as it might ...

If the "Scribe" Fits

July 2017  |  Sheri Smith, FACMPE

Physicians struggle with the increased regulatory requirements of documenting a patient encounter in the Electronic Health Record (EHR). The majority of physicians chose medicine as a career path to take care of patients only to find that they spend an overwhelming amount of time and energy documenting patien...

Quietly Improving Care with QICs

June 2017  |  Justin Joy, JD, CIPP

Just as physician-patient confidentiality encourages frank discussions between the physician and the patient about the patient's condition without concern of involuntary disclosure of that information, documents generated within the parameters of a quality improvement committee (“QIC”) encourage m...

Social Security Number Removal Initiative Reminder: Get Your Systems Ready

June 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

As you know, beginning in April 2018, CMS will start mailing Medicare cards with new Medicare Beneficiary Identifiers (MBIs) to all individuals covered by Medicare. The MBI will, after a transition period, replace the Social Security Number (SSN)-based Health Insurance Claim Number for transactions such ...

Meaningful Use Deadline Looming

June 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

July 1, 2017, is the deadline for physicians to submit a hardship application for the 2018 payment adjustment, based on the 2016 reporting period for the EHR Incentive Program. If you were eligible to participate in the program, but you did not successfully report the program’s required “meaningfu...

ABN Update

June 2017

It is time to update your Advance Beneficiary Notice of Noncoverage (ABN). This important form issued by the Centers for Medicare & Medicaid Services (CMS) is used to communicate with patients about services for which Medicare payment is expected to be denied. The changes as of June 21, 2017 include a new...

Business Suit or Hazmat Suit? Which Do I Wear When Visiting Your Practice?

June 2017  |  Rana McSpadden, FACMPE

The first visual impression a patient has of a medical practice is the lobby.  Do you know what impression you are making on your patients?  As a medical practice consultant, I have seen my share of lobbies through my travels.  As a patient, I can recall a time that the lobby was so inviting an...

Quietly Improving Care with QICs

June 2017  |  Justin Joy, JD, CIPP

Just as physician-patient confidentiality encourages frank discussions between the physician and the patient about the patient's condition without concern of involuntary disclosure of that information, documents generated within the parameters of a quality improvement committee (“QIC”) encourage m...

Meaningful Use Deadline Looming

June 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

July 1, 2017, is the deadline for physicians to submit a hardship application for the 2018 payment adjustment, based on the 2016 reporting period for the EHR Incentive Program. If you were eligible to participate in the program, but you did not successfully report the program’s required “meaningfu...

Quality Reporting Under MIPS

May 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

At first glance, the Merit-based Incentive Payment System (MIPS) may look somewhat like the Physician Quality Reporting System (PQRS), which closed its door on December 31, 2016, but appearances can be deceiving. MIPS features 271 quality measures, of which physicians and other eligible clinicians must repor...

OSHA in a Medical Practice

May 2017  |  C. Anne Pontius, MBA, FACMPE, CHC, MT (ASCP)

The Occupational Safety and Health Administration (OSHA) is part of the United States Department of Labor. The mission of OSHA is to assure safe and healthful working conditions for working men and women by setting and enforcing regulatory standards.  In addition, OSHA is responsible for providing traini...

QPP Clinician Participation Letter

May 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

The federal government granted an exclusion for many physicians to its Quality Payment Program (QPP), which features the Merit-based Incentive Payment System. Physicians – and other QPP-eligible clinicians - are omitted on the basis of billing less than $30,000 in Medicare Part B allowed charges per yea...

Coping with "Difficult" Coworkers

April 2017  |  Stephen A. Dickens, JD, FACMPE

“The staff are not getting along” is a cry for help I frequently hear from physicians and practice executives. Staff relationships can be one of the most time consuming and mentally draining aspects of a manager’s or supervisor’s day. Staff who find it difficult to work with one anothe...

Tips to Prevent Denied Claims

April 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Denied claims cost your practice both time and money. Employees spend precious hours researching and processing denials, only to find that payers are unresponsive or unwilling to overturn their decision. Given the complexity of our reimbursement system, denied claims will always exist. However, there are cert...

Meaningful Use: Avoiding the 3% Penalty in 2018

April 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

If you did not report meaningful use in 2016 – or failed to do so successfully – the government will impose a 3% penalty in 2018 on all Medicare payments.  Now is the opportune time to review government applications to try to get an exemption for that penalty. Just posted on March 7, the appl...

It's Not Easy to Say Goodbye: Properly Discharging a Patient from Your Practice

April 2017  |  Justin Joy, JD, CIPP

Once a physician has established a professional relationship with a patient, the physician has an on-going legal duty to care for that patient. The expected length of this relationship varies based the type of care being provided.  If a patient is referred to a surgeon for a single procedure, the profess...

Just Say Yes to MIPS Participation in 2017

March 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

January 1, 2017, marked the commencement of the Quality Payment Program (QPP). The government’s initiative is mandated for physicians and other eligible clinicians who provide care for Medicare patients. By 2019, non-participation fines will be up to 4% of Medicare payments, so it is important to enroll...

Changes to Medicare "Incident To" Billing Requirements

March 2017  |  Jackie Boswell, FACMPE

Medicare allows a physician to bill for certain services furnished by an Advanced Practice Practitioner (APP) under what is referred to as "incident to" billing.  The "incident to" rule permits services furnished as an integral part of the physician's professional services in the course of diagnosis or t...

Handling Difficult Situations

March 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

When you work in a medical practice, you face challenging situations every day. Particularly as patients wrestle with pain, frustration and fear, you might find yourself handling a difficult circumstance from a customer service perspective. Practices that understand the importance of effectively managing thes...

MU Payments: Not Too Late for Medicaid

February 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Looking for $63,750 in bonus payments? That’s the sum total of the checks you’ll receive over a six-year period if you are eligible to participate in the Medicaid Electronic Health Record (EHR) Program. The days of receiving payment boosts for “meaningful use” through Medicare are long...

New Coding Opportunity

February 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Chronic Care Management (CCM) services offer the opportunity to receive payment for the non-face-to-face services provided to patients by clinical staff. There are certain requirements for billing CCM, one of which is the establishment of a care plan that provides the foundation of the care provided by staff,...

The Afternoon Sweep

February 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Morning huddles offer an exceptional method for preparing for the day; however, it’s not uncommon for the results to fall short of one’s expectations. Even if your reminder calls went out previously, it’s likely that you’ve had a couple of cancellations that morning. Filling empty slot...

Meaningful Use: 2016 Reporting & Potential Relief from Penalties

January 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

Although 2016 has come to a close, the time is now to report for the Electronic Health Record (EHR) Incentive Program. As confirmed in November, the reporting period is any 90 consecutive days during 2016. The criteria were drastically reduced from prior years, so it may be an opportune time to report even if...

Patient Access & Charging for Medical Records

January 2017

Providing patients with copies of their medical record is not a new concept for medical practices. However, processes in place for doing so may need some significant updates based on guidance issued by the U. S. Department of Health and Human Services (HHS) in 2016. In this guidance, which is based on 45...

Film-Based Imaging Reimbursement Cut (January 2017)

January 2017  |  Elizabeth Woodcock, MBA, FACMPE, CPC

If you rely on film-based imaging in your practice, Medicare reimbursement will change when you bill for an x-ray. Film-based imaging services billed globally, or when billing the technical component only, must be submitted with a modifier FX. The new modifier, required as of January 1, 2017, triggers a reduc...

Apply Today

Our team is here to answer any questions you might have or to help you fill out a quote application.

need help?
×

We're always just an email or phone call away.

contact us