Author Archives: tbsmo

Revenue Cycle Management and Contract Compliance: How to Analyze your Payment Variances

Payment variances may have many causes, but they typically land in two major categories. The first category is when a payer has updated their payment system to account for issues like a new contract fee schedule. The second major category of occurrence that can cause payment variances is when a payer has made changes to their payment system, but the configuration wasn’t successfully applied. Since both of these situations tend to happen at the start of a new contract year, that’s the time to pay attention to issues that crop up by analyzing your payment variances before they get out-of-hand.

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What You Need to Know: CMS to Shorten 2015 Attestation Reporting Period

By now, you and your staff are probably quite familiar with the concepts and regulations of “meaningful use” (MU) of electronic health record (EHR) technology which has to be demonstrated in order for hospitals and eligible providers (EPs) to receive the incentive payments from the Centers for Medicare and Medicaid Services (CMS). You are probably also fully aware that there are specific criteria that has to be met and “attested” to in order to document that “meaningful use” has been achieved.

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CMS Delays Final Ruling on Medicare Overpayments – What Could It Mean for Your RCM Payment Program?

In 2012, Centers for Medicare and Medicaid Services (CMS) published a rule that would require providers to report and refund any overpayments within 60 days from the date the overpayment was found. As an orthopedic provider, you have probably received some of these notices from Medicare. However, due to the amount of comments and extensive discussion around the issue, CMS has delayed its final ruling on the 60-Day Overpayment policy. Of particular concern has been the provision that this requirement could include audits going back as much as ten years. So what does this mean for your office? Read on.

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What the New “Doc Fix” Bill Will Mean for Your Practice

While not the first time Medicare funding has undergone revision, (and likely not the last), the “Doc Fix” bill seeks to fix a long term problem with the system. This bipartisan effort is focused on establishing more realistic funding and for Medicare, affecting both patient care and physician reimbursement. This bill is considered a long-term fix, and not the more commonly used patch method to secure funding.

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2016 Updates to Medicare Health and Drug Plans as Proposed by CMS

There are changes that will be coming in 2016 concerning the way Medicare will pay for medical services. On February 20, 2015, the Centers for Medicare and Medicaid Services (CMS) asked for public comment on its proposed changes to Medicare Advantage (MA) plans and Part D Prescription Drug Programs. The goal of the changes is to pay providers based on the quality of services they provide and not the quantity.

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Practices Not Prepared for ICD-10

Beginning October 1, 2015, the medical community will be required to switch from the ICD-9 coding system to ICD-10. This change brings with it many tasks and responsibilities on the part of physicians and their staff. Even so, there are apparently, many orthopedic practices and other medical practices that have taken little to no action to prepare.

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Focusing on Your ICD-10 Conversion Team

After postponements and countless frustrations, the time has finally come for organizations to work seriously toward getting on board with the ICD-10 conversion. While the October 1st deadline may have seemed well into the future when it was first set, now that the date is rapidly approaching it’s time to settle in and turn your attention to creating as smooth a conversion process as possible. This means putting focus on your conversion team.

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