Yesterday morning the Supreme Court ruled in a 5-4 decision that the Affordable Care Act will stand. Now that the fate of Healthcare Reform has become more defined, we can take a look at the practical implications for healthcare providers and medical billing services. IN the NPR article “Health Care Law Upheld: Now What?”  the following key provisions are explained by Mary Agnes Carter of Kaiser Health News. Currently: – Insurance carriers cannot cancel a ...

June 29, 2012   On June 14th, the U.S. Department of Health and Human Services announced the appointment of Bryan Sivak as the Department’s new Chief Technology Officer, Health Data Management reports. Sivak previously served as the Maryland chief innovation officer, where he worked to develop the state’s electronic health record (EHR) platforms. Additionally, Sivak was involved in Maryland’s development of a health insurance exchange (HIX). These HIXs are federally ...

June 28, 2012 Wondering just how many ICD-10 codes will be available come October 1, 2013? According to the most recent 2013 ICD-10 file that CMS published on June 20, 2012, there are currently 71,920 ICD-10 codes on the books. The majority of the codes (nearly 62,000) all fall within the medical/surgical category, while the remaining fall within the fifteen other specified categories (see second table below). For those keeping ...

June 22, 2012 To reflect recent national guideline changes, Carefirst (the BlueCross and BlueShield plan of Maryland and Washington, D.C.) has updated its own preventive service guidelines. According to the guidelines published in April 2012, Carefirst has made changes in the following areas: Recommended Service Guidelines for Children Cholesterol Screenings Testicular Cancer Screenings Counseling/Education/Screenings for high-risk factors Recommended Service Guidelines for Adults Cervical Cancer Screenings Preconception Planning Recommended Perinatal Services ...

June 18, 2012 The nation’s healthcare providers, medical billing companies, insurance agencies, business owners, and health consumers all eagerly await the approaching decision from the nation’s highest court regarding the constitutionality of President Obama’s Affordable Care Act. The Supreme Court is expected to issues its decision later this month (June 2012) regarding the fate of the controversial healthcare act that was signed into law in March of 2010. The core ...

June 1, 2012 On May 19, 2012, the Society for Maternal Fetal Medicine (SMFM) issued a new white paper on how to correctly bill for services rendered by nurse practitioners. The white paper discusses options for direct billing, incident-to billing, and shared/split billing. To access the article, members can log into the SMFM website. For those who are not members, there is still a wealth of information that is publicly ...

May 29, 2012 According to Fiserv’s 2011 Consumer Billing and Payment Trends, online bill payments now account for 50 percent of all bill payment volume in the United States, while checks account for 23 percent. If you haven’t done so already, now is the time to implement your online payment solution! In fact, the American Medical Association very recently published an article on the benefits of online payment systems. The ...

May 17, 2012 Maryland has a unique online forum for healthcare providers to file complaints with the Attorney General’s Health Education and Advocacy Unit and the Maryland Insurance Administrator. On April 30, 2012, the Maryland State Medical Society (MedChi) and Maryland Attorney General Gansler joined together in announcing a new website, “Insurance Watch,” where providers can file complaints against abusive insurance carrier practices. According to the MedChi website, Insurance Watch ...

May 23, 2012 June 30, 2012 is the deadline for physicians to report on at least 10 electronic scripts in order to avoid Medicare’s e-prescribing program penalty. If a physician does not successfully report the production of 10 electronic scripts between January 1, 2012 – June 30, 2012, Medicare will apply a 1.5% payment reduction on all Medicare claims for calendar year 2013. The e-prescribing penalty program originated in 2008 ...