March 16, 2012 Effective January 1, 2012, Highmark Medicare Services (HMS) was acquired by Diversified Service Options, Inc. (DSO). Consequently, the HMS name has changed to Novitas Solutions, Inc. Novitas (pronounced NO-vih-tas) will now be the Medicare Administrative Contractor (MAC) for Jurisdiction 12 (J12) and Section 1011. The states included in J12 include Delaware, District of Columbia, Maryland, New Jersey, and Pennsylvania. Physicians and medical billing companies should not face ...

February 16, 2012 On February 16, 2012, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius announced that HHS intends to delay the compliance date for ICD-10. Currently, the compliance deadline stands at October 1, 2013 (which is already a two-year delay from the original date outlined in the January 2009 final rule). While no new date has been declared, this new release suggests that HHS is listening ...

February 15, 2012 As the March 1, 2012 deadline approaches, all physicians, healthcare providers, and medical billing companies are keeping a watchful eye on Congress to make sure that the staggering 27% reduction in the Medicare Physician Fee Schedule is blocked. The bill, often referred to as the “doc fix,” is wrapped up in a broader deal concerning the payroll tax cut and unemployment benefits. Political analysts most recently are ...

February 4, 2012 Worried about under-coding or over-coding your patients’ Evaluation & Management (E/M) services? Not sure of whether to bill for a level 3, 4, or 5 exam? Many physicians experience confusion when deciphering what level of care is appropriate to bill. On one hand, under-coding can result in a decrease in reimbursement that rightly belongs to your practice; on the other, over-coding can result in denials for lack ...

February 2, 2012 The state of Maryland is considering a proposal for the creation of “health enterprise zones.” These “health enterprise zones” would consist of rural and urban regions in Maryland in which the population has notably underserved medical needs; primary care physicians and healthcare providers who practice in these regions would then be eligible for financial incentives for their service. These financial healthcare incentives may take the form of ...

January 31, 2012 On January 30, 2012 Medicare amended its Not-Otherwise-Classified (NOC) code set to remove unspecified anesthesia codes (CPT’s 00100 through 01996) from the list of codes that require a specific description to be supplied in order to pass 5010 edits. While this change may seem minor, it is indeed good news for medical billing services and providers alike, as one more obstacle toward quick reimbursement has been removed. ...

January 23, 2012 Medicare’s recent policy changes reflect a heightened awareness of the value of preventive care. The newest changes include reimbursement to providers that offer alcohol misuse counseling, cardiovascular screenings, depressions screenings, and obesity screening and counseling. Additional preventive services that Medicare currently covers include annual wellness visits, abdominal aortic aneurysm screenings, bone mass measurements, colon cancer screenings, diabetes screenings, diabetes self-management training, EKG screenings, flu shots, glaucoma tests, ...

January 19, 2012 While our medical billing team keeps on the cutting edge of technology developments on our end of the healthcare reimbursement cycle, we also want our physicians to share in the wealth of available technological resources. Smart phones and tablets are becoming widely used in healthcare, and many applications are being designed specifically for the physician’s use. These apps cover a wide span of functions, including medication searches, ...

January 16, 2012 As we launch into 2012, Carefirst has several new updates to their plans and policies: Carefirst recently launched its new insurance plan, HealthyBlue 2.0. For information on how to recognize this plan and how to properly bill for services, healthcare providers can sign up for free training with Carefirst. Visit www.carefirst.com/providers and check out the Seminars & Training page. Carefirst announced in its December 2011 edition of ...