News

A message from the CMS for Health Professionals: SGR 2013

On December 19, 2012, CMS distributed the following message to healthcare providers accepting Medicare: Attention Health Professionals: Information Regarding the 2013 Medicare Physician Fee Schedule The negative update of 27% under current law for the 2013 Medicare Physician Fee Schedule is scheduled to take effect on January 1, 2013. Medicare Physician Fee Schedule claims for

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Status Update: Where Each State Stands with Health Insurance Exchanges

The Affordable Care Act (ACA) requires each state to have a health insurance exchange through which low and moderate-income individuals can purchase private health coverage at subsidized rates. In line with the mandate that each individual have health insurance by 2014, the exchanges are likewise required to be fully operational in each state by January

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CMS Final Rule: Increased Medicaid Payment Rates for Primary Care

Earlier this year, the Department of Health and Human Services announced its proposed rule to implement the Affordable Care Act provision that Medicaid reimburse primary care providers at the same rate as Medicare. On November 1, 2012, CMS issued a final rule to implement this increased payment for calendar years 2013 and 2014. Effective January

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Good News for Maryland Medical Billers: Carefirst Accepts (Medicare) Electronic Secondary Claims

The news that so many local healthcare providers and Maryland medical billing companies have long awaited: Carefirst now allows for the electronic submission of Medicare secondary claims! This is a huge time and money saver when handling those secondary claims that did not automatically crossover from Medicare to Carefirst. This change actually became effective back

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Is it OK for healthcare providers to routinely waive patient co-pays and co-insurance?

NO! While the practice of routinely waiving a patient’s co-pay or balance may seem like a harmless favor, it actually can be a violation of a provider’s contract with insurance companies. Several of our clients have asked us directly if it is OK to accept insurance payments and then make a courtesy adjustment on the

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Providers & Billing Companies Beware: Insurance Carrier Letters Advising Fee Schedule Changes

It has come to our attention that several commercial insurance carriers have been sending providers a letter that notifies them of an upcoming change to their fee schedule. We encourage healthcare providers and billing companies to carefully review the mail that they receive and pay attention to any correspondence from insurance carriers that discusses a

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Medical Billing Newsflash: CMS Finalizes ICD-10 Date 10.14.2012

On Friday, August 24, 2012, it was announced by HHS Secretary Kathleen Sebelius that the new compliance date for ICD-10 is October 1, 2014. This announcement comes after HHS announced in April 2012 that the original October 1, 2013 deadline would be pushed back, but no final replacement date had been established until today. The final rule will

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CMS Released the Final Rule for Stage 2 Meaningful Use

Yesterday, August 23, 2012, it was announced that the Centers for Medicare & Medicaid Services (CMS) released the final rule for Stage 2 of the Medicare Electronic Health Record (EHR) Meaningful Use Incentive Programs. U.S. Secretary Sebelius states, “The changes we are announcing today will lead to more coordination of patient care, reduced medical errors,

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