2019 New Year Practice Billing Checklist

Commensurate with the new year, it is considered best practice to review your practice's goals, policies and procedures and communicate them to your staff. Below is a short checklist of 10 key items that every practice should review annually to ensure their practice and billing performance for the new year kicks off on the right foot...

PRACTICE BILLING PERFORMANCE – UNDERSTANDING NET COLLECTION PERCENTAGE

In October 2017, we began our review of Measuring Practice Billing Performance, and explained that there is no “silver bullet”, or single measure, that assesses overall performance, but rather a series of key measures to understand and monitor monthly. These measures include, but are not limited to: Accounts Receivable (A/R) balance, A/R Days Outstanding, Net Collection Percentage, and % of A/R greater than 120 days old. In this issue, we will review the calculation and meaning of Net Collection Percentage.

Participate in MIPS/MACRA with ease – with StreamlineMD!

There is a great deal of consternation amongst physician practices as it relates to MIPS/MACRA.  While it is certainly complex and confusing, understanding the requirements and participating wholeheartedly may prove to be a real opportunity to increase reimbursement in a material way. 

PHYSICIAN EXTENDERS – PROPER USE AND BILLING

While CMS rules regarding billing for physician extenders, including Physician Assistants (PA) and Nurse Practitioners (NP) and other Non-Physician Providers (NPP), have been published and consistent for several years, it is common to find practices that do not know or follow them. The purpose of this letter is to simplify the rules to help keep practices in compliance with CMS guidelines. This letter specifically covers rules for billing for an extender that is enrolled with CMS versus not enrolled, and when it’s appropriate to bill the extender as “Incident to”.

MODERATE (CONSCIOUS) SEDATION – EXTENSIVE CHANGES FOR 2017

Currently, for most of the interventional procedures you perform, reimbursement for moderate sedation is bundled into the procedure code, but that will soon change. For dates of service on or after January 1, 2017, reimbursement for the procedure and the moderate sedation will be separated.

Documenting Vascular Interventional Radiology Procedures

When documenting your vascular interventional radiology procedures, it is important to remember your audience extends far beyond the referring physician. On a regular basis, your report is scrutinized by a multitude of non clinical staff such as coders, auditors, billers, payers, and medical reviewers to name just a few...

Documenting Percentage of Stenosis

Whether you are documenting to meet PQRS Measure 195 requirements or are treating an arterial stenosis by PTA for medical necessity, it is the documentation of the percentage (%) of stenosis that counts. Terms such as “mild”, “moderate”, or “severe”, without the specified percentage (%) are not specific enough...