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Reliable Billing, LLC

  Medical Billing Services & Practice Management Consulting 

                     *  Serving all of Michigan *

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2017 Additions

Posted on November 7, 2017 at 10:00 AM Comments comments (6)

We are humbled and honored to add some great new clients this year. 

Homaira Danish, MD of Pure Rejuvenation Center in Troy is a Board Certified Otolaryngologist.  She specializes in head, face and neck reconstructive surgery.

John Vargas, DO of Midland General Practice in Midland is a General Practice office.  A staple of the community for over 40 years and sees an average of 60 patients daily.


AMA/CMS ICD-10 update

Posted on July 8, 2015 at 5:00 PM Comments comments (0)

CMS and the AMA announced an update that will allow providers to get help with the transition, as well as some relief from potential claim denials.  https://www.cms.gov/Medicare/Coding/ICD10/Downloads/ICD-10-guidance.pdf

 

According to CMS guidance issued July 6, for the first year that ICD-10 is in place, Medicare Administrative Contractors (MACs) will not deny Part B claims on the specificity of the ICD-10 diagnosis code as long as it is valid.

 

Claims denials

 

CMS said that for the first year after ICD-10 implementation, Medicare review contractors won’t deny eligible professional Part B claims based solely on the specificity of the ICD-10 diagnosis code, though contractors could choose a claim for review for other reasons. You still must report a “valid code from the right family,” though. CMS said that Medicare Administrative Contractors, the Recovery Audit Contractors, Zone Program Integrity Contractors, and Supplemental Medical Review Contractors will follow this policy.

 

Quality reporting and other penalties

 

CMS said also that 2015 quality reporting programs would not penalize physicians for insufficient specificity related to ICD-10 coding. “For all quality reporting completed for program year 2015, Medicare clinical quality data review contractors will not subject physicians or other Eligible Professionals (EPs) to the Physician Quality Reporting System (PQRS), Value Based Modifier (VBM), or Meaningful Use 2 (MU) penalty during primary source verification or auditing related to the additional specificity of the ICD-10 diagnosis code, as long as the physician/EP used a code from the correct family of codes,” the CMS guidance report stated.

 

CMS added that EPs won’t face a penalty if CMS has trouble calculating quality scores for PQRS, VBM, or MU2 due to the ICD-10 transition period.

 

Help for payment disruptions

 

If Medicare contractors are unable to process claims because of problems with ICD-10, CMS will authorize advance payments to physicians. CMS said that such problems could include contractor system malfunctions or implementation issues, and that an advance payment would be a conditional partial payment that would require repayment. CMS said that it did not have authority to make advance payments in cases where physicians could not submit a valid claim for services rendered.

 

Ombudsman for ICD-10 implementation

 

A “communication and collaboration center for monitoring the implementation of ICD-10” will be set up to quickly identify and resolve issues related to the transition. This center will include an ICD-10 Ombudsman to help receive and triage provider issues, working closely with representatives in CMS regional offices.

 

Reliable Billing has been trained by the American Academy of Professional Coders (AAPC) on ICD-10 as part of our certification and understand the guideline requirements.  Our billing system has been updated to accommodate the new codes to ensure no lag time October 1st.  If you feel unprepared, we are here to help but highly recommend an online or seminar course with AAPC. www.aapc.com

 

Are You Providing an Annual Wellness Visit to Your Medicare Patients?

Posted on June 30, 2015 at 4:45 PM Comments comments (0)

With a few extra steps your office could be increasing revenue while complying with Medicare guidelines AND showing your patients you care about their well being. 


Under the Affordable Care Act, Medicare beneficiaries now receive coverage for an Annual Wellness Visit (AWV), which is a yearly office visit that focuses on preventive health. During the AWV, you will review a patient’s history and risk factors for diseases, ensure that the patient’s medication list is up to date, and provide personalized health advice and counseling. The AWV also allows you to establish or update a written personalized prevention plan. This benefit will provide an ongoing focus on prevention that can be adapted as a beneficiary’s health needs change over time. Help keep your patients as healthy as possible by encouraging them to have an AWV.  Initial AWV fee schedule is $164.03 and subsequent years are $108.99.


Don’t forget. Medicare also provides coverage for the Initial Preventive Physical Examination (IPPE), commonly known as the "Welcome to Medicare" Visit, a one-time service to newly-enrolled beneficiaries. The IPPE is an introduction to Medicare and covered benefits, with a focus on health promotion and disease detection. The IPPE must be performed within the first 12 months after the beneficiary’s effective date of their Medicare Part B coverage.  The fee schedule for just the IPPE is $159.08 with additional revenue opportunites if an EKG is performed.


Important Note: Medicare provides coverage of the AWV and the IPPE as Medicare Part B benefits. The beneficiary will pay nothing for the AWV and the IPPE (there is no coinsurance, copayment or Medicare Part B deductible for these benefits).


For more information go to http://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/MLN-Publications-Items/CMS1243320.html

 


New Clients

Posted on June 15, 2015 at 5:05 PM Comments comments (0)

Welcome Dr. Knochel and Dr. Hunt.  Reliable is honored to bill for two chiropractors from Midland.  They are both well-respected providers in the area, who enjoy being active in the community. We look forward to a long and fruitful relationship with them.


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