:::Holiday Hours Reminder:::

DataPlus corporate and support offices will be closed Monday, July 5th in celebration of Independence Day. Normal office hours will resume Tuesday, June 6th. We wish you a safe and enjoyable holiday!

Deja Vu All Over Again: The Medicare Fee Cut is Pushed Back to November 30, 2010

by Mary Pat Whaley http://www.managemypractice.com/

I don’t know about you but I am emotionally exhausted thinking about and worrying about the on-again off-again cuts in Medicare fees for physicians.

Here’s the scoop: late Thursday evening, June 24, 2010, the House of Representatives passed the ” Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010 (H.R. 3962)” which includes a delay in the 21+% fee cut. Because the same legislation was already passed by the Senate, it now goes to the President for his signature and it becomes law. It is anticipated that this will happen quickly and CMS will have the MACs start processing new claims with dates of service of June 1, 2010 and later at the 2009 fee schedule plus a 2.2% increase. The MACs will also have to reprocess the claims already paid for dates of service June 1, 2010 and later that were processed with 2010 fee schedule and that big fat cut.

Q: What should we be doing for the next 5 months and 6 days?

A: Have someone in your practice take a video of your providers introducing themselves, telling how many Medicare patients they have and how they can’t afford to see Medicare patients unless the SGR formula is replaced with something that works. The video doesn’t have to be slick – just real. Send it to your senators and representatives. Send it your local TV news. Post it on YouTube. Imagine hundreds of thousands of providers introducing themselves and talking about their patients. It would be powerful.

Related posts:
1. Congress Expected to Further Delay SGR Cut to Medicare Physician Fee Schedule

UPDATE: On June 24, 2010 the House and Senate passed...
2. Medicare Cuts Delayed Again, This Time Until June 1, 2010 UPDATE: On June 24, 2010

the House and Senate...
3. House Bill Would Delay June 1, 2010 Medicare Cuts to 2014 and Provide Modest

Increases In Between UPDATE: On June 24, 2010 the House and Senate passed...

CMS Delays Claim Payment Until June 17th, Hoping for Congress Movement to Further Delay or Repeal (?) the SGR Formula

by Mary Pat Whaley http://www.managemypractice.com/

Excerpt From Today’s CMS Announcement (with my bolding):

The Centers for Medicare & Medicaid Services (CMS) is hopeful that Congressional action will be taken within the next several days to avert the negative update.

Given the possibility of Congressional action in the very near future, CMS is now directing its contractors to continue holding June 1 and later claims through Thursday, June 17, lifting the hold on Friday, June 18.

This action will facilitate accurate claims processing at the outset and minimize the need for claims reprocessing if Congressional action changes the negative update. It also should minimize the provider and beneficiary burdens and costs associated with reprocessing claims.

We understand that the delayed processing of Medicare claims may present cash flow problems for some Medicare providers. However, we expect that the delay, if any, beyond the normal processing period will be only a few days. Be on the alert for more information regarding the 2010 Medicare Physician Fee Schedule Update

Related posts:

Congress Expected to Further Delay SGR Cut to Medicare Physician Fee Schedule Congress has yet to pass a bill delaying the June...

Senate Passes 30-Day Pushback of 21.2% Medicare Payment Cut to Doctors Late Tuesday night (March 2), the Senate passed a 30-day...

CMS Announces Delay in PECOS Use Until January 3, 2011 NOTE: On May 5, 2010 it was announced that the...

Question of the Week: "How do I add a user in DataPlus?"

Follow these simple steps to add a new username and password to DataPlus:

• A user with administrative rights will need to log in to DataPlus.
• Select "Utilities"
• Select "User Permissions"
• Select "New Entry" (the arrow with the asterisk)
• Type in the new User Id (usually first initial and last name)
• Type in the User Name (Full Name)
• Choose whether to give this user Administrative, Read Only or Custom access.
• Select "Save" (the disk with the pencil)

By default all new user's passwords are set to "tennessee". Each user will be prompted to change their password the first time they log in. If a user has forgotten their password you can reset it back to "tennessee" by clicking: "Reset User's Password to Default".

You can also change a user's access level by scrolling to their username and changing the "User Class" and selecting "Save"

To remove a user from accessing DataPlus simply scroll to their name and click "Delete" (arrow with the red X)

ARRA Eligible Providers: Who Is Eligible to Receive Stimulus Money and How Much is Available Per Provider?

by Mary Pat Whaley http://www.managemypractice.com

Medicare Definition of Eligible Provider (EP)

For Medicare, physicians and some hospitals are eligible providers. “Physicians” includes doctors of medicine (MD) or osteopathy (DO), dentists or dental surgeons (DDS or DMD), podiatric medicine (DPM), and optometry (OD) and chiropractors (DC).

For providers, their annual payment will be equal to 75 percent of Medicare allowable charges for covered services in a year, not to exceed the incentives in the table below. Payments will be made as additions to claims payments.

Hospitals include quick-care hospitals (subsection-d) and critical access hospitals and only includes hospitals in the 50 States or the District of Columbia.

Medicaid Definition of Eligible Provider (EP)

Medicaid takes the Medicare definition of eligible providers (physicians) and adds nurse practitioners, certified nurse midwives and physician assistants, however, physician assistants are only eligible when they are employed at a federally qualified health center (FQHC) or rural health clinic (RHC) that is led by a Physician Assistant. Eligible hospitals include quick care hospitals and children’s hospitals.

At minimum, 30 percent of an EP’s patient encounters must be attributable to Medicaid over any continuous 90-day period within the most recent calendar year. For pediatricians, however, this threshold is lowered to 20 percent.

The first year of payment the Medicaid provider must demonstrate that he is engaged in efforts to adopt, implement, or upgrade certified EHR technology. For years of payment after year 1, the Medicaid provider must demonstrate meaningful use of certified EHR technology.

Change 1:
The definition of “hospital-based physician” was recently clarified to include physicians working in hospital outpatient clinics (employed physicians) as opposed to the inpatient units, surgery suites or emergency departments. This still excludes pathologists, anesthesiologists, ER physicians, hospitalists and others who see most of their patients in the ER as outpatients or as hospital inpatients.

Possible Change 2:
The Health Information Technology Extension for Behavioral Health Services Act of 2010 (HR 5040) is a bill in the US Congress originating in the House of Representatives that would amend the Public Health Service Act and the Social Security Act to extend health information technology assistance eligibility to behavioral health, mental health, and substance abuse professionals and facilities, and for other purposes. You can track the bill here.

For more information on stimulus money for meaningful use of an EMR, read my post here.

Related posts:

1. FAQ on HITECH, Meaningful Use, Eligible Providers, and the Stimulus Money Where Did the Idea of Meaningful Use of Electronic Medical...
2. Forget January 3, 2011! PECOS Date Moved 6 Months Closer – Referring & Supplying Providers New Date is July 6, 2010 Physicians and “eligible” providers received a jolt today in the...
3. May 19, 2010 Centers for Medicare & Medicaid Services Special Open Door Forum: Medicare Provider & Supplier Enrollment The Centers for Medicare & Medicaid Services (CMS) will hold...
   

What is the Difference Between Fixed and Variable Expenses in a Medical Office?

by Mary Pat Whaley http://www.managemypractice.com/

Operating expenses fall into two categories: fixed and variable. Your fixed expenses are the same from month to month regardless of whether you are seeing patients or not. Your variable expenses change from month to month based on the volume of business you do and what is needed to support that volume of business. Purchases that fall under the operating expense category are less than a pre-determined amount – maybe less than $500 in a practice or less than $1000 in a hospital. Any purchase over that amount will be a capital expense (defined as having a usable life of more than one year) and will appear on your monthly expense statement as depreciation.

Fixed Expenses

• Rent/Mortgage


• Utilities: electricity, water, garbage, cable, alarm system


• Janitorial and Groundskeeping


• Computer System: monthly maintenance


• Phones: monthly maintenance


• Leases: copiers, transcription equipment, some medical equipment


• Malpractice Insurance


• Other Insurance: general, business interruption, directors & officers, umbrella


• Depreciation
  

Variable Expenses – Typically when you are looking at reducing expenses, you will look first at your variable expenses, seeing what you can cut down on or eliminate, or what you can renegotiate.

• Payroll: staff wages, tax match, retirement plan match, bonuses, annual raises


• Benefits: health insurance, life insurance, dental insurance, vision insurance, disability (long term, short-term), worker’s compensation, unemployment


• Computer System: additional licenses, charges for claims, statements, eligibility


• Phones: repair, new lines, new jacks, voice mail changes, cell phone plans, pager plans, answering service, Yellow Pages (hopefully minimal),


• Inside: pest service, plant service


• Medical equipment: small instruments, exam room lamps, Mayo trays


• Laundry: gowns, sheets, towels, shorts, lab coats


• Consumables: (medical – built-in to the price of the service) table paper, syringes, x-ray film, lab supplies


• Consumables: (medical – charged separately to the patient) allergy serum, durable medical equipment


• Consumables: (office) copy paper, toner, kitchen and bathroom supplies, pens


• Printing: encounter forms, appointment cards, Rx pads


• Education: (staff) continuing education, license renewal, CPR, coding updates, dues, subscriptions


• Perks: uniform allowance, parking, lunches, holiday parties, birthday gifts


• Purchased Services: transcription, radiology over-read, accountant, lawyer, consultant, auditor, inspector, outsourced billing, collection agencies


• Marketing: advertising (print, TV, radio, direct), sponsorship of events, meet & greet with referrers, holiday gifts, website

Related posts:

1. Dear Mary Pat: Should a Medical Office Manager Eat Lunch With the Staff? A reader recently posed the question “Should a medical office...


2. Dear Mary Pat: What Is the Best Way To Hold Staff Meetings? Why are staff meetings important? They are important because face-to-face...


3. 101 Ideas for Increasing Revenue and Decreasing Expenses in Your Medical Practice BUILD ON WHAT YOU’RE CURRENTLY DOING: 1. Add physician...