New 2017 PCMH Recognition program

Recently, NCQA released their 2017 PCMH  Recognition program.

Unlike its 2011 and 2014 predecessors, 2017 version will rely more heavily on the EHR/EMR provider is using. It aligns it self with other (current) government incentive programs and reduces the amount of documentation provider needs to submit. It will utilize a new attestation system and not the old version of survey tool.

One major difference between the 2011, 2014 versions and the 2017 is that there will be a provider yealy check in; during which, NCQA representative will contact provider via Skype and go through the topics, review the needed proof. The check-in will last 2 hours, no interruptions and your (team) needs to be there too.

For a free Gap analysis of your prqctice please contact me and mention MEDEVAL code.

I offer EHR/EMR implementation training for either PCMH or other government incentive programs: MU2, MU3, Medicaid/Medicare EHR incentive program.

My training fee is $600* for 4 (3hour each) sessions.

If you would like more informatiom please feel free to contact me

914-338-8074 or email kredicalbilling@gmail.com

* flat fee for training only, does not include the actual PCMH recognition and NCQA (provider) registration.

Important: Check your Provider Information

Whether this is your first year or not, when attesting for any Incentive Programs (PQRS/Medicare EHR/Medicaid EHR), make sure the information for the Provider your are attesting for or the information for the qualified clinic/provider group is correct.

The last thing you need is to find out that CMS or Medicaid has the wrong NPI or Tax ID on file. This will hinder your attestation and will create nothing but delays that would draw a thin line between you receiving that incentive or getting a penalty letter.

If you have any more questions, please feel free to contact me for my consulting services.

Phone:914-338-8074

Email: kr2medicalbilling@gmai.com (fastest way to reach me, I reply within 24 hours after receiving your email)

Financial Incentive Programs in NY

There are several  Incentive programs available for Individual Eligible Physicians, in NY .

 

  1. MU Stage 2 and 3 (Use of EHR and is attested through a Medicare Certified EHR vendor)
  2. Medicare and Medicaid EHR incentive program (Provider can only attest to one of the programs)
  3. Medicare PQRS program (Provider that needs to attest would need to see at least 100 patients per qualifying year or 90 reporting days, whichever you choose)
  4. PCMH-Patient Centered Medical Home program-for Primary Physicians (PCP).

 

Now is your turn, which incentive program are you attesting for 2016?

Medical Billing Collections Companies: patient negative experience, poor customer service

As more and more providers find themselves in the hot water about not collecting the required patient financial responsibility: co-pay, coins, deductible, the more financial burden they are facing and turn to collection agencies.

Collection agencies work on percentage and are “aggressive” when it comes to uncollected money. However, there is a issue of a poor customer service. While most collection agencies and/or Medical Billing service companies promise you to return your lost revenue ie. deductible or OON payment from the patient( they do receive a percentage of that amount), they do it in not very friendly way.

Let me give you an example. When I worked in an Urgent Care-the A/R balance was ridiculously high and yes some of that revenue was actually a legitimate owed amount (some wasn’t), but either way through the course of a year there were 3 Medical Billing Companies/Collection agencies. It was all the same: promise we will get your money. Unfortunately, I worked in the Collections and since the actual A/R amount was small, the agencies just tended to stay on for 2 months and then leave.imagesCAL3COWL

But let’s get back to the customer service part. While my medical collections methods involve in actually researching whether  or not the patient actually owed us Urgent Care, the money, the collections agencies fail that part.  Mind you when I started with the UR I still was looking at 2014 accounts (of which only a small percentage was actually collectible. My UR was OON)

Anyway all three agencies worked on the old accounts, as per request of the owner, hoping for a nice payday (they charged as high as 25% of the collections). Anyway, the issue was that they just would go one by one and search with the account that had an open balance. Then without any research as to why this was the case they would contact the patient in regards to the account. Then of course they would put our company as the contact person, and I would  receive the angry phone calls regarding the letters or phone calls, that were sent to the patient, from so and so collections company. Stating that when the patient contacted the Agency or Medical Billing Company, their agents were not able to help the patient and just tell the patient to pay the outstanding amount, did not even have their current insurance information or all together were just rude, with horrible customer service skills.

Yes, this was double work for me, LOL. I would calm the patient down and do my own research. Sure enough the account would be in a good standing: patient was not liable for the outstanding amount, for various reasons: No OON benefits, no facility benefits, etc., take your pick. I would then calmly explain the patient what was going on, put my note in the patient record so everyone is on the same page.

 

These kind of patient experiences and my own are common. Sometimes the patients become so upset that they start to complain to the provider, making the already somewhat strained relationship between the patient and the provider worse (because of the increase in the patient financial responsibility: co-pay, deductible, coins).

 

To providers: to at least alleviate some of your practice’s collections, there are things that you can do. Like instituting a new patient financial policy, or collecting at least the co-pays the day of the appt. Train your staff to effectively communicate with the patients. Make sure to evaluate all your options before sending your outstanding accounts to the collections agencies. Try to come up with alternative ways to still not put the financial burden on your practice and offer your patients a more flexible way to pay their financial responsibilities. Because if not too careful, you will start to lose your long time in good-standing  patients for good.

Practice Fusion Training for 2017 version PCMH Recognition for PCP providers and Front Staff.

I am proud to present training for providers and front staff of Practice Fusion EHR, for 2017 PCMH Recognition program. If you are in the process of starting the 2017 PCMH certification or renewing it, or still finishing the 2014 version, and having trouble utilizing PF to achieve all the needed elements for the PCMH application then this training is just for you!

This training will help you to not only move along the 2017 PCMH Recognition process quicker but also help you achieve the MU2 and later MU3 stages!

Availability:  Thursdays 9-5pm

Duration: 4 sessions 3 hours each

FEE*: $600 

*This is a flat traning fee.

If you have any questions or need more information, please contact me:

kr2medicalbilling@gmail.com Phone: 914-338-8074

Consulting Services and Fees

Consultation Services/Fees:

Compensation: I charge per hour – the total price depends on your practice needs. Please contact me for a quote today!

Some of the Topics that are covered:

  1. Prior authorization for Specialty Medications (multiple payers)
  2. Patient registration process (work flow)
  3. Billing
  4. Scheduling
  5. Common Denials (multiple payers
  6. Medical policies for certain proceedures (multiple payers)
  7. Medical Practice Policy paperwork
  8. Anything else (based on your practice needs)

If you have any other questions please feel free to contact me via email: kr2medicalbilling@gmail.com or by phone : 914-338-8074

I am here to help you!…Please listen…

The most frustrating part, when I work with clients, is that they are very reluctant to try new things when it comes to their business.

Unfortunately, some providers had to deal with medical billing companies that promise you big things within a little time frame window..and then don’t deliver. So the providers become frustrated, untrusting towards outside Medical Billing companies.

And I understand that!..However, I am here to help! I will do everything in my power to help out a client to save, rescue or better the practice.Choosing to Outsource instead of hiring

Truth hurts and may not be what the provider would like to hear, but it will hopefully create a long and prosperous business relationship for years to come. 

I personally, believe that honesty is the Best Policy!…LOL!

Outsource Medical Billing!…Do not be afraid!!!

 

 

Practice/Patient Financial Responsibility Policy

Having a Practice/Patient Financial Responsibility Policy for your patients, increases your chances of collecting anything that is owned at the time of services rendered. It decreases the number of time and money spent by your practice on contacting/generating patient statements. Not to mention it builds a better relationship between your practice and your patients.

The importance of double checking PrioAuthorizations.

  It is a part of obtaining prior-authorization process that is most often forgotten-double checking the obtained authorization information.

Although, for the most part the authorization process goes without a cynch. It doesn’t mean that your office staff should not check the received authorization, for any errors.

In general the things that your Front Staff should be doible checking are:

  1. Patient Name
  2. Patient DOB
  3. Patient Diagnosis
  4. Approved date range and quantity
  5. Correct insurance submission* With the increasing number of patients acquiring more than one insurance plan, it is extremely important to obtain the authorization from the correct plan-the first time!

Checking all the above things will assure proper and prompt payment, less hassle and no hindering your practice A/R.

ICD-10…more responsibility for providers?

So, I took a ICD-10 training course from AAPC, for professionals. I have to say that from a Medical Biller perspective I didn’t see a lot of drastic change. However, there was a lot more change for the providers/doctors.

Those of you who have been documenting extensively for your patients have nothing to worry about….Yes, it will take a while for the payers to start processing your claims correctly and get payment. But you will have a less change of a rejected or denied claim, based on the simple fact that your diagnosis did not correspond to the treatment codes and you have no supporting documentation to show for it.

ICD -10 are more focused and more detailed but they are also more descriptive and require the supporting documentation to accompany the diagnosis.

There is more pressure on the provider to make sure that the documentation is correct so that the coder could select and code the diagnosis properly.

Please do not be discauraged. There is plenty of help…Courses from AAPC or even Availity. Or maybe you prefer a mobile approach of having an app on your phone with the ICD-10 refences. Of course, lets not forget your EHR/EMR software which could be quiet useful.


So, cheer up and brace the new ICD-10 with open arms and ease!