IPPE and AWV - FAQs
Frequently Asked Questions from the March 28, 2012 Medicare Preventive Services National Provider Call: The Initial Preventive Physical Exam (IPPE) and the Annual Wellness Visit (AWV).
How To Use the Medicare Searchable Fee Schedule
This booklet is designed to provide education on how to use the CMS Medicare Physician Fee Schedule (MPFS). It includes steps to search for payment information, pricing, Relative Value Units (RVUs) and payment policies.
Medicare Audit Guide for Physicians
Making Changes to a Medical Record
Corrections vs. Alterations
Dec. 28, 2012
Appropriate, consistent, and accurate medical record documentation promotes quality patient care by providing a comprehensive patient history and facilitating continuity of care among different members of the health care team....
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Claim Correction Form
A one-page form that can help make the process of filing corrected claims more efficient~Physicians may adapt for use in their own practices.
This publication offers providers the following information: Enrolling in the Medicare Program; Private contracts with Medicare beneficiaries; Filing Medicare claims; Deductibles, coinsurance, and copayments; Coordination of benefits (COB); and Resources.
Advance Beneficiary Notice of Noncoverage (ABN) Second Edition. Official CMS Information for Medicare Fee-For-Service Providers. An Advance Beneficiary Notice of Noncoverage (ABN) is a standardized notice that a health care provider/supplier or his/her designee must give to a Medicare beneficiary, before providing certain Medicare Part B (outpatient) or Part A (limited to hospcie and Religious Nonmedical Healthcre Institutions only) items or services
Medicare Electronic Health Record - Attestation User Guide for Eligible Professionals
Medicare Electronic Health Record - Registration User Guide for Eligible Professionals
Eligible Professional (EP) Attestation Worksheet for the Medicare
Electronic Health Record (EHR) Incentive Program
From the Medicare Carrier Manual, Guidelines on physician's treating family members
The ABC's of Providing the Initial Preventive Physical Examination
The ABC's of Providing the Annual Wellness Visit
Quick Reference Chart: Preventive Services
In November, the Centers for Medicare & Medicaid Services announced that beginning in 2012, eligible professionals who are not successful electronic prescribers may be subject to a payment adjustment...
If you’re an eligible professional and you’re interested in earning incentives from Medicare for using e-Rx technology, take the time to read this guide. It explains the e-Rx incentive and provides other resources for more comprehensive guidance. CMS (the Centers for Medicare & Medicaid Services) encourages you to adopt e-Rx, and we look forward to working with you.
QUICK REFERENCE INFORMATION:MEDICARE IMMUNIZATION BILLING
(Seasonal Influenza Virus, Pneumococcal, and Hepatitis B)
Physicians and non-physician practitioners must enroll and maintain their Medicare enrollment in the Medicare Program to be eligible to receive Medicare payments for covered services
furnished to Medicare beneficiaries.
The Centers for Medicare and Medicaid Services (CMS) and the National Center for Health Statistics (NCHS), two departments within the U.S. Federal Government’s Department of Health and Human Services (DHHS) provide the following guidelines for coding and reporting using the International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10-CM).
This MLN Matters® special edition article provides information about the implementation of the International Classification of Diseases, 10th Edition, Clinical Modification and Procedure Coding System (ICD-10-CM/ICD-10-PCS) code sets to help you better understand (and prepare for) the United States health care industry's change from ICD-9-CM to ICD-10 for medical diagnosis and inpatient hospital procedure coding.
ICD-10-CM TABULAR LIST of DISEASES and INJURIES
12-mo to bill claims.pdf
The Centers for Medicare & Medicaid Services (CMS) is updating edit criteria related to the timely filing limits for submitting claims for Medicare Fee-for-Service (FFS) reimbursement. As a result of the PPACA, claims with dates of service on or after January 1, 2010 received later than one calendar year beyond the date of service will be denied by Medicare. Further details follow in this article. Make sure your billing staff is aware of these changes.
This E/M article shares helpful hints when submitting services to J1 Part B for processing.
This article, written by Palmetto Medical Directors Elaine Jeter, MD; Robert Kamps, MD; and Arthur Lurvey, MD, has been produced due to an escalating number of errors assessed due to signature problems on medical records, x-ray reports, and lab/radiology orders.
For medical review purposes, Medicare requires that services provided/ordered be authenticated by the author. The method used shall be a hand written or an electronic signature. Stamp signatures are not acceptable....
The National Provider Identifier - What You Need to Know
Medicare Manual 100-02 Benefit Policy Manual; Chapter 15; Section 40
How to handle billing Medicare Secondary Claims for conults.
(DEC2009) This chart includes a list of CMS web pages that ALL Medicare providers use most frequently.
(DEC2009) This chart includes a list of CMS web pages that NEW Medicare providers use most frequently.
Use this decision chart to determine whether you should bill with modifier AI.
American Medical Association
How to Lower Your Medical Practice's Banking Fees
By Victoria Stagg Elliott, amednews staff. Posted on-line Oct. 4, 2010.
Adding Patient Administrative Fees Must be Done Sensitively
By Victoria Stagg Elliott, amednews staff. Posted on-line July 5, 2010.
The upcoming transition to the government's modified electronic transaction standards, coupled with the Medicare and Medicaid electronic health record incentive program, will require physician practices to upgrade or replace their current practice management software.
To help you select and purchase the most appropriate software for your practice, the American Medical Association (AMA) and the Medical Group Management Association (MGMA) collaborated to develop a new online toolkit. The new "Selecting a Practice Management System" toolkit provides a roadmap to make this process easier for your practice. You can use this information to establish your practice needs and take advantage of recent improvements in automation.
The American Medical Association's (AMA) National Health Insurer Report Card (NHIRC) provides physicians and the general public a reliable and defensible source of critical metrics concerning the timeliness, transparency and accuracy of claims processing by health insurance companies. Billions of dollars in administrative waste would be eliminated each year if third-party payers sent a timely, accurate and specific response to each physician claim.
The NHIRC is for informational purposes only. Physicians and payers are encouraged to review the NHIRC results and support the AMA's "Heal the Claims Process" campaign, committing to the goal of reducing the cost of claims administration to 1 percent of collections. Visit www.ama-assn.org/ama/pub/physician-resources/solutions-managing-your-practice/coding-billing-insurance/heal-claims-process/national-health-insurer-report-card.shtml for information.
The American Medical Association's (AMA) National Health Insurer Report Card (NHIRC) provides physicians and the general public a reliable and defensible source of critical metrics concerning the timeliness, transparency and accuracy of claims processing by health insurance companies.
Since many private insurance carriers are still accepting consultation codes, The AMA clarified consultation services and transfer of care.
Physicians - Office Staff
This section contains information to assist physicians and office staff on a variety of topics.
If you do not have a username and password, please contact the SCCMA office....
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MLN Matters Articles
Maximum Period for Submission of Medicare Claims Reduced to Not More Than 12 Months.
Timely Claims Filing: Additional Instructions
New HCPCS Q-codes for 2010-2011 Seasonal Influenza Vaccines.
January 3, 2011 PECOS deadline postponed.
Annual Wellness Visit 2011. This revised version reflects the changes made to the deletion of "voluntary advance care planning" as a spedified element of the AWV.
Influenza Vaccine Payment Allowances - Annual Update for 2010-2011.
Physicians and Non-Physician Practitioners (NPPs) Excluded from Deactivation in Medicare Due to Inactivity with Medicare.
Home Health Face-to-Face Encounter - A New Home Health Certification Requirement.
Billing for Services Related to Voluntary Uses of Advance Beneficiary Notices of Non-coverage (ABN)
The Affordable Care Act provides for incentive payments equal to 10 percent of a primary care practitioner's allowed charges for primary care services under Part B.
Incentive Payment Program for Primary Care Services, Section 5501(a) of The Affordable Care Act.
Update to the Initial Preventive Physical Examination (IPPE) Benefit.
Waiver of Coinsurance and Deductible for Preventive Services, Section 4104 of The Affordable Care Act, Removal of Barriers to Preventive Services in Medicare.
Revision to Consults