8/27/14

Shared Genius August 2014 Edition

Shared Genius Practice Solutions From one genius to another.
August 2014 support special includes:
THOMAS date tricks, billed claims, and more!

Available now!

8/12/14

It Takes a Billing Class to Train Some Geniuses

PR Henriksen, the character
You might not know this but here at Genius Solutions the vast majority of our software support staff and all of our trainers have worked in various healthcare settings:  offices, hospitals, support staff, billers, office managers, multiple office managers, and more.  Basically our Genius support is made up of practical medical office specialists, software geeks, and hardware tech specialists who are hardware, networking, and software geeks.  There is a lot, and quite a variety, of expert knowledge on call, for your calls.

Me? I started at Genius in support, as part of the software geek zone (with some generally nerdy hardware tendencies).

8/4/14

Transparency and Leaving Doctors’ Data Hanging out in the Breeze


The Sunshine Act was passed as part of the Patient Protection and Affordable Care Act (health care reform) in 2010, but CMS decided to delay data collection in connection with the act until 2013.  The Act was designed to give transparency to the money and dealings between physicians, pharmaceutical companies, medical device and other medical supply manufacturers, as well as ownership or investment interests in group purchasing organizations.  Physicians and manufacturers are to report (or disclose) any and all such incentives and payments they receive to CMS.  Payments need to be reported by date and amount as well as list the nature of the payment or incentive (i.e. gifts, meals, speaking honoraria, etc). 

The thought was that if these little promos, pluses, gifts, and payments were known, it would cut down on things like drugs being dispensed because doctors got good gifts and perks, rather than prescribing what would be best for their patients or possibly lying about results or usage for drug reporting purposes.  That’s not giving doctors very much credit in my book. 

8/1/14

Finally! CMS Announces New ICD-10 "GO" Date

FINALLY!  CMS announces ICD-10 "GO" date IS now October 1st, 2015!

Interesting, the article doesn't note anything about a comment period, it simply says, this is the date.  I guess nothing but bumping the date ahead, might not need an additional comment period as it had been done before.

So, what are you doing now to prepare?

7/22/14

Shared Genius: July 2014

Shared Genius Practice Solutions From one genius to another.
July 2014 support special includes: Claim Forms, Genius Solutions Training

Available now!

7/11/14

e-Statement Printing Confirmations

If you use our e-Statement service, you will receive a fax confirmation when the statements are printed.  When you sends 2 files (one for each system- especially if you send one from dT and one from eT), and they are printed at the same time, you will only receive a confirmation for the first file processed.

We recommend that you only send one file at a time, wait to receive the fax confirmation from that first file, and then send your next e-Statemtent file. This way you will receive a confirmation for each file.

6/25/14

Shared Genius: June 2014

Shared Genius Practice Solutions From one genius to another.

 June 2014:  277s, "bad address", appointments, time blocks, & more!

Available now!

Editor Addition:
In the e-mail I posted that the new date for ICD-10 was Oct 1, 2015 (after finding said information in more than three good sources).  In investigating further, we crawled through the CMS website and this is the wording posted:

"On April 1, 2014, the Protecting Access to Medicare Act of 2014 (PAMA) (Pub. L. No. 113-93) was enacted, which said that the Secretary may not adopt ICD-10 prior to October 1, 2015. Accordingly, the U.S. Department of Health and Human Services expects to release an interim final rule in the near future with a new compliance date for the use of ICD-10 codes beginning October 1, 2015. The rule will also require HIPAA covered entities to continue to use ICD-9-CM through September 30, 2015. "

So, the current date that has been listed of Oct. 1, 2015 is really wishful/hopeful thinking by everyone.  (Although it does look like CMS is hopeful for the same thing.)  According to the above paragraph the "interim final rule" has yet to be created or released, after which there is always a 60-day comment period, and then, eventually, a final rule will be issued.  There is no date on this note on the CMS website either, so we'll all have to check back into this page to see when some movement begins to occur.  So, continue not panicking, and definitely continue to prepare for ICD-10 implementation.

6/17/14

Michgan Blues Claim Filing DEADline

BCBS of Michigan sent out an e-mail recently stating that the Blues will retire their local system on Oct. 31, 2014. Since they will no longer process claims on that system, all claims filed on the local system must be submitted and received by Sept. 15, 2014, in order to be processed.

If you submit a claim after the filing limits, BCBSM will not offer any special handling or filing extensions, and no payment will be due from BCBSM or the subscriber. All health care providers must follow claim-filing deadlines (as you can see, there are no exceptions here).

For more information about this change, please refer to the March 2014 Record.

Blue Cross defined the local contracts, which have been migrating to their new system and will be completely migrated mid September.
These local contracts include:
  • Local and Medicare Advantage group numbers: Five digits
  • MOS group numbers: Nine digits
  • NASCO group numbers: Five digits, usually starting with a seven or eight
  • BCN group numbers: Eight digits

Any clam submitted with one of the local contracts (listed above); whether it is a secondary, resubmission, or original needs to be received by Blue Cross no later than September 15, 2014 or it will not be processed.

Patients with local contracts should have received a new contract number to go through the new system.

You can contact Provider Inquiry at Blue Cross of Michigan for more information.

Provider Inquiry Information:

If you’re calling from this area code
Hours of operation
Use this phone number
248, 313, 586, 734, 810 or 947
8:30 a.m. to 5 p.m.
1-800-245-9092
517, 989
8:30 a.m. to 5 p.m.
1-800-272-0172
231, 269, 616, *989
8 a.m. noon,
1 p.m. to 5 p.m.
1-800-255-1878
906
8:30 a.m. to noon,
1:05 p.m. to 5 p.m.
1-866-872-5837
Outside Michigan
8:30 a.m. to 5 p.m.
1-800-482-3146
For questions about BCBSM employees only, contact our Ombudsman office.
8:30 a.m. to noon,
12:50 p.m. to 5 p.m.
1-877-258-0167
313-225-8748

6/5/14

New Medicare Summer Audits

Per Dr. Ted A. Arkfeld :

"This summer is starting out with aggressive audits on chiropractic services-- specifically 98942 and 98941 manipulation codes by Wisconsin Physician Services, (WPS).  
 
They are skipping the usual request for records, overpayment demand letters and moving straight to placing chiropractic offices into prepayment reviews.  This means a doctor must submit patient’s documentation for each visit to be reviewed by a nurse case manager at WPS.  The nurse case manager then determines if the services should be paid or denied.  If denied you then have the option of undergoing the appeals process.  

Unsuspecting doctors finding themselves in this situation will have an alteration in the revenue cycle with all of their Part B Medicare claims.  This is not the worse case scenario.  These same offices can expect to be placed in a post-payment audit status as well."

Dr. Arkfeld is the only chiropractic compliance consultant in the state of Michigan, and he has assisted numerous doctors through the audit process.

If your office receives this type of notification and you need additional help, you can contact Dr. Ted A. Arkfeld at Advanced Compliance Technologies.

Ted A. Arkfeld DC, MS, CPC 
Advanced Compliance Technologies, PLLC 
854 N. Center Avenue, Suite 3 
Gaylord, Michigan 49735 
Office (989)448-8065 
Fax (877)620-0872 
Cell (989)614-0261 

5/21/14

Shared Genius: May 2014

Shared Genius Practice Solutions From one genius to another.

May 2014 support special includes: ICD-10: New Date!, ehrTHOMAS, Railroad Medicare,  UB04, CMS-1500, Pre-billing errors and more.

 Available now!

4/21/14

Shared Genius: April 2014

Shared Genius Practice Solutions From one genius to another.
April 2014 support special includes: ICD-10 delay, NDC updates, Railroad Medicare

Available now!

http://www.geniussolutions.com/emailcamps/AAFC.html

4/9/14

THOMAS Users: NDC Update and View!

Due to recent changes with how NDC information is to be reported for payment, a change has been made to accommodate the reporting of a Unit Count in the CTP-04 in the 2410 loop and a Unit Price, if required, in Item 24 of the CMS-1500 (02-12) form. There are detailed instructions and information on our YouTube channel: http://www.youtube.com/watch?v=q5AnkLXxuUU In addition, you can view the printed information at http://www.media.geniussolutions.com/94/NDCChange.pdf



Visit our YouTube channel at www.youtube.com/geniussolutionsinc



Sincerely,
Genius Solutions