Stat Medical Billing Service

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Published August 9, 2018 by Dr. Hoy
Stop Medicare Cuts
CMS.gov Centers for Medicare & Medicaid Services
The Centers of Medicare and Medicaid Services (CMS), under the current federal administration, has released a Proposed Rule that, if finalized, would cut Medicare in the following ways:

1. CMS proposes to consolidate reimbursement for office-based and outpatient visit levels 2 through 5, which increases based on complexity and time spent, into a singular flat, lowest rate payment for new patients and established patients, which would be the same as they currently are for level 2 codes. This would apply to all Medicare physicians.

2. CMS proposes to single out podiatric physicians with reimbursements at an even significantly lower rate, despite being the same evaluation and management services that other medical specialties furnish.

3. CMS proposes to reduce payments when separate services such as procedures are performed during an evaluation and management service. For example, a patient who presents for a sprain, but also needs an abscess drained.

These unprecedented, disastrous cuts target elderly and disabled people by allowing doctors to be paid only at the lowest level of service. They also target elderly and disabled with foot problems by paying podiatrists even less in a discriminatory manner. They further penalize patients who need procedures performed during a doctor visit.

Write to CMS and Congress to oppose CMS’ unfair and discriminatory proposed rule by clicking this link! (https://apma.quorum.us/register/?embedded=true&) Don’t delay and take action today. CMS will not accept comments after September 10th! Thank you.

APMA APMA | Quorum

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Important information regarding MIPS for small practices. The article is informative but bottom line is, for a small practice Medicare is requiring reporting on 200 patients or $90,000. It's not great news, but it's better than they had proposed. It's a hassle, I know.

While private practices reported a per physician operating margin of $16,378, integrated health systems saw per physician operating losses of $31,957 from 2016 to 2017.

Practice size also had an impact with small and mid-size groups reporting increased operating losses per physician, while larger groups saw operating loss decline.

“The results of this survey suggest that groups must be diligent in managing their operational imperatives of their organizations,” Fred Horton said in a statement.

“Without real focus on operational costs and processes, there is a significant inability to grow revenues in a manner that will outpace practice inflation.”

The findings dovetail with the financial struggles hospitals are experiencing in today’s healthcare cost environment.

Both nonprofit and for-profit hospitals are seeing revenue decline and losses mount as new reimbursement models emphasize shorter stays and more care delivered in outpatient settings.

In addition to finances, smaller physician groups also worry about the burden of MACRA reporting. Small and rural providers have repeatedly said their lack of capital and resources make complying with the reporting requirements a serious strain on financials.

In an effort to accommodate smaller provider concerns, CMS raised the low-volume threshold for MIPS participation from $30,000 in Medicare Part B charges or 100 Medicare patients to $90,000 or 200 patients.

The change, finalized in the fall, is expected to exclude about 134,000 clinicians from MIPS, adding to 800,000 already exempted from the program.

Still, despite the potential hardship on providers, AMGA has opposed CMS’ increasing flexibility around MACRA/MIPS. In comments on the Quality Payment Program proposed rule implementing MACRA, AMGA said loosening requirements needlessly delays the shift to value-based care and “fails to recognize the significant investments made in preparation for participation” in MACRA.

One of the major advantages of working with Stat Medical Billing Service is we are not tied to a specific EHR. We strongly encourage our providers to use a free EHR such as Practice Fusion (we have no commercial business relationship with Practice Fusion) as an example.
Using a free EHR gives you the most freedom to make business decisions that are right for your practice such as who does your billing and ultimately and most importantly, it keeps your EHR in one place.
If you use a billing service with an embedded EHR, or an EHR with a billing module and you choose to make a change, you are at their mercy to get your charts. They will send them to you on a CD and your staff then has to upload them, if it's even possible, to the new EHR program. And, you can be sure it will cost you. A lot.
A free EHR does not have any incentive to keep your charts hostage. I believe it is very important for any practice to have your EHR well organized in case of an audit and as well as patient care. If you have to cobble together chart notes on a patient from three different EHR's, it could potentially compromise patient care. And, at the end of the day, what we really want is to provide the absolute top quality care for our patients.
And, when it comes to your EHR, sometimes free really is.....free AND works well.
If you are interested in finding out more about the services we provide, please call 866-522-6640 or email [email protected]
Rachel Greenberg
Owner
Check out our web site at StatMedicalinc.com for more information.