Are you using the most advanced technologies (Analytics, AI and Automation) within your billing environment? Are revenue cycle firms a godsend or an added expense? Do you enjoy the daily business of medicine? Not the world of patients and symptoms, but the domain of claims, collections, receipts, and reports, for which there is woefully little training in the medical school curriculum. If you don’t, you are not alone. Thousands of providers have effectively delegated their entire financial operations...

Based on the Final Rule which was published in November 2018 the following is material pertinent to the Quality and Cost categories: Quality Category The Quality category carries a weight of 45% of your total MIPS score as compared to 50% last year. Claims-based measures can only be submitted by clinicians in a small practice (15 or fewer clinicians). This is the first year that claim submission has been limited by practice size, whether participating individually...

CMS released the 2019 Quality Payment Program Final Rule early November 2018.  Below are highlights of some of the key provisions for Year 3 (2019) of the QPP MIPS program that will go into effect 1/1/19. These are overall changes to the program in 2019. Changes to the MIPS performance threshold and the exceptional performance bonus: The MIPS performance threshold will double in 2019. MIPS eligible clinicians and groups will have to earn at least a...

Promoting Interoperability (PI) Performance category Of the four categories under MIPS, the PI Performance category will see the most change in 2019. The PI category carries a weight of 25% of your total MIPS score which is the same as the 2018 reporting period. In the 2019 reporting period eligible clinicians are required to a 2015 Edition CEHRT. There is no longer an option of using an earlier edition of CEHRT. CMS has eliminated the “base,...

In today’s climate, healthcare providers face increased economic, regulatory and competitive pressures, all of which threaten to reduce revenue and squeeze already decreasing margins. Rising bad debt costs due to the uninsured, increased government scrutiny, and a rise in hospital consumerism are forcing physicians and hospitals to improve clinical, financial and operational performance. The recent issues in the economy have only exacerbated many of these challenges, driving hospitals and ambulatory physicians to cut costs through layoffs...

WINDSOR, Conn., November 26, 2018 – Meridian Medical Management’s VertexDr 9.0 has achieved Office of the National Coordinator for Health Information Technology (ONC-Health IT) 2015 Edition Health IT Module Certification via Drummond Group LLC, an Authorized Certification Body (ACB) that has been empowered to test software for compliance with the requirements of the federal government’s program. The stamp of approval designates that the software offers the functionality that enables eligible providers and hospitals to meet...

WINDSOR, Conn., November 26, 2018 – Meridian Medical Management is pleased to announce that Al Lechner, a healthcare executive with many years of experience in the electronic health records (EHR) and revenue cycle management (RCM) fields has joined the company as Chief Growth Officer, overseeing all sales and marketing activities for the Meridian family of companies (Meridian Medical Management, Origin Healthcare Solutions, and PrecisionBI). “Al is a very dynamic and skilled Chief Revenue Officer with a long...

CPT 2019 Summary of Changes CPT changes go into effect on 1/1/2019.  Please refer to the spreadsheet link here which contains the new/deleted/revised codes. There are 164 new CPT codes added which are high-lighted in green on the spreadsheet, 72 deleted codes which are high-lighted in pink and 49 revised code high-lighted in yellow with a description of the change from 2018 to 2019. There are no changes in the anesthesia and auditory system under surgery....

2018–2019 Influenza Season – Vaccine Chart   There are many different flu viruses and they are constantly changing. Each year research is done to determine the most common three or four viruses. The composition of U.S. flu vaccines is updated as needed on a yearly basis. For 2018-2019, trivalent (three-component) vaccines are recommended to contain: A/Michigan/45/2015 (H1N1)pdm09-like virus A/Singapore/INFIMH-16-0019/2016 A(H3N2)-like virus (updated) B/Colorado/06/2017-like (Victoria lineage) virus (updated) Quadrivalent (four-component) vaccines, which include protection from a second lineage of B viruses,...

The proposed rule for 2019 was released on July 12, 2018. Meridian Medical Management posted a high overview of proposed changes to Payment Policies under the Medicare Physician Fee Schedule. There are also changes proposed for the Quality Payment Program. Amongst the proposed changes are: Changing the definition of MIPS eligible clinicians to include physical therapists, occupational therapists, clinical social workers, and clinical psychologists. Having a third element of the low-volume threshold determination by adding...