Your ConnectiCare patients with commercial and Medicare Advantage plans effective on or after Jan. 1, 2017, will have new member ID cards. We will also be issuing new member ID numbers to all of your ConnectiCare Medicare Advantage patients. The redesigned member ID cards will make it easier for your office to identify the different product names, copayments and where you should send your claims for payment. It will also clearly note whether referrals are needed...

This is the last year for reporting of the PQRS Quality Measures as we know it today. In 2017, the Merit-Based Incentive Payment System (MIPS) will go into effect combining several programs into one. Please refer to our prior Provider News and Alert publication dated October 14, 2016 for more information. If you are submitting your 2016 PQRS Quality Measures via the claims method and are unsure if you will be a “successful reporter,” to avoid...

By Jaime Ojeda It is an understatement, to say the least, that the results of the presidential election was a shock to many.  For those of us intimately involved with the healthcare landscape, and specifically focused on Health IT that supports many goals of the Affordable Care Act (ACA), the question quickly turned to, “How will all this impact Health IT spending in the coming years?” By coincidence, I spent the night of the election, and the...

By Susan D’Agostino, RN Using proper tools of analysis, an organization can drive clinical excellence by managing initiatives, providing patient population management and measuring key performance indicators (KPIs). PrecisionBI can empower a healthcare facility to extract data from the EHR and turn it into information that can help transform healthcare. What can a clinic do in preparation for 2017 MIPS measures?  Keep reading. Assuming that you are already participating in MU, PQRS and so on, the first step...

On Wednesday, November 2, 2016, CMS finalized revisions to payment policies under the physician fee schedule along with other revisions to Part B for calendar year 2017. These changes are scheduled to be published in the Federal Register on November 15, 2016. These revisions and regulations will be effective on January 1, 2017. Among these changes, the final rule outlines: Changes for the 2017 calendar year physician fee schedule for physician services: The current 2016 conversion...

According to the Center of Disease Control and Prevention, receiving an annual flu vaccine is the greatest method in protecting against the spread of the flu. The more people who get vaccinated, the more people who will be protected. Who should be vaccinated? All persons should receive the flu vaccine but the following groups are at high risk: Older people and those that live with and care for them Very young children and those that live with...

HHS finalizes streamlined Medicare payment system that rewards clinicians for quality patient care MACRA rule will accelerate health care system’s shift toward value Today, the Department of Health & Human Services (HHS) finalized a landmark new payment system for Medicare clinicians that will continue the administration’s progress in reforming how the health care system pays for care. The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) Quality Payment Program, which replaces the flawed Sustainable Growth Rate (SGR), will equip...

By: Bill Stone As part of its Revenue Acceleration Program (RAP) and commitment to providing outstanding client service, Meridian Medical Management utilizes the 4 Disciplines of Execution® (4DX) strategy to increase critical goal execution and deliver trustworthy automation with optimal client results. 4DX represents a modernized way of thinking and working that is essential to thriving in today’s competitive medical billing workplace. It is a simple, yet proven formula for executing on what are the most crucial...

Under the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015, CMS is required to remove all Social Security Numbers from Medicare Cards by April 2019.  On September 28, 2016, CMS issued notice of its intent to discontinue the use of Social Security Numbers on Medicare cards beginning April 2018.   CMS will change to a randomly generated Medicare Beneficiary Identifier (‘MBI’) which will replace the prior SSN-based Health Insurance Claim Number (HICN).  The goal is...

Medical Billing and Coding - Healthcare Coding There are two changes occurring on October 1, 2016, that will affect ICD-10 coding: First, there are 1943 new ICD-10 CM codes slated to go into effect 10/1/2016, along with 422 revised and 305 deleted ICD-10 CM codes. These numbers are quite remarkable, and due primarily to a code freeze for the past several years while ICD-10 was planned and implemented. The second and equally important change to note is...