Blog Posts

Doctor

HHS Proposes Stark Law and Anti-Kickback Statute Reforms to Support Value-Based and Coordinated Care

Yeo & Yeo Medical Billing & Consulting

The Department of Health and Human Services (HHS) announced proposed changes to modernize and clarify the regulations that interpret the Physician Self-Referral Law (the “Stark Law”) and the Federal Anti-Kickback Statute. The proposed rules provide greater certainty for healthcare providers participating in value-based arrangements and providing coordinated ... Learn more

Doctors

Costly Consequences of Waiving Patient Copays

Yeo & Yeo Medical Billing & Consulting

Writing off patient copays may be well-intended, but this generosity can have costly consequences. Write-offs may be hurting your practice by compromising your contracts with private payers. Violating these terms of your contract may negatively affect reimbursements from those payers. You may even be ... Learn about the consequences

Meeting

Auditing Begins for Medicare Plus Blue’s Reimbursed Diagnosis-Related Group Claims

Yeo & Yeo Medical Billing & Consulting

HMS will begin auditing Medicare Plus Blue PPO’s reimbursed diagnosis-related group claims for clinical and coding validation, starting Sept. 1, 2019. HMS is an independent company working for Blue Cross Blue Shield of Michigan. The audits will review medical records to ensure claims were billed in accordance with coding ... Learn more Medicare Plus Blue’s reimbursed diagnosis-related group claims

Cost-Cutting

Cigna, UnitedHealth to Stop Paying for Consults in October

Yeo & Yeo Medical Billing & Consulting

Two major commercial payers will stop reimbursing consultation E/M services (CPT codes 99241-99255) in October, finally joining CMS in ditching the high-paying but sometimes confusing code set. UnitedHealth made its announcement in its March 2019 newsletter, stating that it was aligning its policy to ... Learn more

Paperwork

Deadline for HICN Claims Submissions

Yeo & Yeo Medical Billing & Consulting

In April 2018, Medicare began the process of removing Social Security Numbers from Medicare cards in an effort to prevent identity theft. Health Insurance Claim Numbers (HICNs) were replaced by Medicare Beneficiary Identifiers (MBIs), randomly generated combinations of 11 alphanumeric characters. The MBI is ... Learn more about the deadline

Doctors

New CMS Pilot Gives Practices Access to Medicare Claims Data

Yeo & Yeo Medical Billing & Consulting

CMS announced a new pilot program for practices called Data at the Point of Care (DPC). The DPC pilot is based on application programming interface (API) standards and is part of the CMS MyHealthEData initiative. The pilot will provide practices access to Medicare claims data directly within ... Learn about the CMS pilot