M-Scribe Technologies, LLC

11/26/2021

5 Key Metrics to Assess Financial Health of Medical Practice

How to assess medical practice financial health with different benchmarks, metrics, and reams of healthcare data.

11/08/2021

COVID-19 Pandemic Fast Tracked RPM and Telehealth Implementation

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10/04/2021

The Medicare Physician Fee Schedule proposed rule recently came out, and physician groups and individual providers are already calling it a "mixed bag" for practices. While the proposed rule definitely has some good policies in it, there are some concerning ones, too. It's important to be informed on the coming proposed changes and make your voice heard if your practice has concerns.

To help you better understand what may be coming in 2022, we've put together a closer look at the proposal and some of the key points you need to know. From the great changes to the ones that seem most concerning, it's important that you're familiar with some of the key things proposed for 2022.

Proposed 3.75 Percent Conversion Factor Reduction
One of the biggest concerns that many practices and practitioners have is the proposed 3.75 percent conversion factor reduction, put in place due to current budget neutrality requirements. To avert this cut, there must be congressional intervention, so it's currently unknown what will happen.

If this proposed reduction does go through, then the 2022 conversion factor would end up being $33.58, which is more than a dollar lower than the 2021 conversion factor - something that's very concerning for many practices. The reason for this reduction is because the 3.75 rate increase that came last year with the coronavirus-related legislation will be expiring.

The Surgical Care Coalition noted that since this new proposed conversion factor isn't keeping up with inflation, it may prove harmful to some specialists. Ultimately, this has a negative impact on patient care and may threaten patient access to essential procedures and treatments.

Shared Savings Program Changes
Significant changes to the accountable care organization (ACO) program were also included in the new Physician Fee Schedule proposed rule. One of the big changes that are proposed is a transition to new electronic quality reporting requirements that's longer. These electronic quality reporting requirements were finalized in 2020 while the COVID-19 pandemic was going on, and postponing the start of these requirements was a good move.

Some practices and providers were worried about handling the new requirements, and the National Association of ACOs noted that they thought this delay in the changes was the correct thing to do.

Expanding Telehealth Reimbursement
One change that most physician groups are optimistic about is CMS' proposal to expand telehealth reimbursement for some services with the new Physician Fee Schedule in 2022. Many physician groups have been calling for the expansion of audio-only mental health services and additional services, and they find this proposal encouraging.

The new proposed role is mainly focused on expanding telehealth reimbursement for behavioral and mental services. There's also the idea of allowing some services added to the Medicare telehealth list during COVID-19 to stay there, at minimum until 2023.

Most industry groups are also happy that CMS has proposed postponement of the punitive phase of the new Appropriate Use Criteria program. At this point, it's expected to be postponed until after the expiration of the COVID-19 public health emergency. Originally, the program was launched in 2020 and would penalize clinicians ordering advanced imaging if they hadn't consulted with a Clinical Decision Support Mechanism. This would have gone into effect at the beginning of 2022, but will now be postponed.

Currently, CMS continues to accept comments on this new proposed rule until September 13, 2021. This is your chance to make your voice heard.

At M-Scribe.com, we work to help your practice navigate the ever-changing physician fee schedules, CPS changes, and other billing and coding changes that are essential to boosting your revenue cycle. Our professionals stay up-to-date on the latest changes and work with practices to handle their billing, coding, credentialing, and additional needs. If you're looking for ways to improve your bottom line, contact M-Scribe.com today to learn
https://www.m-scribe.com/blog/the-medicare-physician-fee-schedule-proposal-what-you-need-to-know

09/30/2021

Since the very first days of the COVID-19 pandemic, there have been a variety of CPT code changes to deal with the crisis. Now, there's been a new update to the CPT code set by the American Medical Association regarding changes to the way that COVID-19 vaccines and booster shots - slated to begin rolling out soon - are billed. Not only do these updates include new CPT codes for the COVID-19 vaccine, but also a new code for a new Pfizer formulation of the vaccine, a formulation that moved to a tris-sucrose buffer in place of the original formulation's phosphate buffer.

COVID-19 Vaccine Tris-sucrose Formulation Codes

The new codes for the new Pfizer tris-sucrose formulation include:

91305: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3 mL dosage, tris-sucrose formulation, for intramuscular use
0051A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; first dose
0052A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; second dose
0053A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 30 mcg/0.3 mL dosage, tris-sucrose formulation; the third dose
Keep in mind, these codes can be used for the Pfizer tris-sucrose formulation of the COVID-19 vaccine after it receives either full approval from the FDA or it is provided with emergency use authorization, which is likely coming soon.

The original formulation of Pfizer's COVID-19 vaccine has already been granted full approval from the FDA, and emergency use authorization has been providing for this vaccine to include a booster shot, as well. According to news from the White House, there are plans to roll out the third - or booster - dose of Pfizer's COVID-19 vaccine soon, and CPT code 0053A is the code that will be used to document that boost shot. Additional booster shots for other vaccines, such as Moderna, are expected to come soon, but a bit later than the Pfizer booster.

Moderna Boosters - New CPT Codes

While Moderna's vaccine hasn't received full approval from the FDA, the emergency use authorization from the FDA has been altered to allow a third vaccine dose of that vaccine. To prepare for those booster shots likely coming from Moderna, additional new CPT codes were announced by the American Medical Association, including:

91306: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 50 mcg/0.25 mL dosage, for intramuscular use
0064A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike protein, preservative-free, 50 mcg/0.25 mL dosage, a booster dose.
According to the AMA, the third dose of the Moderna COVID-19 vaccine is more likely to be administered at a slightly different dose from the original formulation, unlike the booster of the Pfizer vaccine. This is why the AMA released a new vaccine code for the booster vaccine from Moderna. Of course, these booster CPT codes are provisional codes that will only be effective once the FDA has granted authorization or approval.

Along with the previous CPT codes, additional new CPT codes included in this new release include the following:

0004A: Immunization administration by intramuscular injection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) (coronavirus disease [COVID-19]) vaccine, mRNA-LNP, spike prote
https://www.m-scribe.com/blog/cpt-codes-updated-for-covid-19-vaccines-by-ama

07/27/2021

Understanding Medical Necessity to Prevent Claim Denials

Full understanding of medical necessity is a critical part of preventing claim denials that could cost a medical practice much money.

07/26/2021

Medical billing company or in-house medical billers must have deep knowledge of several areas, including insurer requirements, the rules for Medicare, Medicaid and all the billing codes. They also need to comply with complex state and federal regulations such as HIPAA and Stark laws. However, the most challenging part of a medical biller's duties is often explaining a patient's billing statement.

Anyone who performs medical billing services has to accept the fact that they will be spending a significant portion of their time explaining why a patient received a bill. Keeping a smile in your voice is a basic requirement of all customer service jobs, but medical billers have the added burden of routinely dealing with customers who are ill or in pain. Listening to a patient's concerns with calm understanding is essential for easing their anger. Additional steps for handling billing questions from patients include providing contact information and making follow-up calls.

1. Show Concern to Patient Questions
Everyone has days that began badly, whether it's arriving late for work or dealing with a broken coffee machine. However, it's vital that you not allow your frustration to show when speaking to an upset patient who is under stress from both a serious medical condition and a financial issue. It's easy to raise your voice in response, but it often helps to remember that you chose to work in this field because you wanted to help people. That desire includes explaining medical statements, which often fail to make sense to a layperson.

Some calls from patients may be perfunctory because they merely require you to provide factual information, but others will require months to resolve and multiple calls to the insurer, physician and patient. This process includes reviewing the claim that was submitted to the insurance carrier, verifying the diagnosis and matching the procedures performed with the policy requirements. This effort becomes worthwhile when the patient is finally satisfied with your answers to their billing questions.

2. Provide Contact Information for Call Back
Providing patients with a personal contact number instead of the main number of a corporate office can be a highly effective method of giving them a sense of empowerment over their situation. This simple act can show the patient that you're truly interested in helping them again if they require it. The possibility of future communication with the same patient is also one of the most important reasons for taking detailed notes during each phone call. This practice also allows a third party to determine what was said during the call.

3. Make Follow-up Calls
Follow-up calls are essential for assuring the patient that you're still actively working on their case and are doing everything you can to address their concerns. Additional activities are frequently necessary when appealing a claim, which involves determining a policy's contractual obligation in a particular case. This process can be a lengthy one, since it often involves submitting information to a third party for review.

Related Article: Best Practices for Front Desk to Increase Practice Revenue

It's also important to manage a patient's expectations by keeping them informed on how long this process can take. Outlining the worst-case scenario upfront will help keep the patient happier in the long run, which is always a good public relations tool. The ability of social media to make or break a business of any size means that even small gestures have the potential to bring a practice more business. A reputation for tending to the patient's needs is priceless in the healthcare industry.

Summary
M-Scribe is a national leader in providing medical billing services, including patient support, auditing, and stand-alone medical coding services. We understand that the ability to put yourself in the other person's shoes is a crucial requirement for working in medical practice. Call us 770-666-0470 or email [email protected] to find out more about what we can do for you.
https://www.m-scribe.com/blog/3-tips-for-handling-medical-billing-patient-phone-calls

07/23/2021

More money is due from patients than ever before. While self-pay patients are always a concern, the primary reasons more dollars are due is a function of those patients who have healthcare plans in force.

Two reasons dominate the issue.

The increasing use of high deductible healthcare insurance plans; and
Carriers increasing co-pay amounts regularly

If your practice has had issues with insurance carriers who make a habit of paying late, you have probably installed procedures to hasten payments from these lackadaisical payers. But, what about your patients having high deductible plans or those enduring higher co-pays.

Why allow your accounts receivable increase while your cash flow decreases? Establish a plan to maximize your collections from patients. It need not be overly complex or challenging to execute. However, your plan should include these components, at a minimum.

Collection Plan Considerations

Make it clear and understandable. Avoid confusing "legalese" or sophisticated terminology and buzzwords.

Fill any "holes" and eliminate ambiguities in the written procedure. Unless you use an attorney who specializes in collections or veteran collections consultant, you may allow some loopholes or ambiguous statements to inhabit your practice policy. After you believe your collections strategy is complete and ready to be published, read it again, specifically trying to find any holes or language that may be ambiguous.

Communicate with and train both front- and back-office staff on the new policy. Unless you plan on collecting co-pays and deductibles personally, your staff will have this duty. Expecting even seasoned personnel to enforce a procedure of which they are unaware is foolhardy. Having training sessions will give them the information they need to follow the policy, while encouraging questions about any features they may not understand at first glance.
Include a procedure to contact late payers around every two weeks to remind your patients they have a balance due. This approach allows practice staff to be diplomatic and friendly, before the balance becomes seriously overdue.

Publish the policy, posting the major components (if possible), so your patients know what is expected of them. With various independent studies indicating that co-pays alone can account for up to 20 percent of practice income, posting your policy helps eliminate patient comments like "I didn't know I had to give you my co-payment before or immediately after my visit." Displaying your patient collection policy in a prominent, heavily viewed place reminds your patients that plan co-pays are payable at the time of service or treatment.

Remain objective, keeping your "feelings" out of your collection policy. This is not the time to become "Marcus Welby, M.D." (that was only a 1960s TV show, anyway). You became a physician to keep patients healthy or make sick people get well, but you can only fulfill your mission if your practice remains open and financially sound.
If your A/R aging is reaching unacceptable levels, have procedures to collect seriously overdue outstanding balances. This may seem obvious, but some provider-designed collection strategies and plans do not address this condition. Whether you train your practice staff how to be "firm, but courteous" or farm out overdue balances to a medical collections firm, make a policy for handling these situations.

These are some of the important components of collecting more monies due from your patients. Those that always pay on time can disregard the practice policy, as they do not need to know its features. However, those patients who habitually require more formal collection efforts may become profitable, making co-pays and remitting balances faster.
https://www.m-scribe.com/blog/bid/346987/how-to-maximize-collections-from-patients

07/22/2021

Nothing makes medical practice staff happier than seeing their patients thriving and taking a proactive stance on their health. The better patients do, the better their business does. Every medical practice wants to reach more patients to see their health also improve.

When outlets for advertising perpetually shift to meet new trends and developments, staying up to date poses difficulty. However, medical practices can employ many simple and cost-effective strategies to use the evolving marketing landscape to their advantage.

Start by Conducting a Marketing Assessment
Every medical practice's goals are different. Having an initial outline of the current state of client engagement and goals for growth will be extremely helpful when it comes to ex*****on. Start with self-research. Examining outside company perceptions helps in understanding successes and shortcomings. Google, Facebook - and other social media pages - are excellent sources for insight. They are spaces where clients feel comfortable expressing opinions they may not feel comfortable expressing in person.

Knowledge of common industry practices can also assist a medical office with its sights on acquiring more patients. In understanding what other offices in the local area are providing for their clients, medical practitioners can see what they can offer or build upon. In a perpetually adapting world, there are assortments of possibilities.

Patient Retention Is the Most Cost-Effect Source of Revenue
Although bringing in new faces is the primary goal, the importance of existing clients cannot be discounted. The lowest cost solution to companies is retaining businesses with those they already serve. While their patronage has already been earned, there are ways to enhance their experience and express appreciation. After all, the new faces in the medical office will fall into this category after the initial visit.

There are a plethora of ways to show clients their choice in medical practices is appreciated. From disseminating good news in a newsletter to hosting small gatherings, there are many ways to exhibit gratitude.

Use Social Media to Increase Recognition
Effective marketing does not have to include an enormous advertising budget. Medical professionals have vast amounts of expert knowledge not generally known to the public. Using digital virality to their advantage, healthcare professionals have been known to gain massive followings outside of their practices.

Social media offer fantastic tools that enable groups and individuals to market themselves for free. Although there are advertising features where users can pay to promote their services, it is not required to get started.

Contribute to Public Knowledge While Displaying Expertise
Social media offer a great interactive platform where providers can directly communicate with their patients and attract the attention of new ones. However, client interaction is not the only benefit of virtual platforms. Writing guest articles for popular and reputable blogs and journals is another opportunity for positive exposure. Podcasts and YouTube videos are other examples of useful outlets.

Medical professionals have the potential to become leading contributors to public knowledge on a given topic. As an educator on a global platform, offices can advertise their services far beyond what conventional marketing does. Social media have the ability to transform a medical office into a local landmark.

Get Out Into the Community
The modern virtual landscape allows businesses to communicate and engage with larger groups than ever before, but nothing beats an in-person conversation. Fostering a personal connection with the demographic of interest opens the door to a long-term professional relationship.

Attending community events with business cards or brochures in hand helps future patients become familiar with their local medical office. Different medical groups can join together to attend community events. When community members see trusted professionals interacting positi
https://www.m-scribe.com/blog/effective-strategies-to-boost-medical-practice-patient-count

07/07/2021

Effective Strategies to Boost Medical Practice Patient Count

A medical practice that provides consistent patient care, comfort, and quality ensures the word spreads to boost their patient count.

06/16/2021

Medicare Home Health Billing Requirements

Basic guideline medical practice administrators need to know about medicare requirements for home health billing.