Tag: Medical Group Management Association (MGMA)
Two New Files Added
Annual Regulatory Burden Report, MGMA, October 2021
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2nd Regulation Released Implementing No Surprises Act
On Thursday, Sept. 30, the Office of Personnel Management and the Departments of Health and Human Services, Labor, and Treasury, released the second regulation implementing provisions of the No Surprises Act. On Dec. 27, 2020, the No Surprises Act was signed into law with the goal of protecting patients from receiving surprise medical bills. This rule follows prior rulemaking outlining patient protections against surprise medical bills, establishing out-of-pocket limits, and notice and consent requirements.
This rule implements dispute resolution processes for providers, patients, and health plans and takes effect Jan. 1, 2022. Consistent with the intent of the law and previous rules from the Administration, patients continue to remain harmless from outstanding surprise medical bills.
Follow these links for more information from CMS.gov.
Automate Your Revenue Cycle and Avoiding EFT Fees
ARE YOU PAYING TO GET PAID?
OR
Would you like to lodge a complaint against a health plan?
Tips on Automating your Revenue Cycle and Avoiding EFT Fees, MGMA
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Information blocking requirements now in effect: Is your practice in compliance?
Hear what you need to do to comply with new information blocking regulations firsthand from the Biden Administration’s top health technology official, Micky Tripathi, the National Coordinator for Health Information Technology. MGMA will host an information blocking webinar to review the regulations along with a live Q&A on June 17 at 1PM. Senior Vice President of Government Affairs Anders Gilberg will host this interactive session with Dr. Tripathi to help medical groups comply with ONC’s information blocking requirements that went into effect in April. Reserve your spot today.
POET has registered for this webinar. If you are interested in joining us to watch, please call to reserve a spot.
Important, Time Sensitive
WEDI is hosting a day-long virtual meeting on Wednesday, April 28 to review the Information Blocking regulations, exceptions, and discuss compliance plans. Here you can find registration and the agenda for the event.
This event on Information Blocking is free for all members of the healthcare industry.
6 Keys to Addressing Denials
6 keys to addressing denials in your medical practice’s revenue cycle
MGMA STAT – MARCH 18, 2021
The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Has your organization seen denials increase in 2021?”
- 69% said “yes.”
- 31% said “no.”
Common responses from respondents included payers not reimbursing for codes related to COVID-19 supplies, critical care claims and imaging CTs.
For those healthcare leaders who reported an increase in denials, the average increase in denials was 17%.
- Half responded that they increased by 1% to 10%.
- 34% said 11% to 20%.
- 12% who stated 21% to 30%.
The poll was conducted March 16, 2021, with 576 applicable responses.
For great tips and strategies to use, follow this link or visit “The Business End” folder located in the InK files.
MGMA Community
This question was posed on the MGMA Community, March 2021.
Question: Posed from Community Member in Clearwater FL.
Would like to know how your offices are notating the total time on the date of patient visit for 99202-99215 OVs? Currently there is no statement from CMS re how the time must be documented other than total time is to be noted. We anticipate denials due to a lack of notation of time–is anyone seeing denials associated with this?
Reply #1: Community Member from Anchorage AK
Our provider’s note has the following statement at the end of each note:
I spent a total of 25 minutes on this appointment, including review of results, histories, x-rays, examination, consultation with the patient, and coordination of care.For office injections (which cannot be included in the total above if the patient came in for an office visit and the decision was made to also do an injection) we have this statement at the end of the procedure note:
I spent a total of 10 minutes prepping and performing the aspiration today, exclusive of and separate from the time spent on today’s appointment.
Reply #2: Community Member from New Jersey
We recommend to our clients that total minutes can be given, but giving the actual start & stop time is better. ” Pt. was seen for… from 9:01 – 9:22 for a total of 21 minutes.” Too many providers have total minutes that exceed 10-12-15 hours which is easy for auditors to see. That will keep providers out of trouble.
6 Keys to Addressing Denials in Your Medical Practice’s Revenue Cycle, MGMA STAT – March 18, 2021
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