MMP: Welcome to Manage My Practice, Denise! What is your background in medical practice management?
DPT: My first job in healthcare was in 1975 (I was 5 years old). I was hired to work in radiology having high hopes of developing….but that never happened. I memorized the color coded X-ray jackets and turned locating them for physicians into a challenging game. Because of my consistently positive attitude, I was promoted to receptionist. Later I was recruited to work for a general surgery practice in town where I was employed for the next 32 years. During that time, I was promoted to Administrator and became Certified in Healthcare Management through Pfeiffer College.
MMP: Tell me about the process of becoming a healthcare comedienne.
DPT: Humor has escorted me through many difficult times in my life. By finding the “funny side up” in a situation, I am able to keep an open mind, learn from it and share with others in training programs. A good example ~ when I introduce my contagious characters, i.e. “Ima Gossip” as the person that will keep the bad news stirring and “Shirley Knott” who will surely not schedule another patient for that doctor, I am able to introduce some uncomfortable issues in a way that everyone can appreciate…..”Justin Case” they work around them.
MMP: Things are very gloom and doom in healthcare today – how do you take such a tough subject and inject humor into it?
Check out the latest Manager’s Minute from Manage My Practice!
In Episode #7, Mary Pat explains the difference between the Date of Service on charges and the Date of Entry or Date of Posting.
Everybody wants their medical practice’s website to rank at the top of Google search results for their target keyword phrase. Dominating Google can get your medical, dental, or chiropractic in front of people who are actively looking for exactly what your business offers – something that print, radio and television advertisements are not as effective at doing. Simply put, a top-ranking website can be a business owner’s dream come true.
But most business owners don’t know much about search engine optimization. And getting to the top of Google search results is not a cinch. Depending on the competitiveness of a keyword phrase, it can take months (even years) for a site to climb to the top of the Google ladder.
Don’t let this reality distract you from taking action, though. If your website is new or just isn’t meeting your expectations, there are some simple and powerful things you can do in just fifteen minutes that will help make your medical practice website more search engine friendly.
So here’s the challenge I am issuing you right now: take fifteen minutes to do (or make sure you have done) these three things. After you do, come back and let us know how it went in the comments section below. And of course, if you have any questions, feel free to email me. I reply to every email.
Ready? Here, we go:
#1. Identify your primary target keyword phrase (time: 5 minutes)
Your primary target keyword phrase is the main phrase you will optimize your site for. It is the phrase that members of your target market will use the most to find products and services that businesses like yours offer.
CMS sponsored a conference call last week to make sure that Part B providers are aware of new services payable by Medicare. These services were in effect late in 2011, but most providers are not aware of their existence. Is your practice using these new Medicare reimbursement codes?
Screening & Counseling for Alcohol Misuse
Why does CMS consider alcohol misuse screening and counseling important for Medicare patients?
According to the USPSTF (2004), alcohol misuse includes risky/hazardous and harmful drinking which place individuals at risk for future problems; and in the general adult population, risky or hazardous drinking is defined as >7 drinks per week or >3 drinks per occasion for women, and >14 drinks per week or >4 drinks per occasion for men. Harmful drinking describes those persons currently experiencing physical, social or psychological harm from alcohol use, but who do not meet criteria for dependence.
Which providers can provide alcohol misuse screening and counseling for Medicare patients?
Check out the latest Manager’s Minute from Manage My Practice!
In Episode #6, Mary Pat explains how to do a Daily Reconciliation of your practice’s charges and payments.
And click below to download our free Daily Reconciliation form!
9/29/2012 Medicare pricing just released for flu shots – see pricing added to the codes below.
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Download this excellent 2012 – 2013 grid that shows vaccines by name and the appropriate codes!
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NOTE: Practices using FLUARIX (preservative free) for Medicare patients should be using 90656 and not the NOS code of Q2039.
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Q2034 Introduced As New Medicare Reimbursement Code for 2012 – 2013 Flu Shot Season
Influenza virus vaccine code Q2034 (Influenza virus vaccine, split virus, for intramuscular use (Agriflu)) for claims with dates of service on or after July 1, 2012, processed on or after October 1, 2012 has been introduced for the 2012 – 2013 flu season for Medicare patients.
Effective for claims with dates of service on or after July 1, 2012, influenza virus vaccine code Q2034 will be payable by Medicare. Annual Part B deductible and coinsurance amounts do not apply. All physicians, non-physicians practitioners and suppliers who administer the influenza virus vaccination must take assignment on the claim for the vaccine.
Effective for dates of service between July 1, 2012 and September 30, 2012, contractors shall use local pricing guidelines to determine payment rates for influenza virus vaccine code Q2034.
Contractors shall pay for influenza virus vaccine code Q2034 to hospitals (12X and 13X), SNFs (22X and 23X), HHA (34X), hospital-based RDFs (72X), and CAHs (85X) based on reasonable cost.
Until systems are implemented, contractors shall hold institutional claims containing code Q2034 with dates of service on or after July 1, 2012, received before October 1, 2012.
Once the system changes described in this instruction are implemented, contractors shall release the held claims, appending condition code 15.
How should the flu shot be coded?
Consultant Libby Knollmeyer’s Lab Machine Primer Series Part 1: Hematology Analyzers
When laboratories in physician offices move out of the Waived category into the Moderately Complex category, it is usually because they want to acquire the capability of testing CBCs (Complete Blood Counts). To date, there are no waived hematology analyzers, so to do CBCs in-office, the lab must be at least of moderate complexity.
The major difference between Waived and Moderate Complexity labs is that there is regulatory oversight for all non-waived labs (moderate and high complexity), as well as requirements for lab directors, testing personnel, proficiency testing, and biannual inspections that are not present for Waived labs, which all add to the cost of having a laboratory.
In general, however, CBCs are a profit-generating test and virtually every medical specialty can make use of hematological testing information. A single physician practice can generate a profit performing a minimum of 5 CBCs/day, even with the added financial burdens of having a non-waived laboratory. Preforming CBC tests is a great low-impact way to add revenue to your medical practice with diagnostic medical equipment.
The hematology analyzer analyzes whole blood and counts or calculates the following parameters:
Medicare Fee-For-Service Recovery Auditor Prepayment Review Demonstration
Thursday, August 9, 2012
2:00PM 4:00PM ET
Conference Call Only
The Centers for Medicare & Medicaid Services (CMS) will hold a Special Open Door Forum (ODF) to discuss the recently approved Recovery Auditor Prepayment Review Demonstration that will begin August 27, 2012.
This Special ODF is designed specifically for Medicare Fee-For-Service providers who may be subject to Recovery Auditor review in the 11 approved demonstration states: FL, CA, MI, TX, NY, LA, IL, PA, OH, NC, and MO. Recovery Auditors will review claims before they are paid to ensure that the provider complied with all Medicare payment rules. These reviews will focus on certain types of claims that historically result in high rates of improper payments. Initially, Recovery Auditors will review short stay inpatient hospital claims. This demonstration will also help lower the error rate by preventing improper payments, rather than the traditional pay and chase methods of looking for improper payments after they have been made.
During this ODF, CMS will provide an overview of the Recovery Auditor Prepayment Review Demonstration, including:
Coding and billing can go together like peanut butter and chocolate when you’re talking about private medical practices. Hospitals do things much differently, but either way, here are the differences between coding and billing.
Be sure to check out our Manager’s Minute Page for more episodes!
Health care law offers free preventive services to 47 million women.
Forty-seven million women are getting greater control over their health care and access to eight new prevention-related health care services without paying more out of their own pocket beginning Aug. 1, 2012, Health and Human Services (HHS) Secretary Kathleen Sebelius recently announced.
Previously some insurance companies did not cover these preventive services for women at all under their health plans, while some women had to pay deductibles or co-pays for the care they needed to stay healthy. The new rules in the health care law requiring coverage of these services take effect at the next renewal date on or after Aug. 1, 2012for most health insurance plans. For the first time ever, women will have access to even more life-saving preventive care free of charge.
According to a new HHS report also released today, approximately 47 million women are in health plans that must cover these new preventive services at no charge. Women, not insurance companies, can now make health decisions that will keep them healthy, catch potentially serious conditions at an earlier state, and protect them and their families from crushing medical bills.
President Obama is moving our country forward by giving women control over their health care, Secretary Sebelius said. This law puts women and their doctors, not insurance companies or the government, in charge of health care decisions.
What services are now covered?
The eight new prevention-related services are:
- Well-woman visits.
- Gestational diabetes screening that helps protect pregnant women from one of the most serious pregnancy-related diseases.
- Domestic and interpersonal violence screening and counseling.
- FDA-approved contraceptive methods, and contraceptive education and counseling.
- Breastfeeding support, supplies, and counseling.
- HPV DNA testing, for women 30 or older.
- Sexually transmitted infections counseling for sexually-active women.
- HIV screening and counseling for sexually-active women.
For women who are pregnant or nursing, the new preventive services include gestational diabetes screening as well as breast-feeding support, counseling and supplies. Health services already provided under the health care law include folic acid supplements for women who may become pregnant, Hepatitis B screening for pregnant women, and anemia screening for pregnant women.
These services are based on recommendations from the Institute of Medicine, which relied on independent physicians, nurses, scientists, and other experts as well as evidence-based research to develop its recommendations. These preventive services will be offered without cost sharing beginning August 1, 2012 in all new health plans.
Who does not have to offer these benefits?
Group health plans and issuers that have maintained grandfathered status are not required to cover these services. In addition, certain nonprofit religious organizations, such as churches and schools, are not required to cover these services. The Obama administration will continue to work with all employers to give them the flexibility and resources they need to implement the health care law in a way that protects womens health while making common-sense accommodations for values like religious liberty.
What is “grandfathered status”?
Health plans that existed before the health care reform law have been grandfathered in, meaning that they do not need to comply with the ACA coverage requirements until significant changes (e.g. benefit cuts, cost sharing increases, etc. are made to the plan. Grandfathered plans dont have to follow the new preventive services cost sharing rules. All non-grandfathered private health plans have to comply with the new preventive health services coverage and cost-sharing rules.
A recent survey found that 90% of all large U.S. companies expect that their health plans will lose grandfathered status by 2014. – Stephen Miller, Society for Human Resources Management, Nine of 10 Big Companies Expect to Lose Grandfathered Status (Aug. 20, 2010),
Eventually all plans will lose their grandfathered status and distinctions between the two types of plans will disappear. At that point, all plans will cover these important preventive health services without cost sharing.
Do religious organizations have to comply with the contraceptive coverage requirements of the ACA?
The Department of Health and Human Services has proposed a rule that would exempt a small segment of religious employers, such as churches, from this contraceptive coverage requirement. This decision is not yet final and in its current form, it would not apply to most religiously-affiliated employers such as religious hospitals, church-affiliated schools and universities, and religiously-affiliated charities. Therefore, most religiously-affiliated employers will have to comply with this law. (Courtesy of the National Women’s Law Center FAQ on Contraceptive Coverage in the New Health Care Law: Frequently Asked Questions)
