Revenue Cycle Inc. Blog

Palmetto GBA Prepayment Reviews

Mary — Thu, 12 Apr 2012 17:02:04 +0000

Palmetto GBA will perform a service-specific prepay probe review on outpatient claims in North Carolina, South Carolina, Virginia and West Virginia. There are 13 rad onc services they are reviewing because their data analysis showed significant frequency of these services. Can anyone guess the 13 codes?

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ASTRO Article on IMRT Utilization

Mary — Thu, 12 Apr 2012 02:12:18 +0000

Interesting article that addresses urologists benefitting from downstream radiation revenue.

Click here to view the article.

“Healthcare Hustle” show on CNBC

Mary — Tue, 10 Apr 2012 03:40:30 +0000

Did anyone see the show “Healthcare Hustle” last night on CNBC? It was very eye opening and shows what our future will hold in the fight against healthcare fraud. It is clear, with the additional money that Obama has earmarked to fight fraud, that everyone will be audited at some point by one group or another. What did you think about the show?

HHS proposes delaying ICD-10 deadline to Oct. 1, 2014

Mary — Mon, 09 Apr 2012 18:30:27 +0000

A proposed rule from HHS pushes back by one year the compliance deadline for conversion to the International Classification of Diseases 10th Revision of diagnostic and procedural codes to Oct. 1, 2014. How much more time is needed before we can start ICD-10?

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NCCI Edits April 2012 Release

Mary — Fri, 16 Mar 2012 19:13:55 +0000

Effective April 1, 2012 CMS is going to consolidate the two NCCI edit files into the Column One/Column Two Correct Coding edit file. CMS will no longer publish a Mutually Exclusive edit file on its website. The edits in the Mutually Exclusive file won’t be deleted but moved to the Column One/Column Two Correct Coding edit file. This will simplify the use and search for the edit files.

CMS to enforce 5010 transaction through end of June, 2012

Mary — Thu, 15 Mar 2012 21:16:13 +0000

CMS just announced that they have extended the enforcement of 5010 transaction through the end of June, 2012. This is terrible news for providers that are already suffering from poor cash flow!!

Highmark Medicare Services Changes Name

Mary — Fri, 02 Mar 2012 14:50:55 +0000

Highmark Medicare Services (HMS) new name is now Novitas Solutions, Inc. HMS was acquired by Diversified Services Options, Inc., a wholly-owned subsidiary of Blue Cross and Blue Shield of Florida Inc. Novitas is still the MAC for J12.

Healthcare Fraud Prevention and Enforcement Efforts Result In Record-Breaking Recoveries

Mary — Fri, 17 Feb 2012 15:56:39 +0000

On Tue Feb 14, Attorney General Eric Holder and HHS Secretary Kathleen Sebelius released a new report showing that the government’s healthcare fraud prevention and enforcement efforts recovered nearly $4.1 billion in taxpayer dollars in FY2011. This is the highest annual amount ever recovered from individuals and companies who attempted to defraud seniors and taxpayers or who sought payments to which they were not entitled.

New Deadline for ICD-10 Compliance

Mary — Fri, 17 Feb 2012 15:53:11 +0000

Health and Human Services is going to issue a new compliance date for ICD-10 compliance, postponing the current date. The final rule adopting ICD-10 as a standard was published in January 2009 and set a compliance date of October 1, 2013 – a delay of two years from the compliance date initially specified in the 2008 proposed rule.

Medicare Reimbursement Rates Extended

Mary — Thu, 16 Feb 2012 14:34:57 +0000

House and Senate negotiators early Thursday (Feb 16^th) finalized a deal to extend the payroll tax cut, emergency unemployment benefits and the Medicare reimbursement rate for doctors an additional 10 months. We are waiting now for this to be signed into law.