Technical Resources for Medical and Radiation Oncology Practices

How to Report Once for 2014 Medicare Quality Reporting Programs

This CMS document serves as a guide for individual eligible professionals, group practices, Medicare Shared Savings Program (Shared Savings Program) Accountable Care Organizations (ACOs) and Pioneer ACOs wanting to report quality measures once during the 2014 program year in order to become incentive eligible for the 2014 Physician Quality Reporting System (PQRS), avoid the 2016 PQRS payment adjustment and satisfy the clinical quality measure (CQM) component of the Electronic Health Record (EHR) Incentive Program. In addition, this document will provide necessary information regarding the 2016 Value-Based Payment Modifier (VM) adjustment for group practices.

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Compliance—Cost or Investment?

In navigating requirements set by payors, practices and facilities find they’re able to reach their highest standard of documentation and billing compliance only by applying focused effort and dedicated resources. Though the importance of efficient, accurate processes seems obvious, it’s often overlooked or minimized in light of the resources it takes to implement them—money, staff and the ability to manage often unpopular policies—and achieve what should be the highest standard of care in today’s healthcare environment.

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When It Comes To Reimbursement, Do You Get What You Deserve?

As more and more physicians transition to employment relationships with hospitals, they may ask, "Am I getting paid what I deserve?" With proper due diligence prior to joining the hospital, physicians can determine the answer to this potential question.

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Why Take Unnecessary Risks?

Would you risk your livelihood by taking shortcuts? In healthcare, taking unnecessary risks can put your practice—and potentially your patients' safety—in jeopardy.

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IMRT References

This IMRT Reference List is a compilation of journal articles that could be utilized to support medical necessity for delivering IMRT treatments to anatomical sites whose diagnosis code is not covered under your LCD.

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Incorrect Numbers of Units Billed for Rituximab and Bevacizumab

After a review of claims by Recovery Auditors, it was found that physicians and non-physician practitioners were incorrectly billing the number of units for Rituximab and Bevacizumab. In this article from the Medicare Learning Network(R), specific guidelines are given to accurately bill for these drugs.

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ICD-10 Basics

With the impending implementation of ICD-10, this CMS article contains the latest information and resources available for healthcare providers.

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CMS Clarification of Physician Supervision

In this current update, CMS is further clarifying the CY 2010 physician supervision policies in response to additional questions and comments received since publication of the final rules.

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Planning For Your New Cancer Center

Cancer center design, whether hospital- or practice-based, requires the expertise and leadership of professionals who are highly experienced in not just the delivery of patient-focused clinical care but critical aspects of design and construction. Ultimately, space planning affects the quality of life of cancer patients and empowers everyone involved in helping healing thrive.

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Physician Quality Reporting System (PQRS) Overview

This overview provides helpful information to eligible health care professionals on how to participate in PQRS and criteria that must be met to qualify for incentive payments.

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Physician Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive Program

This CMS presentation provides an overview about the 2014 eRx and 2015 PQRS payment adjustments and includes detailed information on how physicians and practitioners can avoid these adjustments.

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Incident to a Physician's Professional Service

As a physician it is important to know and understand what qualifies as an "incident to" service. This article is designed to delve into the requirements needed to qualify as an "incident to" service and remain compliant with CMS standards.

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MLN Matters on Use of a Signature Stamp

As a provider, it is your responsibility to know when it is acceptable to use a rubber stamp instead of a handwritten or electronic signature. This article will detail the circumstances for acceptable use of a rubber stamp in lieu of a handwritten or electronic signature.

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Complying with Medicare Signature Requirements

As a provider you may have many questions about signature documentation. What are the guidelines for using an electronic signature? What is required for a valid signature? What if I didn't sign an order or the medical record? This document, produced by the Medicare Learning Network, defines the specific requirements regarding a physician signature.

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MLN Matters on Revised and Clarified Place of Service (POS)

With the reported findings by the Office of the Inspector General that physicians and other suppliers frequently incorrectly report the POS in which they furnish services, this article clarifies the national policy for the correct assignment of POS codes.

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Guidelines for Teaching Physicians, Interns, and Residents

This publication, as presented by the Medicare Learning Network, outlines payment and documentation guidelines for physician services in teaching settings. It also includes guidelines on evaluation and management (E/M) documentation for teaching physicians and residents.

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CMS Drugs and Biologicals

This manual contains specific coding guidelines for drugs and biologicals used in both hospital and outpatient treatment facilities.

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Medicare Claims Processing Manual for Physicians and Non-physician Practitioners

This document contains the Medicare claims processing coding guidelines specific to physicians and non-physician practitioners.

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Medicare Billing Information for Rural Providers and Suppliers

As a rural healthcare provider and supplier, there are some unique circumstances for billing specific services. This reference provides comprehensive rural billing information for each specific provider type including ambulance services, office visits, hospital services, radiology and diagnostics, clinical laboratory tests, supplies and drugs, and preventive services.

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Critical Access Hospital

With the establishment of the State Medicare Rural Hospital Flexibility Program, certain facilities participating in Medicare are eligible to become Critical Access Hospitals (CAH). This document contains the requirements for CAH designation, CAH payment information and grants to states under the Medicare Rural Hospital Flexibility Program.

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