CMS will hold a National Provider Call on October 27, 3011, to discuss the
revalidation of Medicare provider enrollment information. Most providers
and suppliers who are enrolled in the Medicare program will have to
revalidate their enrollment which will be reviewed under the new risk
screening criteria required by the Affordable Care Act Section 6401(a).
Learn what you can expect and how to prepare for this process.
http://www.palmettogba.com/palmetto/providers.nsf/ls/J1B~8M6EYP6178?opendocument&utm_source=J1BL&utm_campaign=J1BLs&utm_medium=email

Applies to:
Jurisdiction 11 Home Health and Hospice//General
Jurisdiction 11 Part A//General
Jurisdiction 11 Part B//General
Jurisdiction 1//J1 Part A: General
Jurisdiction 1//J1 Part B: General

Effective immediately, providers are no longer required to provide information which verifies the legalized status of enrollment applicants including those individuals referenced in any ownership related information. This is part of an ongoing Centers for Medicare and Medicaid Services (CMS) review of current enrollment requirements to eliminate unnecessary burden on providers as well as delays in the enrollment process. The instructions in Program Integrity Manual Chapter 10, Section 5.7.2 will be updated in the near future.

Payments under the Primary Care Incentive Payment Program (PCIP) are often electronic, followed-up with a paper report called the Special Incentive Remittance. The remittance is detailed, identifying all of the PCIP-eligible services for the previous quarter from which the Centers for Medicare and Medicaid Services (CMS) calculated the PCIP bonus payment. In 2012, the remittance will be modified to include a summary statement, sorted by practitioner and incentive. Stay tuned for an upcoming Change Request (CR) for more information.

All providers and suppliers who enrolled in the Medicare program prior to Friday, March 25, 2011, will be required to submit their enrollment information so they can be revalidated under new risk screening criteria required by the Affordable Care Act (section 6401a). Providers/suppliers who enrolled on or after Friday, March 25, 2011 have already been subject to this screening, and need not revalidate at this time.

Do NOT submit your revalidation until you are notified to do so by your MAC. You will receive a notice to revalidate between now and March 2013.

This will allow MACs to process revalidations in a timely fashion and allow providers to take advantage of innovative technologies and streamlined enrollment processes now under development. Updates will be shared with the provider community as these efforts progress.

For more information about provider revalidation, review the Medicare Learning Network’s Special Edition Article #SE1126, titled “Further Details on the Revalidation of Provider Enrollment Information.”

The Centers for Medicare and Medicaid Services (CMS) is pleased to announce that incentive payments for the 2010 Medicare Electronic Prescribing (eRx) Incentive Program has begun for eligible professionals who met the criteria for successful reporting. Distribution of 2010 payments Medicare Electronic Prescribing (eRx) Incentive is scheduled to be completed by August 31, 2011.

Effective January 2010, CMS revised the manner in which incentive payment information is communicated to eligible professionals receiving electronic remittance advices. CMS has instructed Medicare contractors to use a new indicator of LE to indicate incentive payments instead of LS. LE will appear on the electronic remit. In an effort to further clarify the type of incentive payment issued (either PQRI or eRx incentive), CMS created a 4-digit code to indicate the type of incentive and reporting year. For the 2010 eRx incentive payments, the 4-digit code is RX10. This code will be displayed on the electronic remittance advice along with the LE indicator. For example, eligible professionals will see LE to indicate an incentive payment, along with RX10 to identify that payment as the 2010 eRx incentive payment. Additionally, the paper remittance advice will read, “This is an eRx incentive payment.” The year will not be included in the paper remittance.

Yes, EMR is beneficial in so many ways.  But it does not guarantee your claims will get paid.  The need for experienced, qualified professionals remains critical.  That’s where MBC comes in.  We are just what the Doctor ordered… a professional, skilled Claims Management team ensuring your claims are first coded properly, then followed by the most important part:  follow-up and follow-through!  

In today’s economy, insurance companies try harder than ever to make sure your claims are not paid.  It takes the right team with the right knowledge and experience to ensure your claims are paid.  No matter the EMR system you choose, MBC has the capabilities to access that system and manage your claims from point of procedure coding all the way to proper payment.   All this and a substantial savings to your bottom line when you outsource… NO employee overhead; NO staff turnover issues to deal with; NO software-tech support charges, etc.  A WIN-WIN.

Under the Affordable Care Act, Medicare beneficiaries may now receive coverage for an Annual Wellness Visit (AWV), which is a yearly office visit that focuses on preventive health.

In addition to the new AWV, Medicare also provides coverage for the Initial Preventive Physical Examination (IPPE), commonly known as the “Welcome to Medicare” Visit (WMV).

The Appeals Board held that, where unauthorized medical treatment is obtained outside a validly established and properly noticed Medical Provider Network (MPN), reports from the non-MPN doctors are inadmissible, they may not be relied upon, and defendant is not liable for their cost.

“We are the first, free EHR vendor that has earned complete certification. This means that physicians who want to earn the meaningful use (MU) incentive payments do not have to pay for their ambulatory EHR system. It makes the MU guarantees of competitive systems that only have modular certification superfluous,” said Chris Riley, chief executive officer of Mitochon Systems.  The certification will allow physician users of Mitochon’s mEMR to meet MU criteria and to qualify for ARRA funding for EHR use, which ranges from $44,000 to $65,000 per physician over five years. Mitochon’s free solution allows physicians to keep their incentive payments and avoid the costs of a traditional system.  Mitochon’s mEMR system is used by hundreds of physicians nationwide. Mitochon provides physicians with a complete, physician-designed, free EHR delivered via the Web. Mitochon’s mEMR includes the unique mConnect (clinical HIE) technology, enabling physicians to immediately share clinical data with their referral network through the system’s Virtual Medical Community (VMC™).

Payments for the Medicare and Medicaid EHR Incentive Programs are distributed based on each year of participation, and follow a specific payment schedule. Medicare Administration Contractors (MACs), carriers, and Fiscal Intermediaries (FIs) will not be making Medicare EHR incentive payments. The Centers for Medicare and Medicaid Services (CMS) has contracted with a Payment File Development Contractor to make these payments.