Jul 1st, 2013
Know how insurers account for physician payment. By Julia Croly, MPA, CPC, CPC-P, CPC-I, A fee schedule is the maximum fee determined as acceptable by the payer for a procedure or service, and which the provider agrees to accept as payment in full. It may also be called a fee allowance, fee maximum, or capped ...
Dec 1st, 2012
By Marcia Brauchler, MPH, CPC, CPC-H, CPC-I, CPHQ The new year is nearly here. Time to get a fresh start on your payer contracts. Gather your year-end data and prepare yourself to approach payers for new agreements or rate updates. Start with a High-level Perspective After you’ve gathered the contracts and information from payer websites ...
Sep 1st, 2012
By Barbara Fontaine, CPC I’ve worked with physicians for almost 30 years. Looking back, I remember thinking each time we added a new provider, “I wish I could have taught you what you need to know about coding while you were learning to be a doctor.” If medical students took a coding class while they ...
In Billing
Mar 29th, 2012
The Medicare Payment Advisory Commission’s (MedPAC’s) report to Congress regarding Medicare’s fee-for-service payment system is clear: Replace the sustainable growth rate (SGR) with specified updates not including an expenditure-control formula. MedPAC: Toss SGR and Replace with Freeze was last modified: March 29th, 2012 by admin aapc...
Sep 1st, 2011
Choose codes wisely because the wrong code may equal lost revenue or an audit. By Sarah W. Sebikari, MHA, CPC Incision and drainage (I&D) is a minor surgical procedure that usually can be performed in the office setting by a physician, nurse practitioner (NP), or physician assistant (PA). I&D is a common procedure for an ...