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    Welcome to the ClaimCare Medical Billing Blog. We strive to provide content that improves the overall quality of medical billing efforts across the US. If you have any specific topics that you would like to see addressed in this medical billing blog please post the topic in the Medical Billing Questions & Answers Forum. If you have an article that you would like considered for publication in the medical billing blog then please email your article to resources@claimcare.net.

    MEDICAL BILLING BLOG

    April 3, 2020 Update to Medicare Telemedicine Notification

    Posted by Carl Mays, ClaimCare President/CEO on Fri, Apr 03, 2020 @ 06:29 PM

    April 3, 2020 Update to Medicare Telemedicine Notification

    telehealthmedicareAt 2:45 this afternoon, CMS notified all providers via Special Edition Message that CMS has made yet another change in the coding requirements for Telemedicine/Telehealth services. Pointed out below are the most critical changes, which pertain to place of service and modifier utilization. Here is the original April 1 Telemedicine Blog Post  that contains the earlier CMS information to which we are now referring. Comparing the April 1 blog to this updated blog will make things less confusing to you. 

    04-03-20 Revised Special Edition Telemedicine Message from CMS

    Building on prior action to expand reimbursement for telehealth services to Medicare beneficiaries, CMS will now allow for more than 80 additional services to be furnished via telehealth. We will notify you when those services are clearly identified.

    For professional claims for all telehealth services with dates of services on or after March 1, 2020, and for the duration of the Public Health Emergency (PHE), telehealth claims need to be billed with:

    checklist

    • Place of Service (POS) equal to what it would have been had the service been furnished in-person. This means you no longer use the 02 Place of Service.
    • Modifier 95, indicating that the service rendered was actually performed via telehealth.
    • As a reminder, CMS is not requiring the CR modifier on telehealth services.

    For telemedicine claims already billed with the “02 Place of Service,” medical billers actively monitoring these claims should show them as having been received and in process.  So, it appears this updated change will only impact claims from today forward. Your medical biller should notify you if they find any problems with older or new telemedicine claims. 

    ClaimCare remains on top of all things that impact practices and will continue to monitor these updates.  You may have numerous resources sending information to you. Make sure your medical biller vets every piece of information that is sent to you to ensure its validity.  

    We certainly hope you and your staff are staying safe and healthy during this crisis. We encourage you to share with everyone, staff and patients alike, that they can keep updated on the news and recommendations on the government’s Coronavirus.com website.

     

    About ClaimCare

    ClaimCare is a 100% USA-based HIPAA-Compliant Medical Billing Company

    ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

    For additional information, contact sales@claimcare.net, or phone toll-free (855) 376-7631, or visit the ClaimCare Medical Billing website. We can assist your practice and/or facility in numerous ways.

    Tags: medical billing coding, COVID-19 Medical Reimbursement, Medicare Billing, Telehealth, CMS Update, Practice Cash Flow

    Accelerated Payment and Advance for Providers

    Posted by Carl Mays, ClaimCare President/CEO on Tue, Mar 31, 2020 @ 08:03 PM

    Accelerated Payment and Advance for Providers:

    How to get it and what it means for your practiceiStock_CashFlow2

    CMS has notified providers about the Accelerated Payment and Advance program available to Part B providers. This is a portion of the legislative CARES Act (P.L. 116-136).  Each Medicare Administrative Contractor (MAC) is required under this regulation to consider advancing payments at the request of a provider.  As we will explain below, this is NOT a cash influx without consequences. It is NOT free money. This advance can represent 100% of the amount typically paid to a provider in a 3-month period.   However, if you want to, you can request less than the                                                                   CMS calculated amount.

     

    ClaimCare advises you to be cautious when requesting this advance.  We completely understand that numerous providers and practices have been hurt by this horrific COVID-19 Pandemic.  However, we encourage you to look at what this would mean for your practice on down the road.  increase-cash-flow-medical-practiceThe amount of money received is not the issue. The issue is that you must carefully consider how the advance will be recouped and reconciled beginning 120 days after you have received it. It is still in flux exactly over what timeframe MAC will reclaim the advance through recoupments. MAC may take a little from every payment over a large number of months, or they may take a lot back from every payment over a shorter timeframe. It appears NOVITAS will be recouping a small amount over many months. However, no matter the timeframe in which the money is recouped, ultimately your future payments will be reduced until the full amount of the advance is paid.

    After you receive an advance through this program, you will continue to be paid as usual for your claims submitted in the normal course of business for the next 120 days.  However, after 120 days following the advance, ANY Medicare claims submitted for payment will be processed against the advance.  This means that after 120 days you will NOT receive full payment for claims submitted to Medicare until your advance is paid in full.

     ClaimCare is not suggesting that you do not pursue the advance. We are only saying that if you do accept it, do so with a full appreciation for the impact it will have on your monthly collections in four months.

    All providers are struggling with trying to provide continuity of care by using telemedicine and videoconferencing. We understand that if your schedules are not full, it is difficult to pay the bills and keep the doors open. If you need these funds, please be sure and submit the appropriate form as quickly as possible to your regional MAC. The forms have either been sent to your primary Medicare contact – OR – you can find them on the MAC website for your region. You should receive the accelerated payment advance in 7 days after your appropriately submitted form is received. This accelerated payment opportunity is only available if the nation us under a National Emergency.  Once this designation is over, the advance will not be available to providers.

     

    To qualify, you must meet the following requirements:  

    • Have billed Medicare for claims within 180 days of the signature on the form
    • Not be in bankruptcy
    • Not under medical review or investigation
    • Cannot have any outstanding Medicare overpayments

    After 120 days from the date you receive the payment, you will have 210 days to repay the advance, which will be offset against claims submitted.  If you do not submit a sufficient volume of claims in that 210-day period to replay the advance, then you will be expected to make a payment directly to Medicare for the difference.

    We certainly hope you and your staff are staying safe and healthy during this crisis. We encourage you to share with everyone, staff and patients, that they can keep updated on the news and recommendations on the government’s Coronavirus.com website.

     

    About ClaimCare

    ClaimCare Medical Billing Company is a 100% USA-based HIPAA-Compliant Medical Billing Company

    ClaimCare has once again been named a “Top 10 Medical Billing and Coding Company.” The honor this time comes from MD Tech Review. The magazine’s Augmenting Medical Billing and Coding Operations article presents solid reasons why ClaimCare has been chosen for this 2019-2020 recognition.

    For additional information, contact sales@claimcare.net, or phone toll-free (855) 376-7631, or visit the ClaimCare Medical Billing website. We can assist your practice and/or facility in numerous ways.

    Tags: medical billing education, medical billing resources, COVID-19 Medical Reimbursement, Medicare Billing

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