Podcasts about medicare physician fee schedule mpfs

Take Action Today! Advocate Against 2024 Medicare CutsOver the past couple of years we have routinely seen reductions in reimbursement underneath the Medicare Physician Fee Schedule (MPFS) and this year is no different. While AOTA is working diligently to advocate for our profession, your voice matters! Writing letters to Congress plays an important role in the legislative process of passing policy in the United States. That's why this week on The Amplify OT Podcast, I am talking about why you need to take action today and advocate against Medicare cuts!Join the Amplify OT MembershipAs an exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It's time to become your own best resource on Medicare and advocacy.In this episode, I cover:The 3.4% reduction we're looking at in 2024 under the MPFS if no action is taken. How AOTA makes it quick and simple to write a letter to your legislators and be an OT Amplifier. Encouraging you to edit your letters and share personal stories of impact.The different pieces of legislation being brought to Congress and the solutions they are proposing.❗ Tune into the next episode of the Amplify OT Podcast to get deeper into the weeds of why we continue to see cuts year after year.Amplify OT ResourcesWant to keep learning about how insurance and reimbursement impact you? Then head to AmplifyOT.com/Services to see what resources we have available!CLICK HERE to save 40% off Medbridge Today! CONNECT WITH AMPLIFY OT:WebsiteServicesFree NewsletterInstagramLinkedInFacebookTikTokHelpful LinksAOTA Presentation: Stopping the 2024 Medicare Payment Cut URGENT: Contact Congress and ask them to Prevent Medicare Cuts to OTAOTA: Legislative Action Center©Amplify OTMentioned in this episode:Join the Amplify OT MembershipAs a exclusive bonus for podcast listeners, you can join the Amplify OT Membership at any time! Join today to take control of your career! It's time to become your own best resource on Medicare and advocacy. Join the Membership Today

Revenue leakage presents a huge challenge for healthcare organizations. According to a study by the Healthcare Financial Management Association (HFMA), it can account for up to 5 percent of a healthcare organization's net revenue – potentially making the difference between an entity being profitable or not profitable.Fear not, however – there are solutions to tackle revenue leakage. One effective strategy is strong denial management. In fact, the Medical Group Management Association (MGMA) found that healthcare organizations with robust denial management strategies experienced an incredible 15 percent increase in their overall net collection rates.During the next live edition of the long-running and popular Talk Ten Tuesdays weekly Internet radio broadcast, Susie Vestevich, chief operating officer for TiaTech USA, will return to the broadcast to report on strategies intended to stop the leak.Talk Ten Tuesdays will also feature these outstanding segments and thought leaders:Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report the latest coding news.SDoH Report: Tiffany Ferguson, a subject matter expert on the social determinants of health (SDoH), will report on news that's happening at the intersection of coding and the SDoH.News Desk: Timothy Powell, CPA, will anchor the Talk Ten Tuesdays News Desk.CMS Report: Stanley Nachimson, former career professional for the Centers for Medicare & Medicaid Services (CMS), will report on two proposed rules published by CMS Thursday: the 2024 Outpatient Prospective Payment System (OPPS) and the Medicare Physician Fee Schedule (MPFS).TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc., and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment.

Aletheia Lawry, General Counsel, NextCare Holdings, Inc., speaks with Tony Kouba, Principal, ECG Management Consultants, and Kelsey Jernigan, Partner, K&L Gates LLP, about some of the recent changes to the Medicare Physician Fee Schedule (MPFS) and how provider compensation programs are responding. They discuss the split in how health systems are using the MPFS, how 2021 compensation data surveys will be impacted, and how compensation structures may change as more health systems move to value-based care. Sponsored by ECG Management Consultants.

The billing rules for shared/split evaluation and management (E&M) visits are changing, as they will again in 2023. But although the Centers for Medicare & Medicaid Services (CMS) considers 2022 a transition year, controversy surrounding the 2022 Medicare Physician Fee Schedule (MPFS) is creating contagious confusion. If you and your team are suffering from such chronic consternation, relief will be within reach when you log on next Tuesday for another live edition of the Talk Ten Tuesdays Internet broadcast. Because that's when National Alliance of Medical Auditing Specialists (NAMA) Founder Shannon DeConda will report on how best to implement the new rule.The live broadcast will also feature these other segments:Coding Report: Laurie Johnson, senior healthcare consultant with Revenue Cycle Solutions, LLC, will report on the latest coding news.Tuesday Focus: What Was Medicare Thinking? Nationally recognized professional coder and auditor Terry Fletcher will join the broadcast to report how best to implement CMS rules when dealing with patients, noting that in 2022, there are some new rules to the Medicare Manual that make little sense to the healthcare professional trying to adhere to best practices when applying the rules.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk-Ten-Tuesdays News Desk.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, will report on a subject that has caught her attention during her popular segment. 

Using artificial intelligence (AI), along with an uncanny ability to misinterpret rules, Medicare auditors – specifically, third-party auditors of Medicare Advantage (MA) plans – are ever-ready to pounce on healthcare providers. And too often, it's like shooting fish in a barrel.The recent posting of three final rules will give auditors ample opportunity to search for more inadvertent errors on Medicare claims. Last week, as reported by RACmonitor, the Centers for Medicare & Medicaid Services (CMS) posted final rules on the same day for the Medicare Physician Fee Schedule (MPFS), the Outpatient Prospective Payment System (OPPS), and the Home Health Prospective Payment System (HHPPS).More rules = more audits.It'll be the area of focus during the next edition of Monitor Mondays, which will also have the latest national audit news updates from well-respected broadcast consultants, including:Monday Rounds: Ronald Hirsch, MD, vice president of R1 RCM, will return with another installment of his popular segment.Special Report: RACmonitor investigative reporter Edward M. Roche will continue with the second installment in his three-part series that for the first time is showing how auditors can skew the universe of claims to be audited to their advantage by hiding zero-paid claims.RAC Report: Knicole Emanuel, a partner at the law firm of Practus, will file the Monitor Mondays RAC Report.SDoH Report: Ellen Fink-Samnick, a nationally recognized expert on the social determinants of health (SDoH), will have the latest news on a trending topic that is attracting significant media attention. Ellen will also conduct the Monitor Mondays Listeners Survey.Legislative Update: Former CMS official Matthew Albright, now chief legislative affairs officer for Zelis, will report on the latest healthcare regulatory news coming out of Washington, D.C.Risky Business: Healthcare attorney David Glaser, shareholder in the law offices of Fredrikson & Bryon, will join the broadcast with his trademark segment, reporting on legal implications facing healthcare providers.

Alex Kirkland joins Mark to discuss changes to the Medicare Physician Fee Schedule (MPFS) final rule. On December 27, 2020, Congress passed and the President signed into law the Consolidated Appropriations Act. The stimulus bill provided temporary relief by partially mitigating cuts to the conversion factor in 2021.   Podcast Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.  Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Follow us on Facebook: @cokerconsulting   Episode Synopsis Many payers use the Physician Fee Schedule (PFS) as the foundation for their rates and how they set their conversion factor. Although the stimulus bill only affects Medicare reimbursement for physician professional services, the impact will extend beyond Medicare. The stimulus package provides support only during 2021, so the full 10% cut to the conversion factor is still expected in 2022. Medical groups need to analyze their financial impact through a CPT level revenue and wRVU compensation analysis. The important concept is compensation increases should not outpace reimbursement, meaning you can’t afford to pay more than your revenue allows. There are also fair market value (FMV) and commercially reasonable (CR) implications and issues to consider. The new regulations state that a hospital may not value a physician’s services at a higher rate than a private equity investor or another physician practice. Click the play button to listen to the episode.   Extras Estimate the Financial Impact of 2021 E/M Coding Changes Episode 82: How the MPFS Final Rule Impacts Medical Practices (and What to Do about It) Webinar Replay: 2021 E/M Coding Changes: What Healthcare Professionals Need to Know

Aimee Greeter and Taylor Cowart join Mark to unpack how the Medicare Physician Fee Schedule (MPFS) final rule impacts medical practices (both employed and private), and offer suggestions to handle the 2021 changes to wRVUs and Medicare reimbursement for professional services.   Podcast Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, Audible, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.  Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Like us on Facebook: @cokerconsulting   Episode Synopsis COVID-19 drew everyone’s focus in 2020, and the surges around the holidays have moved the battlefront and center. In the fray, the Centers for Medicare and Medicaid Services announced big changes to evaluation and management codes that few are prepared for. Budget neutrality dictates there will be “winners” and “losers” throughout 2021. Aimee and Taylor provide an overview of how the final rule will affect certain specialties, and what hospitals and private medical practices need to do. Click the play button to listen to the episode.   Extras E/M and ME: How Will the 2021 E/M Coding Changes Impact Medical Practices? Estimate the Financial Impact of 2021 E/M Coding Changes PSA Progression: What’s Next in the Evolution of Professional Services Agreements?

The Centers for Medicare & Medicaid Services (CMS) 2021 Final Rule and 2021 Medicare Physician Fee Schedule (MPFS) are effective Jan. 1, 2021, and both affect reimbursement.But in a rare move, CMS increased the conversion factor (CF) in the MPFS twice in one week as a result of the COVID-19 relief bill, which added a hike of 3.75 percent.For an update on the major CMS changes for 2021 that will affect your reimbursement under the Part B Physician Fee Schedule, tune in to the next live edition of Talk Ten Tuesdays, coming your way Tuesday, Jan. 12 from 10-10:30 a.m. EST. That’s when nationally recognized professional coder and auditor Terry Fletcher will join the broadcast to report on all the relevant details.The live broadcast will also feature these other segments:RegWatch: Stanley Nachimson, former CMS career professional-turned-well-known healthcare IT authority, will report on the latest regulatory news coming out of Washington, D.C.SOAP Note: Shannon DeConda, founder of the National Alliance of Medical Auditing Specialists and a partner of DoctorsManagement, will provide a long-awaited update to the legendary SOAP (subjective, objective, assessment, and plan) note.News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, will anchor the Talk Ten Tuesdays News Desk.The Coding Report: Laurie Johnson, senior healthcare consultant for Revenue Cycle Solutions, LLC, will report on the latest ICD-10 codes.TalkBack: Erica Remer, MD, founder and president of Erica Remer, MD, Inc. and Talk-Ten-Tuesdays co-host, will report on another thought-provoking topic that has captured her attention.

Justin Chamblee, Alex Kirkland, and Amit Vaishampayan join Mark Reiboldt to discuss the proposed changes to the Medicare Physician Fee Schedule (MPFS). There are three noteworthy changes proposed, including evaluation and management (E/M) coding and payment changes, permanent telehealth changes implemented in response to the pandemic, and updates to the Quality Payment Program (QPP). Contact Information Subscribe to our feed in Apple Podcasts, Google Podcasts, Spotify, or your preferred podcast provider. Like what you hear? Leave a review! Not there? Let us know! We welcome all feedback from our listeners. Email us questions on any of the topics we discuss or questions about issues that interest you. You can also provide recommendations on matters for future episodes.  Please email us: feedback@cokergroup.com Connect with us on LinkedIn: Coker Group Company Page Follow us on Twitter: @cokergroup Follow us on Instagram: @cokergroup Like us on Facebook: @cokerconsulting   Episode Synopsis E/M Coding and Payment Changes Due to increasing RVU amounts, the statutory budget neutrality mandate comes into play to reduce the conversion factor by $3.83 to $32.2605 to prevent an increase in healthcare costs. The Budget Neutrality Act requires that increases or decreases in RVUs may not cause the value of expenditures for the year to change more than $20 million in the absence of changes. If this threshold is exceeded, adjustments are made to preserve budget neutrality.   Telehealth Changes The Centers for Medicare and Medicaid Services (CMS) are adding several telehealth CPT codes that are similar to existing consultations and office visits. They also added temporary codes during the pandemic that will continue to be evaluated. CMS is seeking comments to determine future usage as well as additional temporary codes.   QPP Updates We see ACO scoring and policy changes to acknowledge that providers will not immediately recover from COVID-19, and they will need support throughout their recovery. The Merit-based Incentive Payment System (MIPS) category weightings will shift to reduce the quality weight by five percent (to a total weight of 40 percent) and increase cost by five percent (to a total weight of 20 percent).   Extras Three Quick Tips to Get You Started with the New E/M Guidelines Is Telehealth Past the Tipping Point? Episode 71: The Ongoing Battle of Site Neutral Payments Episode 70: Major E/M Coding Changes Coming in 2021: Here’s What You Need to Know

There are rules to follow when you are using "time" as your element of support for any evaluation and management (E&M) encounter. If a physician elects to report the level of care based on counseling and/or coordination of care, then a number of factors must be in the patient's medical record.During this edition of Talk Ten Tuesdays, nationally recognized professional physician coder and auditor Terry Fletcher discusses the American Medical Association’s (AMA’s) rules, the position taken by Medicare, and how the electronic medical record (EMR) can actually assist you in your efforts.But should time really be the new standard for supporting your patient encounters? The broadcast also features these other segments:Coding Report: Speaking of E&M coding, 2020 proposed Medicare Physician Fee Schedule (MPFS) shows a significant shift from the 2019 version. Sally Streiber, president of Practical Coding Solutions, explores the changes, including removal of 99201, how levels of service may be selected, and what “time” may mean in the future. Tuesday Focus: Susan Gatehouse, CEO of Axea Solutions, returns to the broadcast to continues her reporting on the need to focus technology advancements on real transformation rather than transactional efficiency.News Desk: Timothy Powell, compliance expert, and ICD10monitor national correspondent anchors the Talk Ten Tuesdays News Desk.TalkBack: Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc. and Talk Ten Tuesdays co-host, discusses the recent decision by a Texas federal judge to dismiss a False Claims Act lawsuit alleging that Dallas-based Baylor Scott & White Health overbilled Medicare by improperly upcoding claims.

Are you experiencing this dilemma at your facility? You ask your physicians to add linking verbiage to their documentation for accuracy, which in turn has a negative impact on their publicly reported scores regarding complications and other metrics. Should physicians exclude the linking verbiage? Should they enter “as expected,” or should they simply avoid addressing these issues? Reporting on this complex issue during the next edition of Talk Ten Tuesdays will be Sharon Savinsky, clinical documentation improvement specialist (CDIS) team manager at Winchester Medical Center in Winchester, Va.Other segments to be featured on the broadcast include:News Desk: Laurie Johnson will anchor the Talk Ten-Tuesdays News Desk. Johnson is a senior healthcare consultant with Revenue Cycle Solutions, LLC and an ICD10monitor contributor. Coding Report: Although the Centers for Medicare & Medicaid Services (CMS) has released the final rule on the 2019 Medicare Physician Fee Schedule (MPFS), Dr. Jeffrey Lehrman will report on one issue that CMS did not include in its extensive update.Tuesday Focus: Alarms are being sounded because of the clinical and privacy issues being raised as a result of offshore coding. Terry Fletcher, a nationally recognized professional physician coding consultant, educator and auditor, will report this developing story.TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on the recent decision by U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) to conduct DRG validation audits.

When it comes to defining sepsis, who wins? Is it providers, who rely on the current definition of sepsis as “life-threatening organ dysfunction caused by a dysregulated host response to infection?” Or do payers prevail – the ones who control the reimbursement? And under what circumstances would you ever side with a carrier that has denied a claim of sepsis?Reporting our lead story during this edition of Talk Ten Tuesdays will be Roland Dale, responsible for denials prevention, for Hardin Medical Center, who shares his experience in these situations while offering important and timely advice.Other segments to be featured on the broadcast include:News Desk: Timothy Powell, compliance expert and ICD10monitor national correspondent, anchors the Talk Ten Tuesdays News Desk.Dateline Washington: Talk Ten Tuesdays legislative analyst Rhonda Taller has the latest news coming out of Washington, D.C. Rhonda is a member of the HIMSS professional development committee.Tuesday Focus: The Centers for Medicaid & Medicare Services (CMS) last week released the final rule on the 2019 Medicare Physician Fee Schedule (MPFS) and the Quality Payment Program (QPP). Reporting this developing story is Dheeraj Mahajan, MD, president and CEO of Chicago Internal Medicine Practice and Research (CIMPAR, SC), who leads its affiliated group of companies.TalkBack: Talk Ten Tuesdays co-host Erica Remer, MD, FACEP, CCDS, founder and president of Erica Remer, MD, Inc., will report on the Global Leadership Initiative on Malnutrition (GLIM) during her popular TalkBack segment.

Long awaited and hotly debated, the 2019 Medicare Physician Fee Schedule (MPFS) and Outpatient Prospective Payment System (OPPS) final rules have been on the minds of healthcare shareholders since late July, when the Centers for Medicare & Medicaid Services (CMS) released proposed rules for both. Tucked into the MPFS were the controversial revisions to the regulations governing evaluation and management (E&M) services.For an in-depth analysis of both the MPFS and the OPPS newly released final rules, Monitor Monday has brought together a pair of industry experts for this edition of the broadcast: Duane Abbey, president of Abbey and Abbey Consultants, and Sean M. Weiss, partner and vice president of compliance for DoctorsManagement.The broadcast rundown also will include:OIG Report: In a recent study, the U.S. Department of Health and Human Services (HHS) Office of Inspector General (OIG) reported that Medicare Advantage Organizations (MAOs) overturned 75 percent of their own prior authorization and claim denials from 2014 to 2016. Healthcare attorney Knicole Emanuel, a partner in the Potomac Law Group, provides details on this latest developments.Risky Business: Healthcare attorney David Glaser with Fredrikson & Byron will report on another example of a potentially troublesome issue that could pose a risk to your facility.TPE: Targeted probe-and-educate (TPE) audits are taking place in a variety of settings, from physical therapy providers to skilled nursing facilities (SNFs), including acute-care facilities. Reporting on TPE audits is Cindy Griffith, director of compliance and audits for ATI Physical Therapy.Monday Rounds: Ronald Hirsch, MD, vice president of R1 Physician Advisory Services, makes his Monday Rounds with another installment of his popular segment.

In the latest ASCO in Action Podcast, ASCO CEO Dr. Clifford A. Hudis discusses the recently released Medicare Physician Fee Schedule (MPFS) proposed rule. The MPFS is a complete listing of all fees Medicare uses to reimburse doctors and other providers and suppliers under a fee-for-service payment system.

This episode explains the proposed changes to the site-neutral payment rule for off-campus hospital outpatient departments for CY 2018, as discussed in both the recent Hospital Outpatient Prospective Payment System (OPPS) and Medicare Physician Fee Schedule (MPFS) proposed rules. While the CY 2018 OPPS proposed rule provides surprisingly little new guidance on the rule’s implementation, the CY 2018 MPFS rule proposes to substantially lower the payment rate for non-excepted services from 50% to only 25% of the OPPS rate in CY 2018. Presenter: Darlene S. Davis Download Presentation Materials