Business of Medicine

Somerset Health Care Team: We Understand the Business of Medicine

Health Care Commentaries - April 2012
April 26, 2012

Our Health Care Team’s monthly e-newsletter for April has been published.  Articles include:

Andrea Fugett Joins the Somerset Health Care Team
April 19, 2012

Andrea has joined us as a health care consultant.  Her primary focus is supporting the operations work for the Health Care Team as well as other health care consulting efforts, most specifically on physician practice operational improvement.  Andrea has a diverse management background in hospital managed physician practices with both the St. Francis and Community Health Systems. Throughout her career, Andrea developed an expertise in revitalizing struggling physician offices by reducing expenses, growing profitability, increasing productivity, improving quality measures and streamlining operations.  She is a credentialed EPIC software (EHR) trainer and has assisted in multiple hospital and practice implementations.  Andrea has served as an EPIC Super User for over three years in multiple clinic and practice management applications.  She graduated from Indiana University-Purdue University in 2007 with a B.S. in public health administration.  In addition, Andrea is a member of the Indiana Medical Group Management Association.

>Connect with Andrea on LinkedIn.

Disability Insurance Is a Must for Physicians
April 6, 2012

Physicians, more than almost any other occupational group, fully understand how a simple slip or fall can cause serious injury. They know, too, that even otherwise seemingly healthy people may be stricken by illness and disease. Physicians should also recognize that they are no more immune to accidents or illness than the general population.

The reality is that an accident or illness could prevent you from practicing and making a living. Are you confident that you could pay all your bills if you become disabled and are unable to work? And for how long? The only real protection against such a catastrophic possibility is carrying some combination of short- and long-term disability insurance. Disability insurance can make up for part — or, perhaps, most — of the loss of your income. A private long-term disability policy will generally cover 60% of your salary.

Read more…

Medtrade Spring Conference
March 30, 2012

Steve Diagostino and Craig Hittle are attending the Spring Medtrade conference for DME/HME providers in Las Vegas from April 10 to 12, 2012.

If you are attending, we look forward to seeing you there.  More information…

Health Care Commentaries - March 2012
March 28, 2012

Our Health Care Team’s monthly e-newsletter for March has been published.  Articles include:

Read more…

Somerset Health Care Commentaries - February 2012
February 22, 2012

This month’s issue of our Health Care Team’s newsletter includes articles on the following topics:

  • Indiana Medicare’s Transition to New Accounting System Will Affect Payments and Cash Flow
  • Handling a HIPAA Audit
  • Congress Approves Measure Averting 27% Physician Cut Through 2012
  • Smarter Accounts Receivable Management
  • Executing On Your Strategic Plan Webinar Recording
  • House Ways & Means Summary of Medicare Fix
  • The Work Opportunity Tax Credit: An Employer-Friendly Benefit for Hiring Veterans Most in Need of Employment
  • Tax Day Ahead
  • Somerset Health Care Team News

Read more…

House Ways & Means Summary of Medicare Fix
February 20, 2012

Congress is paying for some of the costs of maintaining the Medicare Physician Fee Schedule by cutting payments to “Providers” - that is, hospital reimbursement – specifically funding for bad debt and “disproportionate share” hospitals.  This summary from the House Ways & Means Committee provides details.

Congress Approves Measure Averting 27% Physician Cut Through 2012

A House-Senate Conference Committee tasked with identifying a compromise to avoid the pending 27.4 percent Medicare physician payment cut reached a 10-month deal that would maintain current physician payment rates through the end of the year. The measure was approved on Friday afternoon, Feb. 17, 2012, by both the House and Senate. The measure now goes to President Obama for his signature, and it is expected that he will sign.

URGENT – Indiana Medicare Transition to New Accounting System Will Affect Payments
February 7, 2012

URGENT – All Indiana Part B Providers and Suppliers Need To Be Financially Prepared to Withstand 2 TO 4 WEEKS WITHOUT MEDICARE PAYMENTS Due To Indiana Medicare’s Transition to a New Financial Accounting System

The summary below has been provided by Joy Newby, LPN, CPC, PCS of
Newby Consulting, Inc.

Temporary Waiver of the Claims Processing Payment Floor
CMS has approved National Government Services’ waiver request to reduce the payment floor for both paper and electronic data interchange (EDI) claims. Beginning on March 6, 2012 payment cycle, payments will be released gradually for claims that have already been approved for payment. [Emphasis added]

  • March 6, 2012: Payment floor reduced to 7 days for EDI claims and 14 days for paper claims.
  • March 7, 2012: Payment floor reduced to 0 days for EDI claims and 0 days for paper claims.

This temporary reduction of the payment floor will result in payments being issued early for both checks and Electronic Funds Transfers (EFTs). This may give the appearance that your cash revenues have increased when in fact you received payments for some of your claims earlier than normal. Providers are encouraged to monitor their payments and make adjustments, as necessary to prevent cash flow problems during the transition period. [Emphasis added]

Depending on whether you are on EFT or are still receiving paper checks, please realize that while your cash flow will increase around March 8 and 9, due to the release of all claims for payment, you are going to experience a lean period because you will not be able to submit new claims beginning March 8th through March 11th (and March 12 may be a “dark day” as well depending on how easy the transition goes).

Further, when Indiana Medicare begins accepting new claims on March 12 (or March 13), the payment floors will once again be in full force.

  • Electronic claim submitters will experience a significant reduction in payments from March 13 through March 21 because regular payments on electronically submitted claims will not be made during these dates!!
  • Paper claim submitters will experience a significant reduction in payments from March 13 through April 5 because regular payments on paper claims will not be made during these dates!!

Please see attached letter for more details.

Executing On Your Strategic Plan Webinar Recording
February 3, 2012

If you missed our Health Care Team’s webinar earlier this week, you can get the recording now.  It’s a discussion with Mike McCaslin and Jeff Boomershine that is moderated by Kara Wieckowski. Go to recording…