MANAGING YOUR MEDICAL PRACTICE
SO YOU CAN FOCUS
ON PATIENT CARE
SERVING HEALTHCARE PROVIDERS SINCE 1984
Since its establishment in 1984, Bill of Health Services, Inc. has been helping healthcare providers face the challenges of accurate billing, coding and reimbursement. The company has grown to a highly-respected firm known nationally and has transformed itself over the years to provide an expansive scope of services that meet the ongoing and evolving needs of healthcare clients, tailoring our services to every client.
Medicine is a business and we serve as our clients’ business partner.
We are pro-active and responsive with our clients, going above and beyond to assist them. Having worked with scores of practices in most specialties over the past 34 years, we offer our guidance and expertise on both "front office" and "back office" operations. Due to this level of detail and attention along all fronts, much of our growth has been through referrals from satisfied clients.
Our revenue cycle management services ensure accurate claim submission and payment posting, negotiation with payers, analyses of trends, and much more.
CURRENT NEWS
Evaluation and Management Documentation Changes for 2021
- Changes only apply to office and outpatient visits
- E/M code will be based on Medical Decision Making (MDM) or Time
- E/M code 99201 will be eliminated
- Continue to document medically appropriate History and Examination
- Number of diagnoses or management options
- Amount and/or complexity of data to be reviewed
- tests, documents, orders, or independent historian(s) [e.g., parent]; each unique test, order, or document is counted to meet a threshold number
- Independent interpretation of tests not reported separatelyDiscussion of management or test interpretation with external physician/other QualifiedHealth Professional (QHP)/appropriate source (not reported separately)
- Risk of complications and/or morbidity or mortality of patient management decisions made at the visit, associated with the patient’s problem(s), treatment(s)Includes possible management options selected and those considered, but not selectedAddresses risks associated with social determinants of health
MDM Elements
- Includes face-to-face and non-face to face time with patient
- Document total time in medical record.
- Preparing to see the patient (e.g., review of tests)
- Obtaining and/or reviewing separately obtained history
- Performing a medically necessary appropriate examination and/or evaluation
- Counseling and educating the patient/family/caregiver
- Ordering medications, tests, or procedures
- Referring and communicating with other healthcare professionals (when not reported separately)
- Documenting clinical information in the electronic or other health record
- Independently interpreting results (not reported separately) and communicating results to the patient/family/caregiver
- Care coordination (not reported separately)
Time
| E/M Code | Total Time (2021) | E/M Code | Total Time (2021) |
|---|---|---|---|
| 99201 | Code Deleted | 99211 | No Time Component |
| 99202 | 15-29 minutes | 99212 | 10-19 minutes |
| 99203 | 30-44 minutes | 99213 | 20-29 minutes |
| 99204 | 45-59 minutes | 99214 | 30-39 minutes |
| 99205 | 60-74 minutes | 99215 | 40-54 minutes |
PREVIOUS NEWS
Thank you to all our healthcare professionals and first responders who are risking their lives to care for others.
Effective on April 26, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it is reevaluating the amounts that will be paid under its Accelerated Payment Program and it suspended this program to Part B suppliers effective immediately. The agency announced this following payment of over $100 billion to healthcare providers and suppliers and in consideration of the $175 billion recently appropriated for healthcare provider relief payments. CMS will not accept any new applications for the Advance Payment Program, and they will reevaluate all pending applications. However, providers can still apply for funds through the CARES Act Provider Relief Fund (see below).
CARES Act Provider Relief Fund
As part of the CARES Act, the Department of Health and Human Services (HHS) has approved $30 billion for healthcare providers. This is a grant and does not have to be paid back.
Payment will be based on the Taxpayer Identification Number (TIN) 2019 fee for service Medicare payments.
The formula used to determine the dollar amount is the following: Divide the 2019 Medicare fee for service received (exclude Medicare Advantage payments) by $484,000,000,000 (total payments made in 2019) and multiple that amount by $30,000,000,000.
If Medicare payments are electronic, providers will receive a direct deposit from Optum Bank with “HHSPAYMENT” as the payment description.
If paper checks are typically received, look out for a paper check.
Providers must sign an attestation confirming receipt of the funds and agreeing to Terms and Conditions. Not returning the payment within 30 days of receipt will be viewed as Acceptance of the Terms and Conditions.
If you have not yet received this grant, contact your Medicare MAC.
The CMS Accelerated and Advance Payment Program
This program is a loan and must be paid back. It is intended to provide necessary funds when there is a disruption in claims submission and/or claims processing.
To qualify, the provider/supplier:
- Must have billed Medicare for claims within 180 days prior to the signature date on the request form
- Not be in bankruptcy
- Not be under active medical review or program integrity investigation
- Not have any outstanding delinquent Medicare overpayments
The applicant will be asked to request a specific amount using an Accelerated or Advance Payment Request form (on each MAC’s website)
Most providers and suppliers can request up to 100% of the Medicare payment for a three-month payment.
Payments should be issued within seven days of receiving the request.
Repayment for providers and suppliers will begin 120 days after issuance of the payment.
Repayment will be made by offsets from new claims.
SBA Loans
Contact your bank to apply for a CARES SBA loan/grant as quickly as possible.
An additional $484 billion for small businesses, hospitals, and testing will be available.
A practice or facility is a business and would qualify.
Medicare Card
Medicare Beneficiary Identifier (MBI)
Your Medicare patients will soon be receiving new cards called Medicare Beneficiary Identifier (MBI) cards. They are being mailed in different phases by geographic location.
The existing card uses social security numbers and it is known as the Health Insurance Claim Number (HICN). However, the MBI cards are only comprised of eleven numbers and uppercase letters. Each MBI is unique and randomly generated. There is no special meaning to the sequence.
The effective date of each card is the eligibility date for each beneficiary.
There will be a transition period through December 31, 2019 to use the existing or new cards. Effective 1, 2020, only the MBI numbers can be used, regardless of date of service.
- The MBI’s 2nd, 5th, 8th, and 9th characters will always be a letter.
- Characters 1, 4, 7, 10, and 11 will always be a number.
- The 3rd and 6th characters will be a letter or a number.
- The dashes aren’t used as part of the MBI in computer systems or file formats.’
Beginning in October 2018 and throughout the transition period, the patient MBI will be on every Electronic Remittance Advice (ERA), in the same field as the current HICN.
For additional information, please indicate your question on our contact page.