Both Medicare and private payers are known to deny coverage for glaucoma screening tests. Knowing which patients qualify for tests based on medical necessity is important. Also, knowing the rules will prevent abuse, while allowing you to confidently report the services you provide.
Asking a financial advisor to assist with business matters for many physicians and other professionals may seem unacceptable. However, financial professionals focus exclusively on a relatively narrow segment of business operations. Their specialized training and experience may open doors to opportunities that haven't been considered.
To help reduce projected expenditures, Medicare is turning to physician profiling. Economic profiling gives a certain level of cache to a commercial healthcare plan. It works by profiling every provider in the system for at least 3 years. The goal is to find providers that cost the system less. However it is differentiating on cost of efficiency not on quality.
The key to hiring good people is setting high standards for whom you hire and sticking to them. Place to find potential hires, job descriptions, and some key warning sign to a bad hire are included.
One's own practice has a lot in common with the standards of a 5 star service. A patient should leave feeling better than when they came in and that it was an overall good experience from the front desk, to the tech, to the doctor. It is a lot to ask to be just like the Four Seasons but little things like displaying flowers or greeting guests warmly can do the trick.
Congress was able to block a pay cut for physicians who serve Medicare patients. Even though the American Society of Cataract and Refractive Surgery (ASCRS) and the American Academy of Ophthalmology (AAO) are pleased for the delay in the pay cut they maintain that the hard work is just beginning.
When you plan to appeal an audit, it's important to know that there's a new process in place. Here are the details.
The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.
The aging baby-boom population will make eye care a growth industry, resulting in ophthalmology practices adding new physicians. Examine whether the practice really needs to add another physician, avoid overcompensating new hires, and negotiate an associate's buy-in as a partner carefully.
The Safe Harbor 401(k) plan allows for greater tax-deferred savings than the SIMPLE IRA and avoids the bulk of the administrative expenses of the traditional 401(k). Participants are permitted to defer up to $15,500 for 2007, with an additional $5,000 catch-up available to participants age 50 and over. Adding a cross-tested plan could provide larger proportionate contributions to those closer to retirement.
Never operate a practice as a general partnership, say two consultants on business planning and wealth protection. They say that a general partnership is a creditor or plaintiff's dream and a partner's liability nightmare.
Change in an office environment can more effectively promoted by management by understanding diverse motivations and personalities, acknowledging a perceived loss, and sympathizing with feelings.
Some ophthalmologists have suggested applying the non-covered services concept, as stated in CMS rulings 05-01 and CMS-1536-R, to other procedures that alleviate the symptoms of presbyopia, specifically pseudophakic monovision-cataract surgery with IOLs to create monovision.
CPT coding for after hours and office emergency services changed in 2006. It is important for practices to be aware of the changes and to implement them promptly if they have not yet done so.
Time may be considered a key factor in selecting the level of service when at least half of the encounter consists of counseling or coordination of care.
San Bernardino, CA-Medicare claims for eyeglasses after cataract surgery are the single most complicated claims to file, according to Kevin Corcoran, COE, CPC, FNAO, president of Corcoran Consulting Group.
You, as co-employer, retain full hiring/firing authority, day-to-day management of your employees, and the normal operation of your practice.
Padua, Italy-Safilo Group has strengthened its presence in Asia by opening a new subsidiary in Korea. Safilo Korea Ltd., with offices in Seoul and controlled 100% by Safilo Group, will start business Jan. 1.
Ophthalmologists should familiarize themselves with the differences between evaluation and management (E/M) codes and eye codes, so that whichever set of codes is used is appropriately documented to ensure proper reimbursement, according to L. Neal Freeman, MD, MBA, FACS, a certified specialist in physician coding.
When it comes to the financial side of your practice, you are running a small business.
St. Thomas, U.S. Virgin Islands-When four leading practice management specialists met as a panel recently, the pearls of wisdom they shared encouraged ophthalmologists to be aware of vital aspects of their business, including finances, human resources, and legal issues. The session, titled "Business, Operation, and Legal Pearls," provided physicians and administrators with suggestions on how ophthalmologists can increase efficiency, maximize profit, and avoid pitfalls leading to liability.
San Bernardino, CA-Fixing common billing and documentation errors could mean improvements of up to 35% to your bottom line, according to Donna McCune, CCS-P, COE.
Ophthalmologists know that a very large number of patients in general practice, and in many subspecialty practices, present with eye symptoms that are too dry or too wet. These common situations trigger coding issues that must be understood in order to ensure proper compensation for care of this sizable patient group.
Base Curve, licensee for the Carolina Herrera Eyewear and John Varvatos Eyewear collections, now has a home online at www.basecurveeyewear.com. The site was designed as a resource for eye-care practitioners and consumers, and includes current, comprehensive information on both brands.
Madison, CT-Common errors related to billing for glaucoma patients may have detrimental effects on the financial success of an ophthalmology practice, said Donna M. McCune CCS-P, COE.
The use of botulinum toxin by ophthalmologists to treat a variety of disorders has exploded over the past several years. It has highlighted many issues of interest, including off-label use, supply charges, and cosmetic indications. All of these have important implications for coding, billing, and reimbursement.
Some of the most common questions in coding arise when an office visit and a procedure are performed almost simultaneously. For our purposes, "almost simultaneously" will refer to same-day office services for small ("minor") procedures and to previous-day or same-day office services for large ("major") procedures.
If a practice is going to make a change to include an incentive program, it must be done as a package by creating a new set of work standards.
Medicare rules regarding multiple procedures have been well-outlined and can be thought of as the standard. Most payers closely follow Medicare guidelines in this area. It is still necessary, though, to check with each individual payer for specific instructions. This is especially true regarding the use of the modifiers as discussed below.
Dorado, Puerto Rico-Make sure that your billing department is aware of common myths associated with ophthalmic surgery billing, so that surgery claims being filed are correct, advised Donna M. McCune, CCS-P, COE, who spoke during Current Concepts in Ophthalmology.