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MiraMed’s eAlerts are distributed via email every Wednesday, and contains the latest industry information regarding business process outsourcing solutions, helpful coding news, or any number of relevant topics in the fast-paced, ever-evolving world of healthcare. To subscribe, simply complete the form below. Below the subscription form, you will find the archived eAlerts available.

Incident-To Services: A Recap

December 26, 2012

The issue of “incident to” billing arises when physicians and certain other practitioners seek to be paid for services that are furnished incident to their services.  The purpose of this alert is to review the requirements for incident-to billing both in the non-institutional and institutional settings.

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Medicare Secondary Payer—Navigating the Trenches

December 19, 2012

Understanding what to do when a patient presents with multiple payers can be an administrative and billing nightmare.  Fortunately, the Centers for Medicare and Medicaid Services (CMS) recently issued a Medicare Learning Network Fact Sheet entitled Medicare Secondary Payer for Provider, Physician, and Other Supplier Billing Staff wherein it clarified billing for services furnished to patients that have health insurance coverage in addition to Medicare.

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Approaching the “Cliff” Regarding the Quickly-Approaching Fiscal Cliff

December 12, 2012

It is difficult to avoid hearing or talking about the fiscal cliff—an impending tax-hike-and-spending-cut disaster that is set to take effect in less than one month.  While Washington appears to be dancing to a familiar routine, the rest of the country is sitting on the edge of its seat wondering when it will see the end of this number and what it will bring.  Generally, Republicans propose severe cuts to spending and limited, if any, tax increases, while Democrats propose limited spending cuts and steep tax hikes for upper income earners.  Amidst all of this debate, it is hard to discern where healthcare fits into the picture. Unfortunately, while navigating through the labyrinth of information, we find little concrete guidance.

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Could Pre-Payment Audits for EHR Incentive Payments Be on the Horizon?

December 5, 2012

Since 2011, over 84,000 physicians and hospitals have claimed about $4 billion in incentive payments for meaningfully using certified electronic health record (EHR) programs.  Estimates revealed that the government will be paying eligible physicians and eligible hospitals nearly $7 billion in total incentive payments by 2016.  Because the aggregate incentive payments are so great, the Office of Inspector General (OIG) conducted an audit and issued a report, Early Assessment Finds that CMS Faces Obstacles in Overseeing the Medicare EHR Incentive Program (Report), which analyzes the fraud and abuse vulnerabilities in the EHR inventive program.  The Report focused on the Medicare incentive payments and did not discuss Medicaid incentive payments. 

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HIPAA: De-Identified Health Information Explained

November 28, 2012

By now, most individuals involved in the healthcare industry have a familiarity with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).  As a brief refresher, HIPAA requires covered entities to maintain the privacy and security of protected health information (PHI) held or transmitted by them.  A covered entity is defined as a healthcare provider that conducts certain administrative and financial transactions electronically, a healthcare clearinghouse, or a health plan. 

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