Azalea Health Innovations Friends Newsletter – August 2011

IN THIS ISSUE

* Welcome
* AHI partners with MedAssets
* Medicare Primary Care Bonus Payment Program
* Medicare releases new educational resources for the eRx incentive program
* Billing Tip: Physician Pay Cut Projected for 2012
* New Features
* Upcoming Events

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Welcome

Greetings to all of our Azalea Health Innovations friends and thank you for reading this month’s Newsletter. We hope everyone is staying cool this summer!

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AHI partners with MedAssets

Azalea Health Innovations has partnered with MedAssets to bring to you a new level of billing/coding validation. By integrating MedAssets’ CodeCheck with Azalea PM™, our users will be provided with the most current coding tools and information. This integration will also help providers maintain compliance to current Medicare Part B coverage rules and Local and National Coverage Determinations (LCD and NCD). This feature can be used to validate your charges against the following Medicare B edits:

• ICD-9-CM code validation (including gender and age)
• CPT/HCPCS code validation (including Correct Coding Initiatives)
• CPT/HCPCS modifier validation
• LCD/NCD validation

To learn more about this feature and how you can integrate it in your Azalea PM™ system, contact info@azaleahealth.com.

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Medicare Primary Care Bonus Payment Program

Did you know that all internal medicine or primary care physicians are eligible for quarterly bonus payments from Medicare?

Congress has established the Primary Care Incentive Payment bonus program through the March 2010 federal health care reform law, the Patient Protection and Affordable Care Act (ACA). Through this, a 10 percent bonus payment on top of the fee schedule payment for select primary care services will be given to qualifying primary care physicians for calendar year 2011-2015. To qualify, a physician must be self-designated in a primary care specialty and a substantial portion of their Medicare billings are for designated primary care services (primarily office and other outpatient visits). CMS determines which physicians qualify on an annual basis, and the bonus payments are made quarterly.

CMS estimates that about 60 percent of general internists will qualify for this bonus in 2011. The incentives are to target physicians to enter and remain in the primary care fields of internal medicine, family practice, pediatrics, and geriatrics. No action is required to qualify. For more information on the ACA primary care incentive payment bonus program, check out this link: http://www.acponline.org/running_practice/practice_management/payment_coding/bonus.htm#

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Medicare Releases New Educational Resources for the eRx Incentive Program

The Medicare Learning Network (MLN) has just released a new 2011 eRx Incentive Program Made Simple fact sheet and quick reference chart, which can be used as a great resource to find out whether or not you are eligible for the program. See below, the new 2011 fact sheet and quick reference chart to find out how you can become eligible for Medicare eRx incentive payments and avoid any additional payment adjustments.

ERX Made Simple Fact Sheet
ERX Quick Reference Chart

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Billing Tip: Physician Pay Cut Projected for 2012

According to the Congressional Budget Office (CBO), physician reimbursement for services rendered to Medicare patients will be slashed by 29.4% in 2012. This decrease is part of a provision of law called Medicare’s Sustainable Growth Rate (SGR) mechanism. Recently these decreases have been overridden by last minute legislative action (called “Cliffs” and “Clawbacks”). The overriding actions have been going on since 2003 and analysts have also discussed a 10 year freeze in payment rates. According to the latest report from the CBO, this drastic cut in reimbursement rates is unlikely to happen during the current 10 year budget window (insert sigh of relief here). This is mainly due to the fact that Medicare recently reported slower than expected growth in spending for physician’s services in 2010. Because of this lower than expected payout growth, the federal government does not feel as compelled to enact such drastic reduction in reimbursement at this time. Please take a moment and read the CBO’s latest report outlining these policies including estimated “Cliff” and “Clawback” options for the next 10 years.
*the word report in bold in the above paragraph should be linked to the PDF I emailed to Ray.

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New Features

In case you missed out on July’s New Features blast, please click the following link: http://www.azaleahealth.com/newsletters/new_features_blast_201107.php

We have already developed even more new features and enhancements since the last blast, which was released just last week! Please see below our most recent developments. There will be an email to follow with more detailed explanations for each of the features or updates listed below. Should you have any questions or would like any addition training on any of them prior to the next blast, please do not hesitate to contact Ashley McGahee at 229-269-4660 or amcgahee@azaleahealth.com.

• Un-collectible Debt Reversal: You now have the ability to reverse un-collectible debt after a patient has been sent to collections and begin making payments on his/her account. This feature works just like the insurance adjustment reversal.
• Arrived Appointments vs. Encounters Reconciliation Report: By pulling the report labeled “Appointments/Encounter Reconciliation Report”, you now have the ability to match every appointment with an “arrived” status along with its corresponding encounter in order to ensure that every patient visit gets billed.
• New Layout of the Daily Schedule: The daily schedule has now been formatted to fit multiple patient phone numbers.
• Primary Insurance Filter added to the Patient Demographics List:  A primary insurance filter drop down box has been added to the Patients list, allowing you to view the patient list by only the specified primary insurance.
• Patient Created By and Patient Last Edited By: Located in the Patient Details screen, you can now view which user created the patient and which user was the last to edit the patient.
• Ability to View a Provider’s Schedule During a Specified Date Range: You now have the ability to view a provider’s schedule as well as all available slots for future dates during a specified date range.
• Ability to Schedule Events on the Scheduler: You now have the ability to schedule events and not just patients on the Scheduler.
• Ability to Override the CPT Price at the Encounter Level:  You now have the ability to edit a CPT’s fee at the encounter level by clicking on the CPT line and changing the amount.
  • Note: This is a permission based feature, if you would like any of your staff to have the ability to override a CPT’s fee, you will need to add the permission “Fee Schedule Override Pricing” to his/her web-user permissions.

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Upcoming Events

We are currently exhibiting our Azalea PM™ product, Revenue Cycle Management Services, and much more at the MGMA / Summer Conference in Destin, FL. The conference will be held at the Hilton Sandestin Beach and Golf Resort. August 1-3, 2011.

If you’re in the area stop by and say hello!

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Thank you!

Azalea Health Innovations, Inc.
105 West Central Avenue
Valdosta, GA 31601
Toll Free: 877-777-7686
Local: 229-269-4620
Toll Free Fax: 866-683-8679
Web: http://www.AzaleaHealth.com
Email: info@azaleahealth.com

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