House and Senate Democrats are purportedly working on a three- to five-year SGR “fix” as part of the so called tax extenders bill, H.R 4213, the “American Workers, State, and Business Relief Act of 2010.”

The original SGR language in H.R. 4213 included a zero percent update or a freeze until September 30, 2010.  The current SGR-freeze expires on May 31, 2010. It is understood that the House Ways and Means Committee is discussing a longer-term extension in the range of three to four, possibly five years.  The amount of any update is not known.  The budget resolution passed by the House and Senate exempted the cost of a five-year SGR fix (estimated a $80 billion) which means the cost of anything less than a five-year SGR fix would not have to be paid for if included in H.R. 4213.

Ways and Means Committee Chairman Sandy Levin wants to move a bill prior to the Memorial Day recess.  It is likely that the House will make changes to the Senate passed version of H.R. 4213 and then send it back over to the Senate for its approval without amendment.  The major sticking points continue to be how they off-set the costs of the non-SGR portions of the bill as the pay-fors used by the Senate were ultimately used to help pay for healthcare reform bill. 

© 2010 Radiology Business Management Association (RBMA), All rights reserved.

By Dave H. Perkins

If your organization is faced with one or more of the following issues then the chances are we can help you, then you should consider outsourcing your billing:

• Need to Focus more on Patients: You find yourself having to divert
  time and attention away from your patients to deal with technical issues.
  You need to simplify.
• Collections are Low: You have a high level of dissatisfaction with the
  effectiveness of your current billing and collections process yet can’t seem
  to get your hands on what needs improving. Professional certified
  coders can make sure all procedures have the correct CPT and ICD codes
  and modifiers to ensure maximum reimbursement for the services you
  provide.
• Not capturing all of your charges? Do you have a good way to know
  all of the services you provide are actually billed? Surgery charges?
  Outpatient services? Hospital patient visits? In-Hospital consults?
  Office Visits and ancillary procedures? We can help by providing the
  tools you need to bill EVERY service in a timely manner.
• You Need a New Practice Management System or Computer
  Upgrade: You know you need to replace your existing practice
  automation system(s) however you are losing sleep just thinking of the
  time, expense, and risks involved with selecting the right solution and
  then successfully implementing that solution.
• You are considering going to Electronic Health Records at some
  time and you don’t think your current practice management system has a
  complimentary EHR/EMR.
• You fear the loss of vital practice data: How can you really know
  your data is protected from Internet viruses, “hackers”, environmental
  disasters or Acts of God? Off-site hosting of your essential computerized
  records gives you assurance that it is safe. Secure hosting sites with
  hourly automated backups and on-site IT service protects you like you
  never could be with an in-house server.
• You don’t want to deal with technical issues or problems. “The
  server is down AGAIN”. If you had rather spend your time in patient
  care rather than computer care, you should consider outsourcing. With a
  hosted-managed off-site server solution, all you would have to have in
  your office would be workstation terminals, printers for relatively low
  volume on-demand printing, and possibly scanners for scanning patient
  documents at time of service.
• You Have Staffing Issues: You are experiencing issues with either high
  staff turnover and/or it is simply taking too much time to manage the
  billing office.
• Your Billing Costs are Too High: If you are concerned that your billing
  and collections related expenses are higher than they ought to be.
  Training and support fees, upgrade fees, software license fees are
  ongoing.
• You are concerned about capital expenditures at a time of
  uncertainty: Recent changes in health care, including the ARRA 2009
  and the “Health Care Reform” in 2010 have complicated your business to
  the point you don’t know what to do and could use the expertise of
  experts with knowledge of these changes in legislation and their impact
  on your practice. You’re not sure if now is the best time to spend more
  money on capital equipment, systems, or staff, when you don’t know
  what the future holds.
• Are you in “compliance” with CMS, OIG, HIPAA, “Red Flag Rule”?
  eHealthTech’s commitment to “compliance” is evident in every aspect of
  our operations. While our primary goal is to achieve the highest possible
  reimbursement to which our clients are legally and ethically entitled to,
  we always work in a manner that fully complies with both the letter and
  the spirit of all applicable guidelines and regulations.

The Compliance Program is under the direction of the eHealthTech Compliance Manager, who oversees quality from the original medical record through the coding process and ultimately through billing and collections. This written plan incorporates the guidelines defined by the “Compliance for Third Party Billing Companies” from the Office of the Inspector General (“OIG”) of the Department of Health and Human Services (“DHHS”), the Center for Medicare and Medicaid Services (“CMS”), and specialty organizations . A key component of compliance is correct coding for all services. eHealthTech’s professional coders are all Certified and members of AHIMA. To ensure they are informed regarding the latest changes in coding guidelines, each is required to earn continued medical education (“CME”) credits throughout the year. eHealthTech subscribes to industry newsletters, including Medicare Part B News to stay abreast of upcoming changes in coding and reimbursement. The plan is maintained as needs evolve and management ensures eHealthTech is continually following its own written program.

eHealthTech’s clients may rest assured that their billing is being handled accurately, professionally, ethically, and in complete compliance with the above-referenced regulations and guidelines at all times. Our account managers regularly review accounts with our coders and auditors to improve communications and fine-tune processes to continually improve data quality and integrity and keep our clients fully informed through regularly scheduled meetings and notices.

For more information on how eHealthTech Marketing, LLC can benefit your practice, please contact me.

For another article on this topic, please visit:  Software Advice

Dave H. Perkins
President
eHealthTech Marketing, LLC
www.ehealthtech.com
Phone: (601) 573-1826
Fax: (601) 898-4404

“Medical billing is not my business, yet billing-related issues and questions from my staff and patients occur on a daily, if not hourly, basis.  The dependability of eHealthTech’s billing services lets me focus on what I do best – patient care. Their accessibility and customer service are excellent, with timely responses for my staff and patients.  From implementation to working claims, eHealthTech knows their business.”

B. Todd Sitzman, MD, MPH
Advanced Pain Therapy, PLLC
Hattiesburg, MS

Read more testimonies and discover the power of  eHealthTech!

A literature review of comparison studies for medical imaging methods, published in the May/June issue of the Journal of Diagnostic Medical Sonography, puts ultrasound at the top of the list for accuracy and cost effectiveness.

“Accuracy and Cost Comparison of Ultrasound Versus Alternative Modalities Including CT, MR, PET, and Angiography” reports the results of research studies that compare the accuracy and cost effectiveness of ultrasound versus other imaging modalities, such as magnetic resonance imaging (MRI), computed tomography (CT), contrast angiography (CA), and single-photon emission computed tomography (SPECT).

Alternate imaging technologies “are often considerably more expensive, include radiation exposure, are less portable, or have an increased risk of complications from contrast media,” write authors S. Michelle Bierig, MPH, RDCS, FASE, FSDMS, and Anne Jones, RN, BSN, RVT, RDMS, FSVU.

“Interestingly, the increase in spending by Medicare for alternative imaging services has been at a higher growth curve than the increase in the use of ultrasound,” the authors note.

Read the article online, free for a limited time.