PMC Recommendation - Confirm PECOS Registration, Or Register Now

PMC recommends that all of our clients take steps necessary to determine if they are already registered with PECOS, and if not, to register. Confirming registration and/or registering now is your best bet to avoid costly claim rejections in the future.

Use this link to check if the doctor is already registered

If you learn that you are not registered in PECOS, sign into the PECOS website and register. Sign in using the login from NPPES (the NPI site). Use this site to verify all of the data. This site is also where to update any incorrect or missing information, or to initiate a new registration. Providers may also enroll using paper enrollment forms; paper forms are anticipated to take much longer.

Read more about our recommendations

 

Medicare Cuts Halted, Medicare Physician Fees Increased 2.2 Percent

Physicians and medical group managers are aware that a 21 percent cut in Medicare fees was scheduled to be implemented June 1.  The cuts were postponed while Congress addressed the issue; and due to delays, the cuts were scheduled to take effect the week of June 14.  We’re pleased to announce that the scheduled cuts have been halted, and a 2.2 percent increase will be implemented retroactive to June 1, 2010.  The following is the exact text of today’s press release from the Centers for Medicare and Medicaid Services (CMS):

On June 25, 2010, President Obama signed into law the “Preservation of Access to Care for Medicare Beneficiaries and Pension Relief Act of 2010.”  This law establishes a 2.2 percent update to the Medicare Physician Fee Schedule (MPFS) payment rates retroactive from June 1 through November 30, 2010. The Centers for Medicare & Medicaid Services (CMS) has directed Medicare claims administration contractors to discontinue processing claims at the negative update rates and to temporarily hold all claims for services rendered June 1, 2010, and later, until the new 2.2 percent update rates are tested and loaded into the Medicare contractors’ claims processing systems.  Effective testing of the new 2.2 percent update will ensure that claims are correctly paid at the new rates. We expect to begin processing claims at the new rates no later than July 1, 2010. Claims for services rendered prior to June 1, 2010, will continue to be processed and paid as usual.

Claims containing June 2010 dates of service which have been paid at the negative update rates will be reprocessed as soon as possible.  Under current law, Medicare payments to physicians and other providers paid under the MPFS are based upon the lesser of the submitted charge on the claim or the MPFS amount. Claims containing June dates of service that were submitted with charges greater than or equal to the new 2.2 percent update rates will be automatically reprocessed. Affected physicians/providers who submitted claims containing June dates of service with charges less than the 2.2 percent update amount will need to contact their local Medicare contractor to request an adjustment.  Submitted charges on claims cannot be altered without a request from the physician/provider. 

Physicians/providers should not resubmit claims already submitted to their Medicare contractor.

 

Comprehensive Health Reform Laws and Their Effects on Medical Practices

In March 2010, President Obama signed comprehensive health reform, the Patient Protection and Affordable Care Act, into law. The new law is full of new taxes and tax increases that will affect many individuals and businesses, but it will be years before most of these are implemented. The law also has tax breaks to help both individuals and small businesses pay for insurance.

For 2010, it provides small employers with no more than 25 employees and average annual wages of less than $50,000 that purchase health insurance for employees with a tax credit. Tax credit is up to 35% of the employer’s contribution toward the employee’s health insurance premium if the employer contributes at least 50% of the total premium cost or 50% of a benchmark premium. The full credit will be available to employers with 10 or fewer employees and average annual wages of less than $25,000. The credit phases-out as firm size and average wage increases. If you have a net loss, credits cannot be carried over to subsequent tax years.

Read more about the effects of these changes on your practice

 

LIMITING POTENTIAL LOSSES
What steps can you take to protect your practice from dishonest employees or fraudulent activities?

We are frequently asked about reducing the risks of theft or fraud. In recent months, several local medical groups have reported employee theft or discovered employee dishonesty. Others have experienced unauthorized financial activities by non-employees resulting in economic losses. In some instances, PMC’s services have led to the discovery of employee or outsider wrong-doing.

What every doctor can do to prevent losses from theft or dishonesty.