The case for G2211, Medicare's visit complexity code
A Medicare-specific add-on code, G2211, is designed to address the complexity inherent to evaluation and management associated with medical care.
Medicare's wellness coverage offers critical services
Physicians must understand the requirements for billing for Medicare-covered preventive services, such as the “Welcome to Medicare” exam and Annual Wellness Visit (AWV).
How you can integrate behavioral health in your practice
Behavioral health integration (BHI) is a way for primary care practices to address patients' behavioral and mental health needs.
A changing landscape: The trajectory of Medicare Advantage
Medicare Advantage is changing the landscape of how care is delivered and reimbursed, and the number of enrollees in such plans is quickly growing.
Tackling administrative burdens one step at a time
ACP seeks to reduce and eliminate sources of administrative and regulatory burden and has developed significant policy recommendations to address the impact of these tasks.
Tools to help track social determinants of health
There has been increased recognition of the impact of addressing social determinants of health.
‘State of the Note’ summit outlines changes for E/M coding
A working group hosted a summit to examine how to ensure that the 2021 changes to E/M codes help relieve some of the burden of documentation.
New rules change handling of patient data
Under new rules, patients must have access to their electronic health information as soon as it is available. But there are also a few exceptions that allow some flexibility on what is released when.
Managing patients' medications effectively
As the number of patients with chronic diseases grows, medication optimization is as important as ever to improve outcomes, decrease costs, and improve quality of life.
Don't put clinician burnout on the back burner
Patient- and non-patient-related administrative tasks can create burnout at any point during a clinician's career.
New reimbursement codes you can use now
Physicians can use new billing codes to garner reimbursement for online services based on time, as well as chronic care management, principal care management, and transitional care management.
Is your practice ‘remote monitoring’ ready?
Adding telehealth to a practice can lower health care costs, expand the patient database, and offer flexible working conditions for physicians and staff.
Is telehealth ready for prime time?
Recent surveys have found that a sizable share of internists and primary care physicians have implemented technology for one or more telehealth services.
Population management for preventing the 80–20 rule
Chronic conditions require longer and more frequent visits, as well as more care coordination. Learn how to anticipate, plan for, and even prevent intensive resource use.
New Medicare identification cards begin rolling out in April
CMS will begin mailing new cards with Medicare Beneficiary Identifiers (MBIs) to all beneficiaries. Practices are urged to remind patients to look out for their new cards in the mail and to be sure to bring them to their next appointments.
MIPS scoring summary rules have changed for 2018
A full year of quality reporting data is required to participate in the Quality Payment Program's Merit-Based Incentive Payment System.
Clarifying issues for telehealth services
Beginning in January 2018, Medicare will pay for certain telehealth services for patients who are enrolled in Part B and live in a Health Professional Shortage Area or in a county that is not included in a metropolitan statistical area.
Customer service can make or break a practice
Patients who receive friendly, competent information are more likely to trust their clinicians, and customer service begins with the management and the physicians setting an expectation for professional behavior among all staff and clinicians.
Patient engagement is more than a catchphrase
When physicians and patients have a more meaningful relationship, it improves physician satisfaction and patient outcomes.
Discussing death, dying, and advance care planning
Clinicians and their teams may want to identify which patients and families to prioritize for advance care planning initiatives.
Ensuring quality referrals and effective care coordination
Effective two-way communication between primary and subspecialty care practices can improve referrals and care coordination for both by making some basic infrastructure adjustments.
Understanding MIPS, how much patients cost 'the system'
As physicians convert to the Merit-Based Incentive Payment System, they will eventually be required to consider the cost of care they deliver to patients.
Quality reporting offers ‘pick your pace’ participation
A “pick your pace” option for quality reporting under the Medicare Access and CHIP Reauthorization Act of 2015 will give internists a chance to ease into the new payment system by choosing their levels of participation.
Navigating the improvement activity component of MIPS
The Quality Payment Program created by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) is not as intimidating as it sounds—at least for 2017, which is a transition year that will determine what internists are paid in 2019.
Handling MACRA's advancing care information component
The ACI final score is composed of three categories: base score, performance score, and bonus score.
Collections for the high-deductible (self-pay) patient
A high number of self-pay patients in the patient panel can lead to increased headaches for front-office staff.
The pros and cons of using scribes
Scribes allow clinicians to talk to their patients eye-to-eye, without a computer screen in the middle. They also come with all the complications of employee management.
New overtime rules take effect December 2016
New overtime pay rules will affect employees whose annual salary is less than $47,476 and who work more than 40 hours per week.
Learn whether you are in a payment model that measures up
Physicians want to know how to tell if their practices might qualify as an Advanced Alternate Payment Model, which will garner extra reimbursement for quality patient care, and whether they might meet the standards of a qualified professional under the Medicare Access and CHIP Reauthorization Act.
Transitioning patients from pediatric to adult care
As adolescents become young adults, there comes a time when pediatricians will no longer see them. For those patients with chronic, sometimes complex, conditions, it can be hard to know how to transition into the adult internal medicine world. ACP, in collaboration with several pediatric and adult subspecialty societies, has developed a toolkit to help patients and practices manage this transition.
Dealing with the hassles of prior authorization
Prior authorization related to medications or referrals to specialty care or testing drain physician and staff time on burdensome administrative tasks instead of patient care. Practices can try some tips to mitigate some of the burdens.
Patients have a right to access personal health information
Confusion exists about how and when patients can access their personal health records under the Health Information Portability and Accountability Act.
Transform to get ahead of the payment reform curve
Value-based payments are on the horizon, and practices need to prepare. There are very worthwhile reasons for getting ahead of the payment reform curve.
Positioning your practice for alternate payment models
Now is the time to begin getting ready for the new Medicare Access and CHIP Reauthorization Act of 2015 payment system, which will shift payment to a value-based model to reflect both the quality and efficiency (cost) of the care provided to a patient population.
Positioning your practice for a new payment system
In 2019, new Medicare incentive programs take effect. There will be 2 avenues from which to choose: participation in an alternate payment model or the Merit-Based Incentive Payment System.
Helping Medicare patients save money on their medications
The cost of medications can be a significant barrier for many patients who are on a fixed income or who might be taking multiple, sometimes expensive drugs. Medicare Advantage and Medicare Part D plans might provide a solution for your patients, and there are tools to help with the enrollment process.
Flexible plans for ICD-10 implementation
The Centers for Medicare and Medicaid Services will allow for flexibility in the claims auditing and quality reporting processes while the medical community gains experience using the new ICD-10 code set.
Keeping practice data electronically secure is important
Data breaches are costly, but there are simple ways to bolster electronic security.
Just say ‘no’ to virtual credit cards
Beware the latest trend that many payers are adopting, a kind of virtual credit card that actually incurs a fee to the practice of between 1% and 5%.
What prescribers need to know about Medicare Part D
Effective July 1, 2015, physicians who prescribe drugs to Part D enrollees must either be enrolled in Medicare or have a valid opt-out affidavit on file in order for the prescriptions to be paid for.
Taking the mystery out of care coordination management
Care coordination isn't new, but value-based payment, patient-centered medical homes, accountable care organizations, and other alternate delivery and payment programs have moved the topic into the forefront of many conversations and policy discussions.
Making patient portals patient-friendly
Patient portals can create barriers to successful use but can also offer benefits to patients. Three simple steps can improve the patient experience.
Taking the fear out of converting to ICD-10
Knowing that many small practices need help, ACP has put together a host of resources to help small practices understand and implement ICD-10.
Getting patient consent for chronic care management
Medicare now reimburses internists for chronic care management services, but a few criteria need to be met. Learn more about how to recoup payment for services that many physicians are already providing.
Motivational interviewing tips for the whole practice
Try motivational interviewing as a method of communication in which the physician coaches—or rather coaxes—the patient toward lifestyle changes via his or her motivations.
Practice Tips: The 3 Ps of physician compensation
Performance, productivity, and profitability are the 3 components of getting paid. These elements all affect one another, so balancing them is key.
Practice Tips: Is ‘secure’ texting an oxymoron or a possibility?
Electronic health communication in health care must be secure. Text messaging is not, but it's how many patients want to talk with their doctors. Consider the ramifications of a message that gets misplaced, and then consider other ways of communicating.
Practice Tips: Administrators are key to running a private practice
Bring in an expert to manage shrinking reimbursement, changing regulations, and rising business costs.
Practice Tips: Review reporting of industry relationships
What should physicians look for when reviewing their Open Payments information online?.
Practice Tips: Overcoming language barriers in your practice
Physicians need to be prepared to use tact and skill when communicating with patients with limited English proficiency and those with hearing impairments.
Practice Tips: Hardship exceptions for meaningful use
There are exceptions that may apply for some physicians who cannot meet the meaningful use electronic health record incentive requirements due to circumstances out of their control.
Practice Tips: Connecting the dots—why benchmarking matters
Efficient practices not only run better, they offer better patient outcomes. Benchmarking is the first step in this process because it shows where to focus attention first.
Practice Tips: Ancillary procedures are win-win-win
There are several ways to increase practice revenue, including patient volume, better collections, or better contract rates.
Practice Tips: Staying on track for ICD-10
Learn what you and your practice should be doing now to meet the Oct. 1 ICD-10 deadline.
Practice Tips: Explore ways to hire, credential new medical assistants
Computerized order entry requires a licensed or certified staffer. Learn how to fulfill this requirement with new hires or by training existing office staff.
Practice Tips: The self-pay conundrum and other tricky HIPAA omnibus requirements
While many of the omnibus changes to the Health Insurance Portability and Accountability Act are subtle and may not require a great deal from a practice, the penalties for noncompliance are severe.
Practice Tips: What your practice needs to know about health insurance exchanges
Learn how to bring patients up to speed on their new access to health care via health insurance marketplaces, or as they're known, “exchanges.”.
Practice Tips: Planning ahead for successful PQRS participation
A new online registration tool may help internists avoid looming penalties by helping them to enroll in the Physician Quality Reporting System.
Practice Tips: Documenting opioid management is as important as doing it
It's important to protect your practice by documenting opioid management in the medical record and adhering to extra regulatory requirements.
Reducing the risks of opioid management
Patients with known drug-seeking behavior can be managed by establishing and closely following office procedures.
HIPAA omnibus final rule—it's time to brush up on the basics
With the release of the Health Insurance Portability and Accountability Act (HIPAA) omnibus rule, it's time to take a fresh new look at office policies, procedures and practices.
Gain efficiency, not overload, through electronic communication
Use digital communications' strengths to streamline its glut of information instead of being carried away.
How to financially survive in a hospital-owned practice
As more and more practices move to a hospital-employed model, internists will have to engage in due diligence about how the change affects billing, service contracts and collections.
What practices need to know about transition care management codes
Two new codes allow for reimbursement for non-face-to-face care when patients transition from an acute care setting back to the community. Learn the fine print of how to properly use these codes.
Tool simplifies quality measure reporting
The Physician Quality Reporting System recently switched from incentive payments for adopting it to penalties for not doing so. To avoid future penalties, use ACP's registry tool, the PQRIWizard, to fulfill the requirements.
Small practices prepare for ACOs
Small practices are wondering how they will fit into the larger networks of accountable care organizations that are springing up nationwide. There are three small steps practices can take as the issue sorts itself out.
Will you be ready for ICD-10?
Even though ICD-10 has been delayed, it is important to continue planning for the eventual transition.
Tools to screen for alcohol abuse
Medicare now reimburses for problem drinking as part of its Annual Wellness Visit, and a few easy-to-follow tips can help doctors screen for alcohol abuse and get paid for doing so.
Why job descriptions matter
Job descriptions not only help practices hire and retain the right employees, they can also have a positive effect on productivity and profitability.
Check finances, costs before consolidation
Financially stressed private practices are seeking shelter through acquisition by a hospital chain. But owners need to scrutinize their costs and expenses before entering into negotiations.
New tool for Annual Wellness Visits
The Health Risk Assessment is a winning proposition for practices to incorporate into their workflow to offer patients a personalized preventive plan and specific action steps to take.
Distributing pay for performance
Once a practice receives pay-for-performance bonuses, how should they be distributed? Do they go to the treating physicians, the entire practice or some kind of hybrid? There options aplenty to consider.
Medicare pays for annual depression screening
One in six seniors suffers from depression. That rises to one in four with comorbidities. Tools and screens are available to help internists integrate this new focus of care into a practice routine.
Prevent disaster by backing up data
Natural disasters can wreak havoc on a practice's medical records. Five simple tips can help create a backup system that could avoid clinical data loss, and the resulting lawsuits and penalties.
EHR training is mission critical
Don't skimp on the raining when it comes to implementing an electronic health record system in a practice or facility. Basic functionality may require two weeks, and advanced functions may require another week to learn.
Options to secure e-mails
Numerous options are available to make e-mail communications to patients more secure.
Why accessibility matters
When deciding on how satisfied they are with a practice, patients look foremost to how quickly they can be seen, and how they can reach a physician for after-hours problems. Eleven quick tips can strongly influence the quality of care and how it's perceived by the patient.
Set up your flu clinic now
Setting up an influenza vaccine clinic is a simple way to immunize all patients in a practice. It's easy to achieve that goal if the practice is well organized. Here is a step-by-step guide to running a successful flu vaccine clinic.
Hang out a digital shingle
Physicians need to understand how to establish their identities and their practices online in order to attract patients in the social media age.
Coding made easy for annual wellness visits
Health care reform now reimburses for annual exams under Medicare. Now, physicians have to reform their practices and prepare patients for them, as well.
Tips and tricks for hiring the right people
Hiring new staff costs both time and money, and frequently a 30- to 45-minute interview is the only opportunity to determine whether a person will succeed in your practice. Here are some tips on ways to increase the odds of making a good hire.
Home health and hospice eligibility now requires face-to-face encounter
Enforcement begins on a new Medicare rule that mandates a personal encounter for the initial certification of home health and hospice services.
Complete version 5010 before starting ICD-10
Offices must convert to a new electronic standard format, called version 5010, befor they can implement ICD-10 in their offices. End-to-end testing must be complete by the end of the year.
The e-prescribing paradox
Practices need to have an e-prescribing system up and running by the end of May. Learn how to qualify by using the G8553 code at least 10 times by then.
Understanding EHR certification
Selecting an EHR system for your practice involves sorting through vendors touting the certification of their products.
Improve feedback with subspecialists
Take the time to improve communication and collaboration between your office and those to whom you refer your patients.
Another security risk: The copy machine
Your office photocopier stores permanently every image it's ever scanned, copied or faxed. Those images stay with the machine after it's re-sold, and the images can be easily hacked. Learn how to maintain security over medical records, taxes, bank statements—or any other document that's ever been copied.
Easy ways to ensure meaningful use
Preparing, selecting and fully implementing an electronic health record require time and money at a time when there's not a lot of either. Six easy steps can prepare staff to meet the core sets of objectives and measures.
A primer in safe vaccine management
Common sense, easy-to-implement practices can be easily worked into a practice to ensure safety for patients, employees and the vaccines themselves.
Quick tips for billing locum tenens doctors
Locum tenens doctors add flexibility and the ability to fulfill specific practice needs. Billing on their behalf requires modifiers and paying attention to a 60-day grace period when using National Provider Identifiers.
The confusing world of EHR incentives
The federal government's substantial incentive program for electronic health records is no reason to rush out and buy one. Final rulings on how to interpret issues such as “meaningful use” won't be decided upon until the summer. Diligence is needed to choose a system that matches the practice workflow.
Hire NPs, PAs to boost revenue, accessibility
A dependent practitioner can increase a practice's accessibility, productivity and revenue while contributing to quality and patient satisfaction—and at half the cost of hiring a physician.
Getting a handle on HIPAA and HITECH
Just as practice staff adjusted to HIPAA regulations, along comes a new set of rules addressing privacy and security. More rules, more enforcement—and more penalties. Learn how to avoid mistakes.
Moving toward patient-centered care
Practice not currently considering the patient-centered medical home model can still position themselves for an eventual transition if and when the idea comes of age.
Improving paper charts to prep for EHRs
Practices should organize their paper charts to ease to conversion to electronic health records. To ease the transitions, ACP has assembled useful forms to download and customize.
Record retention made easy
Nothing raises more questions when closing a practice than what to do with the medical records. Practical tips explain how to handle these important documents.
Consider offering in-office labs
Office-based labs increase efficiency, contribute to faster diagnoses and treatment and improve satisfaction. Increased regulation and reduced reimbursement should be balanced against new technology and a greatly expanded range of tests available.
Shared visits improve access, productivity and satisfaction
Shared office visits offer 90-minute blocks of time to groups facing common and chronic conditions. A few distinct models have gained broad acceptance by doctors and their patients.
The stimulus package and buying EHRs
The recent federal economic stimulus package set aside more than $17 billion for doctors and hospitals to adopt EHRs. ACP has developed extended guides to answer physicianâ€™s questions about the incentives.
A practical guide to creating and maintaining a ‘red flag’ program
Federal regulations require doctors' offices to set up written procedures to protect against identity theft. Practice pearls outline steps to follow to comply with the new law.
RVUs—the common denominator in financial management
In today's economy, tight financial management is more important than ever. Relative Value Units can be used as a powerful tool for financial management in medical practices.
Find mentoring and networking events that work for you
Celebrate, network and learn with special courses tailored to ACP members.
If you can't make the wait shorter, make the waiting room nicer
Patients' perceptions of waiting are key to their satisfaction, and therefore return and referral business. Making waiting rooms more like living rooms is one way to increase patient satisfaction and reduce frustration with delays.
All together now: Office teamwork
A cohesive and efficient team can make all the difference between a practice limping along and one that is willing to try new ideas and work flows.
‘Show me the money’—by maximizing accounts receivable
Make sure your practice is collecting payments from patients and insurers.
To catch a thief (before theft happens)
Don't let employee theft happen to you. Simple internal controls and checks prevent temptation.
Efficient docs make for happier patients
ACPâ€™s Center for Practice Improvement and Innovation suggests simple tips for creating a more efficient practice and happier patients, in turn.
Clearing up confusion about choosing EHRs
An interesting phenomenon occurred on the exhibit floor at Internal Medicine 2008.
Evidence-based tips for common illnesses
Much of the time physicians spend on patients' paperwork is uncompensated, but insurers usually will reimburse physicians for filling out forms, such as home health plans and copying medical records, that require a significant investment of time.
Don't lose money on filling out forms
Insurers usually will reimburse physicians for filling out forms, such as home health plans, that require a significant investment of time.
PMC Tips: Hold to a higher standard on hiring
Medical schools donâ€™t teach management skills, but every physician needs them.
Dividing the pie by keeping it simple
Looking for the perfect compensation plan for your practice? Hereâ€™s the secret.
A road map can guide locum tenens travels
Working as a locum tenens has become more alluring to physicians with varying levels of experience.
Follow a few simple steps to ensure safety with vaccines
Needlesticks happen. Patients have the same or similar names. OSHA inspectors visit. Drugs are recalled. Now what?.
Workflow analysis a critical but hidden step to EHRs
Despite the information-sharing benefits of an EHR, many physicians are reluctant to invest in this technology.
An efficient form-ula for documentation
Good documentation is critical, and in todayâ€™s environment it must be performed quickly, accurately and efficiently.
Staffing can make or break a small practice
In a quest to unveil common problems for small practices and offer solutions, the College's Center for Practice Innovation visited 34 practices across the U.S. over a two-year period. Part one of the six-part series looks at the unique staffing issues faced by small offices.