decisionhealth Newsletters, Part B News - 2010 Issue 9 (September)
3-step checklist to see whether you'll be getting a 10% primary care bonus in 2011
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Article Overview
This article reviews a proposed Medicare payment bonus under the 2011 Physician Fee Schedule and explains the general eligibility framework, the data sources used to assess prior-year billing, and the types of services and provider groups involved. It is intended for physicians, non-physician practitioners, and coding/billing staff who want to understand whether their service mix may place them within the bonus eligibility framework. The discussion also notes advocacy comments from professional organizations about how the policy might be implemented and what services might be counted.
Why This Topic Matters
It helps practices understand a proposed Medicare incentive that could affect payment planning, claims analysis, and revenue expectations for primary care and related provider types.
Article Sections
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Overview of the proposed 2011 bonus
Introduces the Medicare payment bonus discussed in the proposed Physician Fee Schedule and summarizes the general payment timing and eligibility framework.
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3-step checklist to determine eligibility
Presents a practical review process based on historical claims data and provider-level billing information for the relevant services.
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Bonus could become easier to achieve
Summarizes comments from physician organizations on how the bonus methodology could be broadened or adjusted in implementation.
What You Will Learn
- How the proposed Medicare primary care bonus is framed in the 2011 rulemaking cycle.
- What types of provider billing data are used to assess eligibility under the proposal.
- Which provider groups are discussed in connection with the bonus.
- How professional organizations are described as seeking changes to the proposed methodology.
Who Should Read This
- Physicians
- Primary care practices
- Medical coders
- Medical billers
- Practice managers
- Non-physician practitioners
- Revenue cycle staff
Code Ranges Discussed
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