E/M Coding Alert - 2006 Issue 11
PHYSICIAN NOTES: Medicare Needs More Up-To-Date Data On Your Practice Expenses
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Article Overview
This article reviews several Medicare-related policy and administrative issues affecting physician practices. It focuses on MedPAC’s discussion of how CMS measures practice expenses, broader coordination-of-care concepts, coverage confusion between Medicare drug benefit parts, a federal health information technology funding update, and a change affecting electronic remittance advice notices. The piece is relevant to physicians, practice managers, coders, and reimbursement staff who track Medicare payment policy and billing operations.
Why This Topic Matters
The article highlights Medicare operational changes and policy discussions that can affect payment methodology, drug coverage workflows, administrative burden, and practice revenue cycle processes. Readers working in physician billing or compliance may want to monitor these updates because they touch on reimbursement administration, coverage coordination, and electronic claims-related notices.
Article Sections
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MedPAC practice expense recommendations
Discusses recommendations aimed at updating CMS’s approach to physician practice expense data and reviewing costs on a more regular basis.
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Care coordination and chronic patient management
Covers MedPAC’s discussion of approaches for coordinating care across settings and within larger organizational structures.
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Medicare drug coverage confusion and appeals
Summarizes reporting and advisory council comments about administrative confusion involving Medicare drug coverage and related appeals and cost tracking concerns.
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Federal health information technology contracts
Notes a government update on funding awarded to support health information technology development.
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Electronic remittance advice notice change
Describes a CMS transmittal affecting when paper remittance advice notices are no longer sent after electronic notices have been received for a specified period.
What You Will Learn
- How MedPAC is discussing updates to Medicare physician practice expense data
- What general themes CMS is considering for practice expense methodology
- What types of administrative confusion are occurring around Medicare drug coverage
- Why appeals and coverage-related follow-up can create added workload for physician offices
- What broader federal updates are mentioned regarding health information technology and remittance advice delivery
Who Should Read This
- Physicians
- Medical practice managers
- Medical billers and coders
- Revenue cycle staff
- Compliance staff
- Healthcare administrators
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