Some of our members have received a Comparative Billing Report (CBR)
from Medicare and others can access their own statistics upon request.
In order to understand the significance of the statistics, an online
webinar is available that explains what the numbers reflect. Requesting
a CBR is not connected with and does not precipitate a probe, audit or
other adverse action by Medicare. It is a tool to help chiropractors
self evaluate their billing activities as it compares to all Florida
chiropractors and all chiropractors nationwide within Medicare.
(From ACA “Week in Review” of 04/11/2013) In
addition to the results from a May 2009 Office of Inspector General
report covering inappropriate Medicare payment for chiropractic
services, Palmetto GBA/Railroad Medicare has identified chiropractic
services as "vulnerable" due to the high percentage of errors discovered
during the post-payment review process. To resolve this vulnerability, Railroad
Medicare has changed the process for reviewing claims submitted with
CPT codes 98940 and 9894--along with HCPCS modifier AT. The
contractor is currently requesting documentation for claims submitted
with these codes. This review will be performed on a pre-payment basis.
Navigating the Medicare enrollment and revalidation process is among the top concerns voiced by FCA members who call FCA for assistance. Delays are commonplace and have extended to over a year in some instances. To assist members in reducing the delays, confusion and frustration, the FCA presents their third webinar available for members. It includes the more common and some less well known obstacles to getting the application completed correctly. One of the advantages of the webinar is the ability to pause it along the way to take notes or even go back: Highly recommended for anyone responsible for getting this job done. The FCA thanks Mollie Frawley, R.N., FCA Insurance Liaison and presenter in this webinar, for this outstanding webinar and for her constant and excellent service to members each and every day. And we acknowledge with appreciation the assistance of Dr. Sig Miller and ChiroView Presents for his role as moderator and with production.
Although the Medicare Allowable Fee Schedule will not change April 1st, payments for services will be reduced by 2%. The 2% will be applied after all co-payments and deductibles are applied and will be reflected on the remittance advice or EOB. It appears this will affect the provider on assigned claims and the patient on the unassigned claims.
We are receiving questions now that our members are viewing the PQRS Webinar and beginning to report their performance to Medicare. These questions and answers will be posted as the come in for the benefit of all our members.
The FCA is pleased to offer for our members’ viewing pleasure a webinar giving the basics on PQRS, Physician Quality Reporting, a 2013 Medicare mandate that could have a negative financial impact on 2015 reimbursements if not implemented. This webinar by Mollie Frawley, FCA Insurance Liaison Coordinator, is only 42 minutes and is intended to introduce this topic in a common sense, informal manner. FCA members can access this webinar at their convenience, pause it if interrupted and even rerun it to catch what you missed the first time through. This does not replace the official documents on the FCA, ACA or Medicare websites. It does however make PQRS more understandable.
In response to member calls about the effect of sequestration on Medicare fees. According to First Coast Service Options, the physician fee schedule for 2013 will change April 1, 2013:
The Governor released his proposed budget late last week and, once
again, as it has been for virtually every year since FCA successfully
lobbied to include chiropractic in Florida Medicaid, the bureaucracy and
Governor are recommending it be eliminated (along with podiatry,
another “optional service” per the federal law). The Governor’s staff
gave a courtesy call to the FCA (and the Florida Podiatric Association)
late last week to report the position. If you have been attuned to FCA
legislative reporting over the last 20 years, you know that we have
been successful each time, thus far, in having it reinstated in the
legislative budgetary process. We do not take this lightly, however.
What this means is that the FCA will need to fight this issue once again
in the 2013 legislative session. We cherish your continued support.
Medicare/CMS 