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Medicare Plans to Cut Specialists' Payments - Wall Street Journal

Medicare Plans to Cut Specialists' Payments
Wall Street Journal
WASHINGTON -- The Obama administration said Wednesday that it plans to cut Medicare payments for imaging services and specialists, ...
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Publ.Date : Thu, 02 Jul 2009 01:46:18 GMT

53 Indicted in Medicare Fraud Sting - Washington Post

Washington Post

53 Indicted in Medicare Fraud Sting
Washington Post
The Justice Department yesterday unsealed criminal indictments against 53 people for allegedly bilking the Medicare system, ...
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Publ.Date : Wed, 24 Jun 2009 17:43:05 GMT

Why It's Easy to Steal From Medicare - Wall Street Journal

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Why It's Easy to Steal From Medicare
Wall Street Journal
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Government moves to staunch massive Medicare fraudReuters
Department of Justice charges 16 in multi-million dollar Medicare ...IFAwebnews.com
Miami doctor gets 8 years in HIV-Medicare scamMiamiHerald.com
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Publ.Date : Thu, 02 Jul 2009 01:22:29 GMT

Health Care Reform Series: Distortions in the public debate on ... - Examiner.com

Boston Globe

Health Care Reform Series: Distortions in the public debate on ...
Examiner.com
After all, publicly-funded programs, like Medicare, do not have an overhead of 30% like private insurers - it's more like 3% – and 1% in Canada's ...
Give us a break...and Medicare for allHelena Independent Record
Health care reform made simplerSt. Louis Post-Dispatch
Reform? What "reform"?Florida Times-Union
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Publ.Date : Sat, 04 Jul 2009 09:03:41 GMT

Mr. President, First Heal Medicare - Town Hall

Xinhua

Mr. President, First Heal Medicare
Town Hall
Setting aside the questionable validity of that statistic, compare it instead to the 45 million people currently enrolled in Medicare. ...
Obama supports Medicare-reimbursement fixFresno Bee
Medicare reimbursement rates need fixing, Obama saysMcClatchy Washington Bureau
Manitoba-born doctor opposes US President Barack Obama in medicare ...Vancouver Sun
New Hampshire Business Review -msnbc.com -Examiner.com
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Publ.Date : Fri, 03 Jul 2009 01:50:09 GMT

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Medical Practice Management Company Influences Major Reimbursement Policies

by June Marshall-kingsley

mpowermed, inc., a medical practice management company in Mahwah, NJ, influenced Aetna and Pennsylvania Centers for Medicare and Medicaid to change their reimbursement policies for certain medical procedures. Both patients and physicians benefit from these reimbursement changes.

The world of medical billing and coding for physician reimbursement is complex and can be daunting. Staying on top of the game with reimbursement policies from such large insurance organizations as Aetna, Medicare, and Medicaid takes knowledge and experience. But sometimes the policies don’t make sense, are not in the physician’s best interest, or have not changed to keep up with current medical practices.

That is where a proactive, dedicated, and experienced practice management company like mpowermed, inc., of Mahwah, New Jersey makes a difference -- by fighting for every cent due when the polices seem unfair, outdated, or simply incorrect for today’s needs. Such was the case with a policy regarding a breast cancer treatment involving a treatment device known as a breast board. Pennsylvania Medicare and Medicaid were denying payment for more than one use of these treatment devices a day. mpowermed appealed with the following words in a letter, “In a given course of treatment, it is most common to see more than a single treatment device in a day. We are confident that all medical documentation would prove medical necessity.”

Because of this letter, the Pennsylvania Center for Medicare and Medicaid Services wrote back to mpowermed saying they researched the treatment device situation and actually visited a large cancer treatment facility, “to view the devices and discuss their use and billing with a radiation oncologist.” Based on these findings, Pennsylvania Medicare and Medicaid will update their policies regarding this treatment device (CPT Code 77334).

Prior to this victory, mpowermed had written to Aetna about rejecting claims for another reimbursable item, Portal Film (CPT Code 77417) usage on the same day as the physician’s weekly management charge (CPT Code 77427). After amassing impressive documentation proof, mpowermed suggested the changes to differentiate between portal film usage in a freestanding clinic versus a hospital setting. Aetna agreed to reimburse the technical use of portal film in freestanding, privately owned radiation oncology clinics.

According to mpowermed, “It takes patience and perseverance to influence policy changes in large insurance organizations. Both Aetna and the Centers for Medicare and Medicaid Services were more than cooperative in affecting the necessary changes. It is for the benefit of the patient and the physician when they do! This is what makes medical practice management, billing, and coding such a rewarding opportunity!”

Company contact:

mpowermed, inc.
June Marshall-Kingsley
Marketing Manager
201-684-1616 Ext. 130
 

 

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