2019 covid has brought new telehealth rules in 2020

By Dialysis Billing, Medical Billing, Nephrology Billing, Nephrology Billing, Podiatry, Renal No Comments

This article was published in the July  issue of Nephrology Times and written by our own Sarah Tolson, Director of Operations.

Physician offices and dialysis facilities alike have been scrambling to provide their patients with the best possible care, minimize the risk of exposure to COVID-19 for both patients and caregivers, and comply with ever-changing state and federal safety guidelines during this public health emergency. Insurance companies have also made changes to facilitate contact-free access to healthcare for their members. Medicare released a list of 239 Current Procedural Terminology (CPT) codes that are payable under the Medicare Physician Fee Schedule when they are furnished via telehealth. Most insurance companies have followed Medicare’s lead and expanded their list of covered telehealth services to allow patients more flexibility in accessing healthcare. Now, more than any time in our history, people are receiving healthcare via telehealth.

Along with all the changes in covered services, there have been changes in the billing requirements for telehealth services. Now, it is critical to stay up to date on billing regulations and requirements. Not only has the number of patient visits dwindled in many practices, but staff being unfamiliar with current telehealth billing requirements can result in a loss of revenue. There are three steps that can be followed by billing staff to ensure maximum reimbursement is obtained for telehealth services during this time of change.

Continue reading https://www.docwirenews.com/nephtimes/a-year-of-change/

A Year of Change

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Three Tips to Improve Accounts Receivable

By Dialysis Billing, Medical Billing, Nephrology Billing, Renal No Comments

Three Tips to Improve Accounts Receivable

Published in Nephrology Times, May/June 2019

By Sarah Tolson, Sceptre Management Solutions

In our company, we deal with insurance companies across the nation. Working with a variety of payers gives us a wide range of experience but we also
encounter our fair share of challenges in obtaining reimbursement. Here are three simple tips that make collecting from payers a little easier….Read More

 

Increasing pressure on patients to pay for out-of-pocket costs, Part 2

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From the Field: Patient Payments Part 2

Published in Nephrology Times, Jan/Feb 2019

By Rick Collins, Sceptre Management Solutions, Inc.

Last issue I mentioned that a social worker commented to me that she wishes providers would stop trying to collect from patients. She said providers “make enough money” and wondered why they feel the need to collect from patients who cannot afford their large coinsurances and deductibles. She pointed out that increasing pressure on patients to pay for coinsurances and … Read More »

Increasing pressure on patients to pay out of pocket, Part 1

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Growing Pressure on Renal Patients to Pay Out-of-Pocket

Pubilshed in Nephrology Times, Nov/Dec 2018

By Rick Collins, Sceptre Management Solutions, Inc.

At a conference I attended recently, a social worker lamented how much grief is placed on dialysis patients due to the large bills they receive from renal providers. She openly wondered why providers feel they need to bill patients since they already are paid “a lot” by Medicare and commercial insurance companies. When I first entered the … Read More »

Cheap Billing Can Be Costly

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From the Field: Cheap Billing Can Be Costly

Published in the Oct 2017 issue of Nephrology Times

By Rick Collins, Chief Operating Officer, Sceptre Management Solutuions

“We can do your billing for much lower fees than you’re paying now!” While this is a tantalizing phrase for physicians, management, ownership, and accountants, paying for “cheap” billing frequently costs you much more than any savings you realize from the cheaper billing rate. To illustrate this point, following are personal experiences from our company’s 20 years in … Read More »

When Medicare and Medicaid Regulations Clash, You Lose

By Dialysis Billing, Medical Billing, Nephrology Billing, Nephrology Billing No Comments

January/February 2017, Published in Nephrology Times, From the Field: Competing Medicare and Medicaid Regs: You Lose

By Sarah Tolson, Director of Training, Sceptre Management Solutions, Inc.

Providers are in a no-win situation when Medicare and Medicaid regulations conflict with one another. A perfect example of this is reflected in the sample question below we received from several billers: Question: Medicaid requires us to report the NDC (National Drug Code) for each vial size we use in dosing a patient. For example, if our physician … Read More »

New Bill Cuts Delays in Survey Certifications and Expands Telehealth Options

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September 2017: Nephrology Times,  From the Field: New Bill Cuts Facility Certification Delays and Expands Telehealth Options

Rick Collins, Chief Operating Officer, Sceptre Management Solutions

Ridiculously lengthy delays in getting new dialysis facilities certified might finally be going away. H.R. 3178, sponsored by ten members of the House of Representatives, would allow new facilities to be certified by government-approved agencies other than Medicare. In this age of few agreements between political parties, this bill appears to have great appeal to both parties as … Read More »

Knocked Sensiparless–high deductibles and co-insurances hitting patients and providers hard

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April 2018, Nephrology Times, by Rick Collins Chief Operating Officer Sceptre Management Solutions, Inc.

Patients and providers using Sensipar® (cinacalcet) and Parsabiv™ (etelcalcetide) are experiencing significantly increased financial liability due to inconsistent coverage of the drugs by payers and the dramatic increase in the coinsurance amount assigned by Medicare Part B. The biggest causes of potential lost reimbursement for providers are Medicare … Read More »

Parsabiv and Sensipar

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April 2018, Nephrology News & Issues: Medicare payment for Parsabiv and Sensipar moves to Part B, by Sarah Tolson and Rick Collins

Editor’s note: In January, both Parsabiv and Sensipar moved from the Medicare Part D reimbursement to Part B for patients with end-stage renal disease. We asked Sarah Tolson and Rick Collins at Sceptre Management Solutions to explain how the change impacts dialysis providers and physicians.

Read the full article at: https://www.healio.com/nephrology/kidney-care-community/news/print/nephrology-news-and-issues/%7bbe4a80cc-e798-4d6b-9504-0a8163d77ae0%7d/medicare-payment-for-parsabiv-and-sensipar-moves-to-part-b