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3 Min Read

Don't proceed with eRx and PQRS audits, AMA tells CMS

Following a Centers for Medicare & Medicaid Services announcement of a proposal to conduct audits of physicians and other eligible professionals who received incentive payments under the Medicare Physician Quality Reporting System and ePrescribing programs, the AMA called on the agency to abandon its plans because of numerous implementation problems.

Medicare & Medicaid
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1 Min Read

Model tests comprehensive care physicians and high-risk patients

A new idea being tested at the University of Chicago is targeting high-risk patients with comprehensive care physicians. Physicians are assigned patients identified as being at high risk for hospitalization and follow them through inpatient, outpatient and home care settings

Payment & Delivery Models
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2 Min Read

Multi-hospital systems may now have one integrated medical staff

A multi-hospital system can now have a single integrated medical staff, rather than requiring a separate medical staff at each hospital, under a final rule (AMA login required) issued last week by the Centers for Medicare & Medicaid Services (CMS).

Payment & Delivery Models
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3 Min Read

3 things physicians can do to avoid high virtual credit card fees

If your practice accepts virtual credit card payments from health plans, you may be losing a significant amount of your contractual payments to high interchange fees. Fortunately, there are three steps you can take to make sure you aren’t paying unnecessary charges.

Claims Processing
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2 Min Read

Physicians need cost, outcomes data, not Medicare claims data

It’s been about a month since the Centers for Medicare & Medicaid Services (CMS) released its raw physician Medicare claims data, drawing a great deal of attention from the press and leaving physicians to provide context about the data to patients. 

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Leadership
Leadership Viewpoints
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2 Min Read

Where you need to go for Medicare claims data release assistance

As reporting about the Centers for Medicare & Medicaid Services’ (CMS) recent release of physician Medicare claims data continues to cycle through the media, a new resource page from the AMA offers the essential information you need to know about the data release.

Medicare & Medicaid
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3 Min Read

No more secrets: Insurer claim edits come into the light

Expensive claim denials and unexpected payment adjustments that stem from the hundreds of proprietary claim edits individual health insurers create behind closed doors could become a thing of the past in a few short years, thanks to an initiative underway in Colorado.

Claims Processing
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3 Min Read

What physicians need for practice transformation: Doctors to CMS

Assisting physicians in adopting new models of care and payment that will enhance quality and lower costs is the aim of a recent request for information from the Centers for Medicare & Medicaid Services (CMS).

Payment & Delivery Models
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2 Min Read

Physician groups should register now to avoid PQRS penalty

Physicians who practice in a group can register for the 2014 Physician Quality Reporting System (PQRS) Group Practice Reporting Option (GPRO) now through Sept. 30. Physicians who do not participate in PQRS this year will be hit with a 2 percent payment penalty in 2016. 

Payment & Delivery Models