CPT Billing Codes reimburse for Care Coordination (Medicare)

Let's face it: physicians spend a lot of time coordinating care for their older adult patients, especially when patients leave hospitals or nursing homes. These "transitions of care" are becoming increasingly important opportunities for primary care providers to check medication reconciliation, prevent readmission, and facilitate appropriate follow-up.

Medicare is now accepting newly created Current Procedural Terminology (CPT) codes for care coordination to pay physicians for the management of patients who have recently been discharged from a hospital or skilled nursing facility.

The American Medical Association CPT Editorial Panel created new codes (99495 and 99496) to capture transitional care management services.

Learn more about these CPT codes here.

Mobile Payments: The biggest tech trend of 2011?

Originally published on MobileHealthComputing.com here

Author: Riley Alexander, MD, MBA

2010 saw the rise of Android and the introduction of the iPad, which has made the slate tablet the hottest device in computing (or recreated the sector if you remember the awful tablet PCs of the early 2000's). Despite this, I would still argue the biggest tech trend of 2010 was Groupon and its many clones. With recent valuation estimates placing the company at $15 billion and its largest clone, LivingSocial, selling over 1 million Amazon gift cards in one day, the daily deal/group coupon has changed the way consumers engage with business. 2011 may offer something of the same--mobile payments.

As of now, there are actually several ways to use your phone to make payments, but they all go about doing this in different ways. I'll try and cover some of the bigger ones, but I'm sure to leave out a few.

Card readers:

The simplest solution to paying with your phone is simply hooking up a card reader to your phone. There are several options for this...I was even surprised how many there are out there when I did a Google Shopping search for "iPhone credit card readers." The biggest player in this market is Square. Square is the brainchild of Jack Dorsey, who created a little website called Twitter. Square requires the use of a free card reader that plugs in to the headphone jack of your smartphone or iPad. The app and reader are free for the user. It is targeted at both the business user and personal user. The big drawback for personal use is, of course, that you have to have this square card reader sticking out of your phone or on you to use it.

Credit Card Processing Tips for Doctors

This is a guest post by Stella Fayman from FeeFighters.

Credit Card Processing Tips for Doctors

Doctors have enough going on in their busy schedules without having to worry about getting ripped off by a credit card processor. That’s why many doctors sign up with the first credit card processing salesperson to swing by their office. However, this means that they are most likely paying more (sometimes significantly more!) than they should be. Luckily, doctors can stand to have major savings just by reexamining their credit card processing terms. Here’s what to look for:

1) Never allow cancellation fees- Make sure to read the fine print on the credit card processing contract--it may sometimes hide a cancellation fee of at least $250 to several thousand dollars. This fee is a way of guaranteeing loyalty to the processor, regardless of customer satisfaction. The good news is that getting rid of this fee should not be a problem: most salespeople have the authority to waive it. To avoid this issue, talk to the salesperson and make sure the fee is waived in writing either in the contract or as an amendment. As a startup, making sure to have the no cancellation fee clause is a great hedge in case anything goes wrong.

2) Only interchange plus pricing- The bulk of credit card processing fees go to Visa and Mastercard—these are called “interchange” and are set in stone. “Interchange-plus pricing” is the fairest form of pricing, and is comprised of interchange plus a constant processor markup (the fees processors charge for their services). With interchange plus pricing, there is never a question of how much the processor will charge per transaction since those costs are fixed. Having this structure ensures there are no tricky fees or hidden costs, unlike tiered pricing structures.

Medical credit cards or medical debt?

More consumers are charging their medical bills on their credit cards. Good idea or bad? According to CNN/Money.com,

Consumer advocates warn that this is a dangerous trend, but industry watchers see a multi-billion dollar opportunity for lenders to offer specialized "medical" credit cards..."Now with high unemployment, consumers have to reach into their pockets even more to fund their health care."

Read the CNN story here. We spend $294 billion on annual out-of-pocket medical costs. McKinsey Consulting expects that $150 billion worth of health care expenses will go on credit cards by 2015. As more moderate-to-low income consumers pay their bills with plastic, they may dig themselves deeper into debt during this economic recession. Then what? Hopefully more medical providers will be willing to provide economic-hardship discounts to patients who are truly in financially in need. Clinics offering free medical services may get bombarded and they may need additional volunteers and other helpers. If you're a medical professional, are you willing to volunteer and/or offer discounts for your healthcare services?

Things are getting ugly between Sermo and the AMA

Wow, things are starting to get quite nasty here. The marriage has turned into an ugly divorce. When Sermo announced its partnership with the AMA, I was optimistic. However, they have had an ugly split recently and they're now at war.

I just got an e-mail from Sermo's founder Dr. Daniel Palestrant. The subject line reads: "From the Founder: CPT - Why physicians always get screwed, thanks AMA"

He highlights the results of a recent survey that included over 4,000 US physicians and it generated over 700 comments on Sermo. The results are quite striking:

• 75% of physicians surveyed are not members of the AMA.
• 89% of physicians claim, "The AMA does not speak for me."
• 91% of physicians surveyed do not believe the AMA accurately reflects their opinion as physicians.

Now, the focus on Sermo is shifting towards Current Procedure Terminology (CPT) coding. Here's some background on CPT codes:

For most physicians, Current Procedure Terminology or CPT codes have become a defining aspect of how we must practice medicine. They have become the "currency" of healthcare, mandating all manner of payments to physicians from the most complex surgical procedures to routine office visits. In the process, the CPT coding system has turned into an incredibly complex system of codes, modifiers, and exceptions. Add to that the RVU formulas, and it is no wonder that most physicians are drowning in paperwork.

So, now it's time to consider some questions related to CPT codes:

• Who publishes these CPT codes?
  
• Is it right that the AMA makes more money from selling licensing for CPT codes than it does from membership dues?
  
• Should our government continue to support the AMA’s monopoly on CPT codes?
• Who should manage CPT codes?

If you're a U.S. physician, have you joined Sermo? Are you a member of the AMA?