Creating Fluency in the Language of Prevention!
Creating Fluency in the Language of Prevention!

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Stay current on all the news that matters to you with our blog: MRA Alerts and Updates

Is your practice looking for ways to increase revenue while protecting vulnerable patients? If so, mHealth Games can help! We build custom e-visits, virtual check-ins, online assessments and patient education that can be launched from your patient portal. In need of a patient portal? We can help with that too! Our patient portals start at $2,500 and can be completed in 7-10 days. Recent projects include: COVID-19 – Real-time monitoring of symptoms with personalized instructions Heart Failure – Monitor daily weight and BP to prevent exacerbations Diabetes – Patient management and education COPD – Patient management and education Major Depression – Online assessment and daily check-in Substance Use Disorder – Patient management and education Dermatology – Assessment of patient submitted images of skin rashes and other lesions E-Visits In all types of locations including the patient’s home, and in all areas (not just rural), established Medicare patients may have non-face-to-face patient-initiated communications with their doctors without going to the doctor’s office by using online patient portals. These services can only be reported when the billing practice has an established relationship with the patient. For these E-Visits, the patient must generate the initial inquiry and communications can occur over a 7-day period. The services may be billed using CPT codes 99421-99423 and HCPCS codes G2061-G2063, as applicable. The patient must verbally consent to receive virtual check-in services. The Medicare coinsurance and deductible would apply to these services. Medicare Part B also pays for E-visits or patient-initiated online evaluation and management conducted via a patient portal. Practitioners who may independently bill Medicare for evaluation and management visits (for instance, physicians and nurse practitioners) can bill the following codes: 99421: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 5–10 minutes 99422: Online digital evaluation and management service, for an established patient, for up to 7 days cumulative time during the 7 days; 11– 20 minutes 99423: Online digital evaluation and management service, for an established patient, for up to 7 days, cumulative time during the 7 days; 21 or more minutes. Clinicians who may not independently bill for evaluation and management visits (for example – physical therapists, occupational therapists, speech language pathologists, clinical psychologists) can also provide these e-visits and bill the following codes: G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes  G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes. VIRTUAL CHECK-INS Medicare pays for these “virtual check-ins” (or Brief communication technology-based service) for patients to communicate with their doctors and avoid unnecessary trips to the doctor’s office. These virtual check-ins are for patients with an established (or existing) relationship with a physician or certain practitioners where the communication is not related to a medical visit within the previous 7 days and does not lead to a medical visit within the next 24 hours (or soonest appointment available). The patient must verbally consent to receive virtual check-in services. The Medicare coinsurance and deductible would generally apply to these services. Doctors and certain practitioners may bill for these virtual check in services furnished through several communication technology modalities, such as telephone (HCPCS code G2012). The practitioner may respond to the patient’s concern by telephone, audio/video, secure text messaging, email, or use of a patient portal.  Standard Part B cost sharing applies to both. In addition, separate from these virtual check-in services, captured video or images can be sent to a physician (HCPCS code G2010). HCPCS code G2012: Brief communication technology-based service, e.g. virtual check-in, by a physician or other qualified health care professional who can report evaluation and management services, provided to an established patient, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment; 5-10 minutes of medical discussion. HCPCS code G2010: Remote evaluation of recorded video and/or images submitted by an established patient (e.g., store and forward), including interpretation with follow-up with the patient within 24 business hours, not originating from a related e/m service provided within the previous 7 days nor leading to an e/m service or procedure within the next 24 hours or soonest available appointment. RHCs and FQHCs RHCs and FQHCs may bill G0071, payment for communication technology-based services for 5 minutes or more of a virtual (non-face-to-face) communication between an RHC or FQHC practitioner and RHC or FQHC patient, or 5 minutes or more of remote evaluation of recorded video and/or image by an RHC or FQHC practitioner, occurring in lieu of an office visit; (RHC or FQHC only). G0071 will be paid at $24.76 beginning March 1, an increase from the prior rate of $13.53. RHCs and FQHCs may also bill the “messaging” codes 99421–99423, on-line digital services. MACs will automatically reprocess claims with G0071 for claims processed after March 1. The new rate is a blended rate, based on the payment rates of 99421—99423, and the two HCPCS codes for virtual communication, G2012 and G2010. Download the MLN Matters article SE 20016. Visit mHealth Games today or contact Kameron Gifford to learn more. 
25.04.2020
MRA Alerts and Updates
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Are you looking for the best education available in risk adjustment, value-based payments and/or CDI? Good News - You have found it! Join us for a day of risk adjustment, catch up with colleagues over lunch, and get the best tools in the industry for FREE! Do you need CMEs or CEUs? We have that too! All Workshops are approved by the American Medical Association, American Academy of Family Practice and the American Academy of Professional Coders. Register your team ( 3 or more) today to save 10% on any 2020 Workshop! Take advantage of Early Bird pricing and Save $100! Overview: Vast changes are coming to the way we purchase healthcare. What should your team be doing now to be successful in the world of value-based payments?  How do HCCs impact benchmarks and quality scores? Review CMS-HCC Model V24 for risk adjustment in 2020 and NEW HCCs that have been added to the model.  Discuss the importance of managing HCCs year over year. What resources are available from CMS to help?  Take a deep dive into the 20 most common HCCs per Medpac data.  Common GAPS in claims and encounter data that lead to inaccurate risk scores.  Download the Agenda Here Who Should Attend? -Providers - MDs, DOs, PAs, and NPs -Medical Directors - Medicare Advantage, ACOs, CPC+ and Medicaid -Hospitals and Academic Medical Centers -Medical Coders, Billers and CDI Specialists -Executive Leaders, Administrators, Directors and Managers -MSO and IPA Teams -Rural Health Centers, FQHCs and Community Health Centers -Health Alliance Members and Medical Society Members -Medicare, Medicare Advantage, Medicaid and Commercial Plans    Each Attendee will Receive ($130):  - Color copy of the presentation  - 2020 CMS-HCC Quick Coder  - Laminated HCC and CDI Tools  - CME from AAFP and AMA  - CEU from AAPC To REGISTER for a WORKSHOP  - Click here to register for Orlando on 10/22/2020  - Click here to register for Ft. Lauderdale on 10/28/2020 To SPONSOR an EVENT Please email Kameron Gifford Early Bird Pricing and Group Discounts Register NOW to save $100 with Early Bird Pricing! Bring the WHOLE TEAM!  Register 3 and save 10% on your order!  Register 4 and use the code TEAM4 to save 20% on your order!
22.04.2020
MRA Alerts and Updates
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CMS has broadened access to Medicare telehealth services on a temporary and emergency basis due to the Coronavirus. What does this mean for your practice? Which services are covered? What are the documentation and coding rules? Sections:  Medicare Virtual Visits Review Medicare Virtual Visit Quiz Course Objectives: Review the following Expansion of telehealth services due to the COVID-19 health emergency.  Three basic types of virtual visits covered under the waiver.  Which patients are eligible for the services? Specific types of communication allowed. Does cost sharing apply?  What is the correct POS? Which modifier should be assigned? Master coding for Medicare Virtual Services! Register for a free account at ERM365 On-Demand COVID-19 Telehealth Billing for Medicare Advantage Plans. 

 

 

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