{"id":7686,"date":"2020-02-11T11:15:18","date_gmt":"2020-02-11T16:15:18","guid":{"rendered":"https:\/\/systems4pt.com\/staging\/?p=7686"},"modified":"2020-02-28T13:56:57","modified_gmt":"2020-02-28T18:56:57","slug":"four-reasons-why-cash-feels-tighter-than-usual","status":"publish","type":"post","link":"https:\/\/systems4pt.com\/staging\/four-reasons-why-cash-feels-tighter-than-usual\/","title":{"rendered":"Four Reasons Why Cash Feels Tighter Than Usual"},"content":{"rendered":"

Four Reasons Why Cash Feels Tighter Than Usual<\/strong><\/h1>\n

The surprise start to 2020 is beginning to negatively impact cash flow for many practices. Below are four reasons why cash is tightening and three recommendations to address that.<\/p>\n

1. Surprise January 2nd CMS Coding Changes<\/strong><\/h3>\n

Practices are just now noticing lower reimbursements from early January Medicare visits.<\/p>\n

    \n
  • As of 1\/2\/20, Therapeutic Activities, 97530 is no longer paid during an eval visit.<\/li>\n
  • Manual Therapy, 97140, isn\u2019t paid when billed during the evaluation unless the code is properly defended, and the appropriate modifier is added.<\/li>\n<\/ul>\n

    Many practices did not hear about these changes so two of their most widely used CPT codes are not being paid for Medicare evals.<\/p>\n

    Since January 4th<\/sup>, Systems 4PT\u2019s HardStop™ technology has blocked non-payable codes and guided therapists toward full payment for 2020 Medicare evaluations.<\/strong><\/span><\/p>\n

    2. Poor Communication and Widespread Confusion <\/strong><\/h3>\n

    The collective response to the above is \u201cNO! THE CMS REVERSED THIS DECISION!\u201d<\/em> <\/strong><\/p>\n

      \n
    • Yes, on 1\/20\/20, the CMS announced they would reverse the ban on these codes. Because of this, many therapists went back to charging 97530 during eval visits, but NO!<\/strong><\/li>\n<\/ul>\n

      \u201cAnnouncements\u201d don\u2019t make codes payable; the MACS need time to update their computers<\/strong><\/p>\n

        \n
      • On Feb. 7th <\/sup>the APTA announced \u201cIt’s official: Medicare Administrative Contractors for CMS have been notified of the agency’s decision to reverse [the 97530 ban on evals]\u2026\u201d<\/li>\n
      • Again, the words \u201cMACS have been notified\u201d DO NOT SAY that the MACs have updated their computers.<\/li>\n<\/ul>\n

        Because of this, from January 1st through today, <\/strong><\/p>\n

        many practices have been paid dramatically less for their Medicare evaluations.<\/strong><\/p>\n

        Systems4PT HardStop™ technology will allow therapists to charge 97530 on the eval, as soon as the MACS have updated their adjudication.<\/span><\/strong><\/p>\n

        3. Deductible Nightmare<\/strong><\/h3>\n

        For many practices, patient deductibles are more than one-third of January and February revenue.<\/p>\n

          \n
        • Their EMR does not communicate patient deductible balances during intake. When a patient\u2019s deductible balance is $539, that web based EMR shows that patient owes $0.00.<\/li>\n
        • These practices are doing everything right, but because billing is in a separate database from their EMR and scheduling, they\u2019re losing out on more than $10,000 in patient payments that should be collected.<\/li>\n<\/ul>\n

          Systems 4PT integrates scheduling, EMR, and billing into a single database. Front Desk Staff see that $539 is due during patient check in and collects as much of it as possible!<\/strong><\/span><\/p>\n

          4. EMR Error<\/strong><\/h3>\n
            \n
          • Clinicians using another EMR have told us that, as of January 1, their EMR attempted to auto-remove 97530 from their Medicare evaluations. Instead, that EMR erroneously removed the eval code<\/u> instead of removing the 97530. A nightmare for those practice owners!<\/li>\n<\/ul>\n

            Recommended Solutions<\/strong><\/h2>\n

            1. Glance Through Your Medicare ERAs<\/strong><\/h3>\n
              \n
            • Look for visits with an eval code.\n
                \n
              • Are 97140 codes denied because they lack the necessary defense and modifier?<\/li>\n
              • Was 97530 submitted during Medicare eval visits? If so, were they denied?<\/li>\n<\/ul>\n<\/li>\n
              • If you find either scenario:\n
                  \n
                • Audit all 2020 Medicare evaluations.<\/li>\n
                • Wait for news that your MAC has updated their eval coding rules.<\/li>\n
                • Then rebill all mis paid\/unpaid dates of service.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                  2. Look at Patient Self-Pay Balances by Month<\/strong><\/h3>\n
                    \n
                  • Key in on the \u201c30 day\u201d and \u201c60 day\u201d columns.\n
                      \n
                    • If those balances are high, something is wrong.<\/li>\n<\/ul>\n<\/li>\n
                    • If 30-day self pay balances are rising, re-address your deductible collection protocols.\n
                        \n
                      • If billing isn\u2019t integrated, your staff may need to calculate balance\u2019s due manually.<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n

                        3. Upgrade to a Trustworthy EMR<\/strong><\/h3>\n
                          \n
                        • For 18 years Systems 4PT has delivered the fastest compliance response times and the highest first pass claim acceptance rate in outpatient rehab.<\/li>\n<\/ul>\n

                          Systems 4PT enables you to focus on using your expertise to restore your patients <\/strong><\/span><\/h3>\n

                          to their full potential!<\/strong><\/span><\/h3>\n

                          Ask about our Stress-Free Installation™<\/strong><\/h2>\n

                          Treat More, Type Less™<\/span><\/strong><\/h2>\n<\/div>[contact-form-7 id=\"5393\" title=\"Free Demo_copy\"][fusion_blog layout=”grid” blog_grid_columns=”” blog_grid_column_spacing=”” blog_masonry_grid_ratio=”” blog_masonry_width_double=”” equal_heights=”yes” number_posts=”3″ offset=”0″ pull_by=”category” cat_slug=”” exclude_cats=”” tag_slug=”” exclude_tags=”” orderby=”date” order=”DESC” thumbnail=”yes” title=”yes” title_link=”yes” content_alignment=”” excerpt=”” excerpt_length=”10″ strip_html=”yes” meta_all=”no” meta_author=”yes” meta_categories=”yes” meta_comments=”yes” meta_date=”yes” meta_link=”yes” meta_tags=”yes” scrolling=”pagination” grid_box_color=”” grid_element_color=”” grid_separator_style_type=”” grid_separator_color=”” padding_top=”” padding_right=”” padding_bottom=”” padding_left=”” hide_on_mobile=”small-visibility,medium-visibility,large-visibility” class=”” id=”” \/]<\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"","protected":false},"author":1,"featured_media":7687,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"content-type":"","footnotes":""},"categories":[1],"tags":[50],"class_list":["post-7686","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized","tag-billing"],"yoast_head":"\nFour Reasons Why Cash Feels Tighter Than Usual - 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