Are You Prepared For The Medicare Audits?

Medical Billing–most of which revolve around dollars and cents.

As many of you recall, HPSA was replaced in name, although the money continued to flow, and was increased for certain specialties including PA and NP extenders. Now, in addition to the old HPSA cash there is a flow of quarterly cash for these specialties. This program is called Primary Care Incentive Payment Program (PCIP) and is Section 5501(a) of the Patient Protection and Affordable Care Act (the ACA). That in and of itself is a bit of a snicker because they are now going to pay more money due to the word Affordable Care Act from a program that already has a projected unfunded liability of some $47 Trillion dollars. You read it right that first letter is a “T”–$47 Trillion dollars in liabilities that Medicare already knows it has to pay and does not have the funds to meet.

This is just the first step in the salvo that is to follow. They are also going to pay out additional incentives to physicians who use EMR/EHR and/or eprescribe. Additional money from a fixed source. Does anybody see a problem here. Not only is there a stipend for using these systems, but you can also apply for additional money ($60,000.00 from Medicaid or $48,000.00 from Medicare) for simply purchasing the right software. These figures are not per practice, they are per physician. Assume you have a five physician practice that qualifies for the Medicaid purchase bonus–they will receive $300,000.00. A lot of money from a system that is broke.

You can understand why Medicare is pushing the systems. They stand to generate millions if not billions of dollars from the automatic audits they will now be able to do on those practices utilizing EMR/EHR. You see they can now enter your systems and audit your records without your knowledge or consent. The first round has already begun and not one practice was spared punitive monetary fines–repeat, not one practice escaped without paying a hefty penalty. The smallest was $25,000.00 per physician in the practice and the largest to date was $75,000.00 per physician in the practice. Medical billing dollars and cents.00 per physician practice, that was $225,000.00–five physicians as in the Medicare example above and you get the picture–$375,000.00. Have you got a picture in your head?

Our Medical Billing system can spare you the loss and in the same time increase your net revenues by at least 30%. You cannot do it alone! The technical support alone will cost you more than we charge to handle your account. Unless you have skilled technical support 24/7 you simply are not covered and will ultimately pay the price.

More tomorrow…