Archive for Headlines

Pharmaceutical Reps and Physicians: The Changes I’ve Seen

Pharmaceutical Reps and Physicians

As a recent announcement by GlaxoSmithKline highlighted – the pharma giant will stop paying doctors to promote its products – the relationship between physicians and pharma reps is a complex and sometimes twisted one. At my first job in healthcare as a receptionist in the 1980s, I remember being puzzled when I was told one of the physicians was being “detailed”. Detailed? What the heck was that?

Detailing the Physician


Posted in: Day-to-Day Operations, Headlines, Leadership

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Using Medical Credit Cards: The Ugly, The Bad and The Good

Credit Card Payment Plans in Your Medical Practice



Physicians have been extending credit to patients almost since the beginning of time. Any time a patient receives healthcare services, has a financial responsibility and does not pay their portion at time of service, they are in essence receiving credit from the physician. Typically, medical practices have extended credit to patients without interest added, and usually on a schedule that patients can handle. Physicians have created payment plans for patients, or allowed them to carry a balance as long as the patient made a payment every month.

Exchanges and employer-sponsored plans carry higher deductibles in 2014.


Posted in: Collections, Billing & Coding, Day-to-Day Operations, Finance, Headlines

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CMS Announces Payment for Eggless Flu Vaccine Flublok (90673)

Eggless Flu Vaccine Flublok is Our Hero!









Flublok, a influenza vaccine manufactured without  live influenza virus or chicken eggs, was approved by the Food and Drug Administration (FDA) in early 2013 for adults ages 18 to 49. Flublok is not only free of egg protein, it has no other ingredients not essential to the vaccine itself including antibiotics, latex, formaldehyde and the mercury preservative thimerosal.

Protein Sciences, the Meriden, Connecticut company that manufactures Flublok, anticipates selling 5 million doses in 2014 and expects to receive additional FDA approval for use in adults ages 50 and older. As reported on, “…the vaccine’s target market includes the more than 600,000 Americans who are allergic to eggs. They also want to target the “Whole Foods” crowd, or people who prefer organic products that don’t contain chemicals or antibiotics.”

Today the Centers for Medicare and Medicaid Services, announced payment for Flublok for dates of service beginning January 1, 2014, although claims will not be processed until April 1, 2014.

The local Medicare contractors will add influenza virus vaccine CPT code 90673 to existing influenza virus vaccine edits and will determine payment rates. Note that the cost of this vaccine is higher than that of other influenza vaccines.

Photo Credit: Nina Matthews Photography via Compfight cc

Posted in: Collections, Billing & Coding, Headlines, Medicare & Reimbursement

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Medicare’s New Single Level of Service for Outpatient Visits

Hospital Outpatient Clinic



You may have heard the news last week that CMS will be collapsing the five levels of service for outpatient visit into a single flat rate.

What you may not have realized, though, is that this news relates only to HOSPITAL outpatient visits, and not to the professional (physician fee) component, but only to the facility (hospital) component. Let’s unpack this announcement and understand exactly what it means.

First, some clarifying terminology:


Posted in: Collections, Billing & Coding, Finance, Headlines, Medicare & Reimbursement, Medicare This Week

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Free HIPAA Webinar Tuesday Discussing Email Encryption, Smartphone Security and Release of Records

Brand New and Fresh at Manage My Practice!


For anyone who tried to register after we were full, or couldn’t attend, there will be a Webinar Replay here: as well as replays on the webinars from previous months and an Action Pack of resources – all free!


Please join us Tuesday, November 12, 2013 for our free monthly HIPAA Webinar. The topics we will be discussing this month are based on the following questions you’ve asked:


Posted in: Compliance, Day-to-Day Operations, Electronic Medical Records, Headlines, HIPAA

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2014 Medicare Parts A, B, C and D Deductibles and Premiums

Medicare Enrollment for Parts A, B, C and D










We are now in the Medicare Enrollment Period (October 15 through December 7) and Medicare-aged patients are making decisions about which type of Medicare coverage they want. See a description of the different types of Medicare coverage here. Currently-enrolled patients should have already received a “Plan Annual Notice of Change” (ANOC) that describes any changes in their coverage, costs, or service area that will be effective in January.


Posted in: Collections, Billing & Coding, Day-to-Day Operations, Finance, Headlines, Medicare & Reimbursement

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Medicare: Original, Replacement, Supplemental and Extra Crispy

There is not a type of Medicare called "Extra Crispy"Okay, so there really isn’t a version of Medicare called “Extra Crispy,” but everything might be clearer if patients only had to choose between Original Medicare and Extra Crispy Medicare. Confusion abounds when talking about Medicare and for good reason – there are lots of parts to it: Medicare A, B, C and D, as well as Medicare supplemental insurance (Medigap.)


Posted in: Day-to-Day Operations, Headlines, Medicare & Reimbursement

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The Five Minute Guide to Answering Obamacare Phone Calls

Starting today, October 1st, 2013 – physician offices and hospitals will probably start fielding calls about the Insurance Exchanges and Obamacare.

The Five Minute Guide to Answering Obamacare Phone CallsOctober 1st is a big day for heathcare reform in the United States because Open Enrollment is beginning in the health insurance marketplaces created by the Affordable Care Act. Today is the first day patients can see what their options are for health insurance on the state exchanges, and purchase insurance if they decide to.


Posted in: Day-to-Day Operations, Headlines

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Flu Vaccine Information for the September 2013 – July 2014 Flu Season

Flu Shots







For your viewing pleasure, we’ve placed this year’s flu vaccine information in a slide format as well as in the post.  We hope you enjoy it!


Posted in: Collections, Billing & Coding, Day-to-Day Operations, Headlines

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Will Your Employer (Or Your Practice) Drop Coverage Under Obamacare?

Obama and Banksy

As someone actively engaged in the conversation around health reform, I get a lot of questions about the Affordable Care Act from clients, readers and relatives. With the approaching open enrollment in state healthcare marketplaces (exchanges), and all the recent news stories about employers paring back benefits in the wake of reform, one of the most popular questions recently has been about the possibility that rising insurance costs and regulations will force companies to reduce or abandon health benefits for employees.


Posted in: Day-to-Day Operations, Finance, Headlines, Human Resources, Leadership

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