Posts

Verden Group, Telephone Codes, Harvard Pilgrim

I was paging through my daily Verden Alerts and I noticed that Harvard Pilgrim had released a new set of payment policies regarding E&M codes.  In fact, you can read it here on their WWW site, Verden just makes this a lot easier.  I suspect that most of you are like me and wouldn’t normally …

Followup On Fee-For-Appeal

I have tried to get a little more information about the new appeals process being put into place by the signatories to the Love Settlement (you can read details here) but I am still not clear on a few things.  I am told by someone who is heavily involved in this process in NC that …

“Happy” Thanksgiving – Feel The Pinch

Recently, Susanne Madden predicted that the payers were going to start making “administrative” changes in the face of the economic downturn.  Well, if these two examples from the last 24 hours are any indication, we’re in for a rough ride. First, BCBS of NC and LA (and perhaps many more) institute a little change.  You …

The Cost of Healthcare

There’s a nice, generic blog title for ya. It all began with a 1/2-innocent post on PedTalk about this entry regarding a RWJF report entitled “High and rising health care costs: Demystifying U.S. health care spending” over at the Health Populi blog.  What a surprise – rising malpractice rates aren’t one of the primary reasons …

Fear And Loathing in Columbus, OH (UHC, Humana)

I am in lovely Columbus, OH, about to meet Dr. Lander, Donelle Holle, and some clients for dinner as we prepare for our pediatric coding and practice management event tomorrow morning.  We obviously won’t have the crowds we get in Washington or NYC, but it will be a pretty full room still!  If you are …

The Worst Insurance / Fewer Primary Care Docs / PedTalk Cited!

All external references today, folks. I had two people send this to me, but I’ll give Susanne credit 🙂 It’s an paper from the American Association for Justice entitled “The Ten Worst Insurance Companies In America“. You can find the article here (I couldn’t find it on their site). A “fun” read. Here’s an AP …

Most Common Pediatric Codes

I am doing some research into the most common pediatric codes in order to set up a spread/worksheet for use during an insurane negotiation.  Lots of “consultants” routinely make the mistake of suggesting that you look at your top 10 or, more daringly, top 20 or 30 codes when comparing reimbursement between two plans. That’s …

Vision Screening Waiver

In my final installment from Bonnie regarding screening payment challenges, here is a sample Vision Screening Waiver used in a Real Live Pediatric Practice with success. We have already reviewed an Audiogram Appeal Letter and a Typanometry Appeal Letter. Here is the document you can use to pre-empt all the trouble. As before, the text …

Typanometry (92567) Appeal Letter

As promised earlier, here is an excellent version of an appeal letter for bundling of the 92567 CPT code (Typanometry). I will include the text of this one below, as well as PDF, OpenOffice, and M$ Word versions. Thanks, Bonnie! Great stuff! Your Practice Name Address City, State ZIP Phone July 1, 2008 APPEAL LETTER …

Primary Care Audio Conference Series

As I work on my great content for tomorrow, I just realized that I haven’t blogged about the upcoming Primary Care Audio Conference Series sponsored by Physicians Alliance and produced by PCC. You can read about the entire thing (including full course descriptions and bios) on our WWW site, or peruse below. I am excited, …