4 Important Things That Affect Doctors This April Fool’s Day. No Joke.

Health Insurance Companies Process 1 in 5 Claims Wrong

Medicare Increases Physician Reimbursements by 109% Today!

ICD-10 and Medicare Cuts DelayJust kidding…April Fools.

No, the government did not increase doctors’ reimbursements today. But this April Fool’s Day, 2014, does bring a lot of changes that affect physicians’ offices immediately.

These changes include:

  1. The 24% Medicare cut will not go into effect April 1
  2. ICD-10 has been postponed to October 1, 2015.
  3. The newly refined CMS-1500 paper claim forms (aka HCFAs) must be used in order to get paid by Medicare and commercial payers
  4. CMS is holding Medicare claims for the next 10 days starting April 1, 2014

24% Medicare Cut

Congress voted on delaying a 24% cut in Medicare reimbursements until April 1, 2015. Great news for physicians, medical offices and other health care facilities around the country, but come next April we’ll be in the same boat again, with substantial Medicare cuts looming in our not so distant future.

ICD-10 Delay

As for ICD-10, that has been delayed until October 1, 2015, pushing it back ANOTHER full year. Now, billers, coders, software vendors will all have extra time to get ready for the big change in diagnosis coding that will take effect one day soon.

New CMS-1500 Form

The new CMS 1500 forms dated 2/12, goes in effect today, April 1, 2014. If you do not use one of the new CMS 1500 forms when submitting your paper claims to insurance (if you’re still submitting paper claims to insurance) those paper claims will be returned right back to you. Medicare insurance companies are not accepting the old claims. Might as well just throw those out.

CMS Will Hold Claims

In a notice sent out by CMS at the end of March, CMS said that they will be holding claims for 10 days starting April 1. This is due to the fact that as of 12:01 AM, April 1, President Barack Obama had not signed the bill that came from Congress delaying the 24% cut in Medicare.

CMS did not know which fee schedule to use, either keep the old one or implement the new one into their system. These 10 days allows CMS to update their computer systems as soon as the President signs the bill into law.

So, are you relieved ICD-10 is postponed for another year? I know you’re glad there’s no 24% cut in Medicare. And what about CMS holding your Medicare claims for 10 days?

Leave me your thoughts and comments below. I always love hearing from you.

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