3405 Kenyon St., Ste. 300
San Diego, CA 92110 Tel: (619) 757-2200
Fax: (619) 757-2230 |
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Services: |
Medical Billing and Collections
Coding / Compliance Programs, Medical Chart Reviews
Billing / EMR System Sales and Support
Contracting and Credentialing (Payers/IPA's)
Medical Office Staff Education and Training
Contract Review, Fee Schedule Analysis
New Practice Setup
Bookkeeping Services |
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Our Mission
To optimize financial performance by combining personal integrity, innovative technology, and practical experience for the benefit of our valued physician clients. |
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CMS Eliminates Payment for Consults |
| Beginning in 2010, Medicare will no longer reimburse physicians for office consultations (99241-99245) or inpatient consultations (99251-99255). Providers are advised to use the corresponding office visit or hospital follow up visit codes in place of the consult codes for Medicare patients only.
At the moment, only Medicare has discontinued payment for consultations - it remains unclear if private payers will follow suit or not. The inpatient and outpatient consult codes still appear in the 2010 CPT manual published by the AMA.
We recommend that all clients update their office superbills and hospital charge forms to reflect that consult codes may only be used for "non-Medicare" patients. |
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Blue Cross Adopts CMS SoS Policy |
| Effective January 1, 2010, Anthem Blue Cross will implement a Site of Service (SoS) Rate Differential in its Prudent Buyer Plan fee schedule. This is the same methodology currently used by CMS to adjust Medicare reimbursement based on the setting where services are rendered.
Anthem states that their fee schedule will allow "higher rates for certain services when they are performed in an office setting and lower rates when they are performed in a facility setting." They say the purpose of this change is to "recognize the different costs to physicians in performing these services in different settings."
Our experience with the comparable Medicare SoS policy is that services performed in a facility often reimburse about one-third less than the same service would if performed in the physician's office. If you currently perform any procedure in both settings, please contact PDS for the corresponding Medicare facility and non-facility reimbursement rates. |
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PDS Reunites with Aviacode |
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PDS is pleased to announce our return to Aviacode for our external coding support. We've long believed that industry experts like Aviacode provide objectivity and expertise that perfectly compliment our internal coding capabilities.
Aviacode is the leading provider of medical coding services to physician practices across every medical specialty. All coding is validated using their "Coding Analyzer & Rules Engine" (CARE™), which checks coding against all national and local coding rules as well as specific organizational coding policies and guidelines. Coding is reviewed again as charts are sampled on an ongoing basis by their QA department to verify individual coder performance and overall quality. Coding results are returned within 24-48 hours and accessible online via their web-based reporting system.
PDS recognizes the value that an independent third party brings to the coding process. We also understand the potential conflict of interest issues that can arise when a billing company also performs procedural coding for its clients. As a result, we've chosen to partner with an industry expert like Aviacode that shares our commitment to high quality and exceptional accuracy in all aspects of medical billing and coding. |
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'Tis the Season for Deductibles |
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As the New Year approaches, we'd like to take this opportunity to remind our clients that practice collections are always lower at the beginning of the year when patient deductibles must once again be met. Remind your front desk staff to collect a payment of $50 from those patients that don't have a fixed co-payment for office visits. This will help to maintain your cash flow while the insurance claims are processed and the patients are billed for the remaining amounts they will likely owe. |
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Dear Valued Client,
We hope you'll find this electronic newsletter to be informative, quick, and convenient. If you do, please feel free to share it with a friend or colleague by clicking on the Forward email link below.
Got a question, concern, compliment, or criticism you'd like to share? We want to hear from you! Please call Chris at (619) 757-2200 or send an email to feedback@pdsmedical.com to share your thoughts and suggestions. Thank you!
Chris Burns, President
(619) 757-2200 x102 |
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