Newsletter #10September 2013
In This Issue
Practices Get Help From SMB
ICD-10 Transition
Employee Spotlight
PECOS & NPPES
Quick Links

Dear SMB Client,

 

As temperatures cool down and football games start up, we wanted to keep you informed on some hot topics in podiatry medical billing.  In this newsletter we will discuss the upcoming ICD-10 transition and the importance of providing correct information to Provider, Enrollment, Chain & Ownership System (PECOS) and National Plan & Provider Enumeration System (NPPES).  In addition, we are spotlighting one of our employee's MaryKay Jones.   

 

We hope you enjoy reading our newsletter.

 

Sincerely, 

SMB 

Chad
Chad Bixler, Business Development
Many More Practices Get Help From SMB

SMB would like to welcome all of our new clients. 

 

Over this summer, demand for SMB's services has increased. More podiatry practices are learning about the benefits of working with SMB:

    

1) Maximizing Reimbursements

2) Free EHR & PM Tools

3) Reducing Workload

4) Lowering Accounts Receivables

 

Each new client helps SMB better serve you, our existing client.  Some of the ways that it helps are: 1. more cash flow to support the EHR & PM tools and 2. with more practices comes more clout when SMB pursues your claims with insurance payors-to name a couple.

 

Thank you to our new and old SMB clients. We truly value every practice
ICD-10 Transition: October 1, 2014

Starting October 1, 2014, ICD-10 will be a requirement for all podiatry practices. Although it seems far away, a lot of detailed work needs to be done to ensure a smooth and successful transition to the updated codes. Due to the magnitude of the transition, Centers for Medicare & Medicaid Services (CMS) recommends that you reach out to your billing service now to iron out any potential difficulties. In fact, CMS advises that you should consider enlisting them to help you with your transition. SMB is here to help and we are prepared and equipped to handle the conversion.

 

Currently, SMB is taking steps to ensure the transition on the billing end goes as smoothly as possible.  We are prepared to meet the ICD-10 deadline of October 1, 2014. We are setup to do the beta testing with Gateway, Medicare, and Blue Cross, among other insurance agencies. Moreover, there will be no pricing changes to your bill due to the ICD-10 transition.

 

SMB will be prepared but we will need your help. It is up to each practice to be able to document and code their exams and findings correctly.  There are many references available to help in the transition and education of the new ICD-10 codes.  Please click here, here and here to learn more. 

 

Please note, CMS will not conduct end-to-end external testing with physician practices.  As a result, this could slow the process of claims being paid.

 

SMB suggests you take a proactive approach to the upcoming changes and contact the insurance companies you are signed with to find out if they will indeed be switching over to ICD-10.  There will be some vendors (possibly workman's comp and others) that will not switch; therefore you'll have to dual submit.

 

In addition, you should also contact your vendors to ensure your contracts with them are up-to-date and renegotiate anything they might be changing. Moreover, you will have to think about the referrals needing revised, new forms, authorizations, extra documentation, etc.

 

SMB is committed to making ICD-10 go as smoothly as Version 5010. Together, as a team, we will transition to the new set of codes. If you have any questions, please feel free to contact Tammy Coetezee at t_coetezee@smbmedicalbilling.com.
Employee Spotlight: MaryKay Jones
MaryKay Jones, EDI Enrollment Specialist/New Accounts
 
ABOUT MY FAMILY AND I
  
I have been married for 28 years to my high school sweetheart. We grew up six blocks from each other in the Northeast Kansas City area. We currently live in Lee's Summit, Missouri where we raised our three amazing boys, 25, 22 and 15. Having two adult children certainly proves the statement " time flies when you are having fun!" The 15 year old is involved in sports which keeps us young and on our toes, especially since he is also going through the "permit driver" age!

I have been with SMB for 7 years. I started as a biller and also worked in Customer Service Department for about one year. When I was offered a new position to coordinate the new account set up, I knew it was exactly what I wanted to do.
 
FUN(NY) FACTS
 
* I LOVE football! I am a Chiefs fan at heart, but also love the Steelers!
* I volunteer/teach a 2nd grade Sacrament class at my Church. 2nd graders keep it real!
* I enjoy watching golf! I know it sounds boring, but I have to watch something until Football Season!
  
MY GOALS TO HELP YOUR PRACTICE
1) Assist you with any start-up questions you have. My goal is to assure you that you made the right choice with SMB from the beginning! 
2) I would like to set up as many remits (that are available) to be received electronically which will decrease the paper EOBs you receive in your office. I am also available to assist you with PECOS updates and credentialing advice.  
doc nurse computer The Importance of Correct Information: PECOS & NPPES

 

 

Facts about Provider Enrollment, Chain and Ownership System (PECOS) and National Plan and Provider Enumeration System (NPPES)

 

In May, it was reported by the Department of Health and Human Services Office of Inspector General that an estimated 58% of enrollment records in PECOS were inaccurate and 48% of records in NPPES had errors.   Even more alarming, most of the records were inconsistent between the two systems for health professionals containing mismatched information for 2010.  As a result, the enrollment sweep has led to 10,041 physician billing privileges being revoked and 83,188 being deactivated.  A felony record or noncompliance with Center for Medicare & Medicaid (CMS) rules can lead to revocation.  Currently, work is under way to fix NPPES and CMS has led an effort to fix PECOS.  Most importantly, SMB has an in house staff member, MaryKay Jones, who oversees all of SMB's clients to ensure correct enrollment in PECOS and NPPES.

 

What is going wrong?

 

Simply put, the errors could be the result of a clerical mistake either by the practices or the contractors. In NPPES, about a third of the records had the wrong mailing addresses and about a third had the wrong practice addresses.The mailing addresses were incorrect in nearly half of PECOS records.In addition, physicians have not been told the importance of keeping their records updated or the possibility of being revoked. For example, a podiatrist could have a fellowship in one state and enroll through the fellowship.  If they decided to move out of state to accept another position and forget to deactivate enrollment in the fellowship state, the podiatrist will be revoked.

 

How SMB Can Help!

 

When you sign up with SMB, MaryKay checks your PECOS and NPPES enrollment data to ensure the information is correct.  If we find incorrect information, we notify our podiatrists and walk them through on how to correct their records.

  

Useful Tools                                                                                        

 

You can review, update and correct your Medicare enrollment records by checking the online PECCOS.

  • Go to the PECOS website and enter login information (link).
  • Click the "My Enrollments" button under the Manage Medicare and Account Information section.
  • Select "view Enrollments" under the Existing Associates section.  Each enrollment record shows the physician's specialt type, state and current status.