Dosimetry is Back! CMS to delete 77295/77300 NCCI Edit

Some hard work by ASTRO and ACR, along with the American Association of Physicists in Medicine( AAPM), has paid off as CMS  has agreed to delete the NCCI Edit which ruled that Basic Dosimetry Calculations ,77300, was bundled with 3D Plan 77295.  

The correction will become official on July 1st 2016 and will be retroactive to January 1st 2016. UHN will continue to track all dosimetry calculations which would have been affected by the previous bundling and submit the retroactive charges upon official release of the NCCI Edits on July 1st.

Radiation Oncology Pay Freeze

On December 28th President Obama signed the Patient Access and Medicare Protection Act. The big headline grabber from this law has been the Meaningful Use Hardship Legislation, which expands eligibility for hardship exemptions for Stage 2.

Bigger news for Freestanding Radiation Oncology Centers is found when digging a little deeper into bill S.2425: Payment for treatment delivery and image guidance codes in 2017 and 2018 will remain at the same levels set for 2016.  

This law removes the looming threat of removing the vault as a direct expense when calculating reimbursement, as well as increases in equipment utilization rates, which would have lead to major reductions in payment.  Radiation Oncologist can rest easy knowing that reimbursement will remain steady, at least for a few years.  The Bill also sets 2019 as the target for a transition to an episodic alternative payment model.

Medical Billing Questions to Ask - Radiation Oncology

Are you asking yourself the right questions?

Revenue cycle management can be a cumbersome component of running your practice and managers often become so comfortable with current protocols that they don’t recognize how industry changes are impacting their business.  Once it becomes apparent that something needs to be done to improve collections, where do you start? The questions and concerns can become overwhelming, but the worst thing you can do is avoid change and remain at a standstill. How are practices supposed to know what questions to ask themselves and the companies they are considering outsourcing to?

We sat down with Universal Health Network’s (UHN) CEO Peter Wall last week at ASTRO 2014 in San Francisco and discussed the questions he advises potential new clients to ask themselves.

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• With extensive coding changes on the horizon, who is going to train your staff?
• How much will that training cost you?
• How much time will that training take up?
• Who is acting on your behalf with local representatives to fight increased reimbursement cuts proposed by CMS?
• How will you make up for the revenue lost with these inevitable cuts?
• How do you measure and improve the efficiency of your revenue cycle management process?
• Can your billing protocols be simplified?
• How much money each month could you be losing due to ineffective processes?
• If you decide to outsource, how will the cash flow transition work?
• Do you have anyone fostering relationships with payers across the board? Ex: Insurance Providers, Medicare, Medicaid etc.
• Can you provide cost estimates for all kinds of payers if a patient requests it?
• What is your biggest fear regarding outsourcing your billing?  Is it fear of the unknown, fear of losing control or fear of wasted revenue?

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Coding changes and reimbursement cuts account for just the first round of adjustments radiation oncology practices and organizations will need to make in order to remain successful.  The team at UHN has been working to stay ahead of the curve in regards to industry changes, urging practices to see that they can do better. 

Wall commented saying, “We tell our clients, don’t settle for your current income. Don’t you want to be making more? You could be collecting up to $10,000 more each month, we want to help make that happen.”

UHN’s goal is to be a resource powerhouse for radiation oncology practices, giving them the tools to increase revenue and improve their processes. To discuss the customized answers to the aforementioned questions that UHN can provide to your practice, simply fill out the form below.