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August 2021

Medical practices and rural hospitals nationwide can’t seem to catch a break. Just as soon as things started to calm down (relatively speaking), cases of the Delta Variant began to increase. Breakthrough infections continue to be a challenge as well. Providers are doing their best to keep patients safe while also navigating continually-changing coding and reimbursement guidelines. This month, we’ve compiled four news stories to help providers stay abreast of industry changes. As we head into the fall, what are your concerns, and how can Physician Practice Resources help? Email us at info@ppr-corp.com. Most importantly, stay safe out there.

COVID-19 continues to strain primary care practices. Is your practice one of them?

Pandemic-related stress may be decreasing, but not for primary care practices. Twenty-four percent of these practices say pandemic-related stress is at ‘severe’ or ‘near severe’ levels, according to a recent study published by the Patient Centered Primary Care Collaborative. Thirty-eight percent continue to face structural obstacles, such as an inability to staff positions and address fluctuations in patient volumes. Four in 10 clinicians worry that primary care will be gone in five years while one fifth expect to leave the profession within the next three years.

What is your practice doing to change the current reality? Are you focusing on revenue integrity to protect reimbursement and enhance cashflow? Are you taking steps to move toward value-based payment contracts with payers? Are you embracing healthcare consumerism and digital transformation to enhance patient attraction and retention? Do you prioritize staff well-being? These are just a few of the critical questions practice managers must ask.

There are two new HCPCS codes for third doses of COVID-19 vaccines. Are you ‘in the know?’

Effective August 12, 2021, coders can report two new HCPCS codes to denote third doses of the COVID-19 vaccine. Report 0013A for Moderna and 0003A for Pfizer. Both of these codes have a national payment allowance of $40. These third dose ‘booster shots’ are currently available for moderately or severely immunocompromised individuals.

The struggle for rural hospitals during COVID-19 is real. Is there any end in sight?

Imagine driving by your local hospital only to find a huge sign stating, ‘hospital closed.’ That’s exactly what happened for people driving by Patterson Hospital in rural Georgia. Although many rural hospitals nationwide have survived COVID-19, many have not, and it’s devastating to the communities they serve. In fact, 17 rural hospitals closed during the first three quarters of 2020. Of the 20 total rural hospitals that closed in 2020, 13 were in the South, according to data from the Sheps Center at the University of North Carolina at Chapel Hill. The Sheps Center defines a closed hospital as one that no longer offers inpatient services. If there was ever a time when revenue integrity matters most, it’s now. Accurate and complete coding is paramount as rural hospitals continue to navigate financial uncertainties.

Telehealth isn’t going anywhere. Is your practice prepared?

More than 90% of patients said they were satisfied with their telehealth visit and were likely to use telehealth again in the future, according to a recent study published by the Bipartisan Policy Center. What is your practice’s strategy to embrace telehealth in the long-run? For example, what are you doing to stay abreast of ever-changing telehealth guidelines, laws, licensing requirements, and waivers? As of July 28, 17 states and the District of Columbia still had some type of telehealth waiver in place. Be sure to check out these resources: The Federation of State Medical Boards that publishes a state-specific summary of telemedicine laws for 2021 as well as the Center for Connected Health Policy that provides a state by state comparison for 2021 telehealth laws. Finally, the Centers for Medicare & Medicaid Services (CMS) published a telehealth toolkit that includes federal and state policies, including coding and documentation tips to ensure revenue integrity.

About us

Physician Practice Resources, Inc., founded in 2002 and headquartered in Midlothian, IL, is a full-service company that partners with small and large healthcare organizations to build solutions that enhance operational effectiveness, improve clinical documentation, and decrease overall compliance related risks. Contact us at https://www.ppr-corp.com/about-ppr-corp/ for more information.

 

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