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September 2020

In many ways, it’s hard to believe that October is right around the corner. In other ways, the last month has flown by in a blur. Some practices have returned to mostly normal patient volumes while others continue to struggle in the wake of COVID-19. Practices that have been most successful in terms of remaining profitable tend to be the ones that have embraced telehealth and prioritized patient engagement and the patient experience. However, challenges remain—particularly coding and billing COVID-related services for which payer-specific guidelines change frequently.

It’s too soon to tell how the remainder of Q4 will unfold. However, knowledge is power, which is why we’ve compiled four news topics from this month that may help your practice and facility navigate what lies ahead. Take a look, and let us know what you think. What is your number one challenge at this point, and how can Physician Practice Resources help? Email us at xxx. Most importantly, stay safe out there.


CMS extends timeline for repayments of advanced Medicare payments
Some good news. Providers who took advantage of loans that were part of the Medicare Accelerated and Advanced Payment Loan Program now have 210 days (up from 120) to pay back those loans. Inpatient acute care, children’s, cancer, and critical access hospitals have an entire year to pay them back. After 210 days, there is a 10.25 percent interest rate. Will this flexibility be enough? Only time will tell.


New CPT codes take effect January 1
Effective January 1, there are 206 new codes, 54 deletions, and 69 revisions. Also note updated COVID-19-related coding guidance found on the American Medical Association’s website. In particular, there’s a new CPT code (99072) for additional supplies, materials, and clinical staff time required for patient symptom checks over the phone and upon arrival. This code also covers donning and removing PPE as well as increased sanitation measures. Take the time to review all of these codes and ensure physicians and staff are ready to start using them in the new year.


Revenue still lower than anticipated in many practices
Nearly two-thirds of physicians have seen a reduction in their revenue during COVID-19, according to a recent Medscape survey. Primary care practices have been hit especially hard. More specifically, 28% of primary care practices have had a 30%-50% drop in fee-for-service revenue over the past four weeks, according to the Primary Care Collaborative. These grim statistics highlight the need for coding accuracy and compliance that promote revenue integrity.


Support for telehealth keeps growing
Although once viewed as an optional service, telehealth has become a necessity during the current pandemic, accounting for more than 20% of medical visits this year, according to a recent study. Stories about how telehealth helps rural providers overcome access barriers continue to be told. Telehealth has also shown promise for retaining patients in medication-assisted treatment for opioid use disorder. On a federal level, a new FCC pilot program will offer grants to cover 85% of healthcare provider connectivity costs for telehealth programs, including broadband access, internet connectivity for patients and some network equipment. The goal? To support providers who serve low-income Americans and veterans. Does your practice perform and bill telemedicine? If so, how do you ensure that you’re following payer-specific guidelines and requirements? You don’t want your practice to become the focus of a post-payment audit and recoupment.


About us
Physician Practice Resources, Inc., founded in 2002, headquartered in Matteson, IL is a full service company that partners with small and large organizations to build solutions that enhance operational effectiveness, improve clinical documentation and decrease overall compliance related risks. Our core competencies include: Consulting Services, Medical Coding, Temporary Help Services, Professional Management and Development Training, Continuing Education Webinars/Workshops and Coding Exam Preparation and Tutoring. Contact us at https://www.ppr-corp.com/about-ppr-corp/ for more information.


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