Author: VettersEnt

Preventing Sciatica with Chiropractic Care

Posted on by VettersEnt

While there are several different reasons that a patient could experience short-term or chronic lower back pain, a pinched sciatic nerve is a common culprit. The sciatic nerve is the longest nerve in the body, and when it is compressed or irritated it can result in severe pain. Keep reading to learn more about chiropractic treatments and methods for preventing sciatica.

 

 

 

What is Sciatica?

Sciatica refers to a leg pain caused by a pinched nerve that originates in the lower back but can radiate into the back or side of the legs. Pain can vary in intensity from dull, achy pains similar to a toothache, to pins and needles that are comparable to electric shocks. As you can imagine, this can be incredibly hindering and downright intolerable for patients. In most cases, the pain of sciatica dissipates within 6-weeks when a specialized treatment plan is in place.

Chiropractic Treatment and Other Methods for Preventing Sciatica

While many disorders can cause sciatica, a herniated disk is commonly to blame. Patients experiencing sciatica tend to respond well to a combination of treatments that are specific to their symptoms and cause of pain.  Effective sciatica treatment plans for long-term relief often include:

  • Chiropractic Manipulation – Spinal adjustments are a non-invasive and drug-free option for relief. They can help relieve pressure on the sciatic nerve by freeing restricted movement of the spine and minimizing the nerve irritability that causes inflammation, pain and muscle spasms.
  • Exercises – Extra weight and lack of movement can put pressure on the spine and weaken the muscles, increasing the risk of further strain. Physical therapy, deep stretches and exercises that promote core strength in the back and abdomen, such as yoga, are helpful for relief.
  • Posture Practice – Eliminate poor posture by aligning the ears over the shoulders, shoulders with the hips, tucking in the buttocks and engaging an active core. When sleeping, it is helpful to put a pillow under the knees and avoid sleeping on the stomach.
  • TENS Unit – Transcutaneous electrical nerve stimulation (TENS) units minimize muscle spasms and treat acute pain through variable intensities of electrical current control.
  • Anti-Inflammatory Medications – NSAIDs, such as ibuprofen and naproxen, can relieve pain by reducing inflammation.

The Shift from Volume to Value: The Challenges

Posted on by VettersEnt

Now that we have covered the basics of volume-based reimbursement and value-based reimbursement and all of the wonderful benefits it will bring, we will address some of the anticipated challenges your healthcare facility might face.

In Case You Missed It

Healthcare providers are currently shifting from volume-based reimbursement plans to value-based reimbursement. This dramatic change is designed to benefit patients, healthcare providers and the payers. Value-based reimbursement promises to give patients the highest quality care for the lowest possible amount and shift the focus of healthcare providers to the actual health of their patients.

Medicare and Medicaid

As the baby boomer population grows older and more reliant on Medicare for their medical expenses, the reimbursements that healthcare facilities receive will decrease. In addition to the growth in Medicare patients, the use of Medicaid has also grown. The new mix of revenue will definitely take a toll on your office’s bottom line if you are not prepared.

Reconciling Volume-Based and Value-Based Payments

The next challenge healthcare providers face is reconciling the new value-based reimbursement model with your current fee-for-service environment. Tracking progress can be tricky, as you need to maintain detailed logging in two different payment systems at the same time. Your accounting systems and software might need a major upgrade in order to track value-based reimbursement patients, populations, and billing.

Keeping Track of Quality Measures

Most incentives for practices that meet certain value standards rely on keeping track of quality measures. You are probably already used to submitting some quality measures, but their effect on your bottom line might be new. The value-based reimbursement shift means that your ability to meet quality standards, benefit patients and cut costs is directly tied to whether or not you receive incentives or penalties.

This transition period is the perfect time to have an evaluation performed on your facility’s systems to see where you can further reduce costs and increase efficiency. Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Changing Healthcare Reimbursement from Volume to Value

Posted on by VettersEnt

Healthcare providers are shifting from volume-based reimbursement to value-based reimbursement to benefit patients, providers and the payer. The goal of this dramatic shift is to provide patients with the highest quality care at the lowest cost to them.

Volume Based Reimbursement

Traditional healthcare used volume-based reimbursement or fee-for-service (FFS) mechanisms. Unfortunately, this model led to many healthcare providers feeling the need to over-treat, over-medicate and over-spend in order to make their ends meet. If healthcare facilities needed to earn more, they had to do so by treating more patients. Many times, treating more patients meant providing a lower quality of care at the expense of the patient and the practice.

Value Based Reimbursement

Value based reimbursement holds patient care at the center and makes it easier for patients to get the care they need and only the care that they need.  This model pays doctors, hospitals and healthcare facilities for keeping patients healthy and improving the health of people with chronic illnesses.

What Will Change?

Healthcare providers need to focus on transitioning their business model to one centered around tracking patient data throughout networks. Patients should be encouraged to change behaviors and get healthier, not herded through to achieve high volume. In turn, patients with value-based reimbursement will be more invested in their healthcare and have motivation to improve. Financially, healthcare facilities need to transition to accepting value-based payments.

This restructuring period is a great time to have an evaluation performed on your facility’s systems to see where you can further reduce costs and increase efficiency. Vetters Enterprises specializes in practice management, revenue cycle optimization, and private practice business support. We can perform detailed assessments of your practice or facility and identify potential issues. Let us keep your business as healthy as you keep your patients! Give us a call at (443) 352-0088.

Telehealth Consultation Requirements for Maryland Mental Health Providers

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The Tele-mental Health Guide defines tele-mental health as “the provision of mental health services using live, interactive videoconferencing.” We recently shed some light on the benefits of tele-mental health services for both practitioners and patients. Many agree that convenient remote access to mental health services will increase efficiency and allow patients in underserved areas to receive continuous quality care on a greater scale.

If you are a Maryland mental health provider you may be wondering, “Where can I sign up?” Let’s discuss the next steps and potential barriers to implementing telehealth consultations.

Telehealth Consultation Requirements in Maryland

The regulations governing the provision of telehealth services varies state-to-state, and this can get tricky if you plan to practice with patients across state lines. According to the Maryland Health Care Commission, telehealth consultation requirements include the following:

  • Licensing – A physician must be licensed in the State if either or both the individual practicing medicine or if the patient is physically located in Maryland
  • Credentials – If a multi-site hospital credentials physicians specifically for the site at which they are located, every physician within the hospital system must be credentialed at all hospital sites in order to provide telehealth services
  • Liability – A physician must work with their insurance carrier to determine if coverage is available and if so, the extent of coverage allowed under their policy (liability and malpractice insurance for tele-health services varies by carrier)
  • Financial – Physicians must purchase and maintain equipment for these services
  • Staffing – For organizations interested in providing telehealth services, access to providers that are able and willing to provide these services and support the needs of the organization as they implement and grow their services is a must
  • Registration – Those registering to be telehealth providers must be enrolled in the Maryland Medical Assistance Program and register as an originating or distant site via an online form before rendering services

Technical Requirements for Telehealth Consultations in Maryland

According to the Maryland Medicaid Telehealth Provider Manual, providers shall, at a minimum, meet the following technical requirements:

  • A camera that has the ability to manually, or under remote control, provide multiple views of a patient with the capability of altering the resolution, focus, and zoom requirements according to the consultation
  • Have display monitor size sufficient to support diagnostic needs used in the telehealth service
  • Bandwidth speed and image resolution sufficient to provide quality video to meet a minimum of 15 frames per second, or higher, as industry standards change
  • Audio equipment that ensures clear communication and includes echo cancellation
  • Creates audio transmission with less than 300 millisecond delay

Provider Registration – Take the First Step to Implementing Telehealth Today

If you are a provider who is interested in offering consultations, you may be enrolled in the fee-for-service (FFS) program or a HealthChoice managed care organization (MCO). Don’t let the requirements overwhelm you – be proactive! Taking the first required step is simple, all you have to do is fill out this Telehealth Registration Form. To complete the registration process you will need:

  • Your Maryland Medical Assistance provider number
  • Your National Provider Identification (NPI) number
  • An email account to receive for communications from the Telehealth team

*Note: After Medicaid verifies your registration information, you will receive a confirmation email. Until Medicaid confirms your registration, providers should not bill for telehealth services. If you have any questions, you should email dhmh.telemedicineinfo@maryland.gov or refer to this Telehealth Provider Manual*

Need Help with Practice Management? Contact Vetters Enterprises, LLC Today

Vetters Enterprises is a full service practice management company specializing in practice management, revenue cycle optimization, and private practice support. Give us a call at 443-352-0088 or contact us online if you’d like to see how we can help improve your cash flow.

Provide Quality Care through Tele-mental Health Consultations

Posted on by VettersEnt

The National Alliance on Mental Illness reports that anxiety, depression, substance abuse and other psychological ailments affect nearly one in five Americans, or 43.8 million people. However, it can be difficult for people with behavioral problems to seek help from a mental health professional and receive an accurate diagnosis. Mental health services are often offered in abundance in urban and suburban areas, making it difficult for people in rural areas to conveniently access the help that they need. That’s where tele-mental health comes in.

 

What is Tele-mental Health?

The Tele-mental Health Guide defines tele-mental health as “the provision of mental health services using live, interactive videoconferencing.” It makes sense, doesn’t it? In an instant we can use videoconferencing to virtually connect face-to-face with our friends, out-of-state relatives and business associates – so why not use this technology to serve mental health patients from afar? Tele-mental health consultations are an increasingly popular way to provide quality mental health services to those living in underserved communities with limited clinicians.

What are the Benefits of Tele-mental Health Services?

Without convenient access to mental health services, those suffering tend to neglect seeking proper treatment. Who wants to drive 200 miles out of town to the closest specialist for continuous care? In the past, patients were forced to make that kind of time and shell out for gas, potential childcare and missed work days if they wanted to be seen. Tele-mental health consultations provide mental health access like never before for both doctors and patients. Some of the benefits associated with tele-mental health services include:

  • Access to patients worldwide, resulting in an increased patient pool for practitioners
  • Ability to facilitate an immediate 3-way consultative session with a specialist through video conferencing, allowing for more comprehensive care on the same visit
  • Higher consumer and practitioner satisfaction
  • Increased convenience and efficiency
  • Minimized/eliminated travel costs for patients
  • Increased comfortability for those who find it difficult to open up to specialists in person
  • Same day psychological test results
  • Reduced emergency care costs (by diagnosing and treating illnesses earlier on).

What is the Goal of Tele-mental Health Services Moving Forward?

The primary goal of tele-mental health services is to provide patients with the highest quality comprehensive care. Many clinical groups and medical professionals that have employed tele-mental health capabilities have reported that the efficiency of remote care is on par with in-person care.

Want more useful information? Visit our blog again! Vetters Enterprises is a full service practice management company specializing in practice management, revenue cycle optimization and private practice support. Contact us today if you’d like to see how we can help you improve your cash flow.

CMS Changes for 2017: MACRA and APMs

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In the last Vetters Enterprises blog, we discussed the Centers for Medicare & Medicaid Services (CMS) changes for 2017 regarding the model by which physicians are reimbursed for care. The Medicare Access & CHIP Reauthorization Act (MACRA) was implemented to streamline reporting of quality care and emphasize consequence for those performing poorly. The main goal is simple – make patients healthier by rewarding high quality care. The Quality Payment Program (QPP) under MACRA that we discussed in our last blog consists of two tracks physicians can choose from: MIPs and APMs. Let’s break down APMs.

Quality Payment Program: What are APMs?

CMS defines Advanced Alternative Payment Models (APMs) as new approaches to paying for medical care through Medicare that incentivize quality and value. The QPP offers additional incentives for Qualifying Professionals (QPs) who participate in APMs. MACRA states that APMs include: CMS Innovation Center model, Medicare Shared Savings Program (MSSP), Demonstration under the Health Care Quality Demonstration Program, and Demonstration required by federal law.

How Do You Qualify for APMs?

Most physicians will be subject to the MIPS track based on eligibility requirements. The following three groups will be excluded from the MIPS track: first year of Medicare Part B participation, certain participants in advanced alternative payment models, and those below the low patient volume threshold – meaning those who provide care for 100 or fewer Medicare patients and whose Medicare billing charges are less than or equal to 10k annually. To qualify as an Advanced APM and be excluded from MIPS, the following criteria (as defined by MACRA) must be met:

  • The APM requires at least 50% of the participants are required to use certified EHR technology; after year one, this threshold increases to 75%
  • The APM payments are based on quality measures comparable to those in the MIPS Quality of Care performance category
  • The APM entities bear more than nominal financial risk for monetary losses OR the APM is a Medical Home Model expanded under CMMI authority

Qualifying APM participants are eligible for a 5% lump sum bonus each year from 2019-2024 if the APM revenue is met, as well as annual updates of .75% after 2026. In layman’s terms, the MIPS track consists of fixed funds, regulations, restrictions, and penalties; whereas the AMP track consists of a significant share of provider revenue, two-sided financial risk, financial incentives, and exemption from MIPS. Want more useful information? Visit our blog again!

Vetters Enterprises is a full service practice management company specializing in practice management, revenue cycle optimization, and private practice support. Contact us today if you’d like to see how we can help you improve your cash flow.

CMS Changes for 2017: MACRA and MIPS

Posted on by VettersEnt

The Centers for Medicare & Medicaid Services (CMS) changes for 2017 are centered on changing the way physicians are reimbursed for care so that they can focus on giving quality care and making patients healthier. Let’s break down MACRA and MIPS as it may relate to you.

What is MACRA?

In April 2016, CMS published a proposed regulation to implement MACRA, the Medicare Access & CHIP Reauthorization Act. MACRA replaces the contentious Sustainable Growth Rate (SGR) model and provides new tools, models, and resources to help physicians give their patients the best possible care. MACRA created the Quality Payment Program (QPP), the framework through which physicians are paid for the value of the care they provide as opposed to being paid for the quantity of care they provide on a fee-for-service payment model. The QPP consists of two tracks physicians can choose from based on practice size, specialty, location, or patient population: MIPS and APMs.

What is MIPS?

MIPS, the Merit-based Incentive Payment System, is a single incentive program that consolidates three current pay-for-performance programs within in: the Physician Quality Reporting System (PQRS), Value Based Payment, and the Medicare EHR incentive program for eligible professionals (aka Meaningful Use). MIPS will go into effect in 2018 and begin adjusting payments in 2019. Physicians will be ranked on quality and cost of care vs. their peers based on four performance categories that will make up a composite performance score (CPS) of a potential 100 points. The categories and how they weigh into the score are as follows:

  • Quality of Care – 50%
  • Resource Use/Cost – 10%
  • Clinical Practice Improvement Activities – 15%
  • Advancing Care Information – 25%

Physicians may submit their individual score or a score for their entire group practice, which will be published by CMS on Physician Compare. After a year’s worth of data in 2017 is reported to CMS, a national threshold will be calculated to determine an appropriate pay adjustment for those physicians performing above/below average. For every physician that earns more through MIPS, there will be one who earns less – rewarding quality over quantity. Those performing poorly may see their payments cut by up to 9%, whereas those performing well may receive an adjustment up to 4% in 2019, increasing to 9% by 2023. Please note that note that MIPS does not apply to hospitals, meaning the EHR incentive program for hospitals will continue.

In the next Vetters Enterprises blog we will discuss Advanced Alternative Payment Models, or APMs.

PARTY TIME!!

Posted on by VettersEnt

So I moved into my own officeclose-up-of-explosion-of-champagne-bottle-cork2 on October 1, 2016!  It’s amazing to believe that only 3.5 years ago I was scared as hell to be leaving Corporate America and embarking on this new journey.  I had no confidence, no marketing ability, and really no idea if I could actually make it in my chosen field.  So I took steps to ensure success.  I joined a networking group and got over my fear of meeting other business professionals.  I found a business coach who showed me that it is OK if someone doesn’t want what I have to offer, move on to the next potential client.  He also showed me that there is a “negative voice” inside that needs to be pushed out and never listened to.  I also surrounded myself with others who complemented my skills with theirs and together we bounced ideas off each other, supported each other and made each other’s business grow as a result.  Most importantly my confidence in what I could do, make and achieve for myself exploded.   Now I’m celebrating my success as a result of relentless perseverance and shear will.

So for any of you who have beaten yourself up in a cube for several years because it only seems like you can get so far.  Or lost that promotion you were sure to have gotten to someone else who clearly was a chump and didn’t know anything about the project.  Or stuck up for what was right only to have it overturned by the “powers that be” because it was all about the MONEY.  Or most importantly, got downsized and left to pick up the pieces and send your resume to every job on Monster, Career Builder, and even Craigslist, just to be told you are too qualified, too old, or too whatever their excuse may be.  Find your WHY and get out there and do it.  Take the chance, drain your 401K to finance it, you only have one life to live so make it the best life you can possibly live.  Enjoy, hell love, what you do for the first time in your life.  If it works, it will be all you and no one else can take it away from you.  If it fails, start over, don’t ever give up.  To quote Thomas Edison “I have not FAILED, I just found 10,000 ways how not make a light bulb”.  Make your light bulb.

Patient Payments Simplified

Posted on by VettersEnt

Most practitioners don’t know that you are 50% less likely to recoup a patient copay if they leave your office without paying.  This impacts your cash flow more than you know.

I wanted to share with you a great idea from a great company – Payspan.  Some folks who work with Medical Assistance or any of the Beacon Health Options carriers may be very familiar with logging on to Payspan to pick up their EOPs but they have a great program for helping you get that payment up front that you need.  Check out this webinar if you can.

 

Webinar: Simple Techniques for Accelerating Patient Payments

Join us Thursday, October 6th for the Simple Techniques for Accelerating Patient Payments Webinar

If you missed Simple Techniques for Accelerating Patient Payments Webinar join usOctober 6th, 2016 and let us help you accelerate patient payments.

The abundance of high-deductible health plans is presenting unique revenue challengesfor healthcare providers, and many practices are struggling to quickly and accurately collect patient financial responsibility dollars. There are simple tips and solutions every practice can adopt to increase patient revenue and improve operational efficiency.
SAVE YOUR SEAT TODAY
Please join us on Thursday, October 6, for a complimentary webinar titled, “Simple Techniques for Accelerating Patient Payments.” We will be speaking about:

  • Best practices for dealing with the increase in patient responsibility and high-deductible health plans;
  • Best practices for accelerating patient payments; and
  • Innovative patient payment solutions that will get your practice where it needs to be today.

With the shift to new reimbursement models and the increase in out-of-pocket patient responsibility, it is more important than ever for providers to adopt innovative tools in order to stay financially viable. If you are interested in maximizing revenue in today’s evolving healthcare economy, join us at 2:00pm, EDT on October 6th, 2016.

Sincerely,

The Payspan Team
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ABOUT PAYSPAN
With the largest healthcare network in the U.S., we provide payment automation services that improve administrative efficiency, meet regulatory requirements, and enable payers and providers to manage new reimbursement strategies. We bring together healthcare expertise with proven financial services technology to empower a new generation of healthcare economics. CONTACT US

 

Message from the CEO of Compliancy Group

Posted on by VettersEnt

Today I want to talk about the odds of being audited.

It’s been all over the news lately that OCR has finally launched their Phase 2 audit program, ushering in a series of 200 desk and onsite audits that will be completed by the end of the year. If you consider the odds of being randomly selected for one of these Phase 2 audits, you wouldn’t be alone in thinking that the chances are slim. It’s a claim we’ve seen time and again.

But set aside these Phase 2 audits for a moment and consider that two of the largest fines ever–totaling $5.5 million–were levied against North Memorial Health System of Minnesota and the Feinstein Institute for Medical Research just a few weeks ago. In each of these cases, an OCR investigation was triggered by a PHI breach. And in each case, OCR discovered a lapse in the organization’s HIPAA compliance which lead to these behemoth fines.

So while the odds of being selected for a Phase 2 audit are relatively slim, the odds of having a breach and triggering OCR investigation are as high as they’ve ever been.

If you need help with your compliance efforts, reach out to VE Cycle Management today.  We can get you on track wth Compliancy Guard, the tool that saves you more than money.

Read on to check out some of the content we’ve put out this month, and some of the free educational webinars we have slated for the weeks ahead. And remember that Compliancy Group is here to give you compliance with confidence.

Marc Haskelson 

President, CEO