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New Medicare Cards are in the Mailbox

new Medicare card

Last June’s post was about new Medicare cards.  At the time of the post, it seemed like a long time away and something that could be pushed off until a later time.  Well, that time is upon us.  Beginning next month, the federal government will begin issuing new Medicare cards.  Gone are the days of using the patient’s Social Security numbers as their ID numbers.  The new Medicare cards will have unique, randomly assigned numbers and letters that replace Social Security numbers.  The new Medicare cards are being mailed in waves beginning April 1 and continuing through April 2019.

What the new Medicare cards mean to your practice

This is good news and bad news for all medical practices.  The good news is that the old cards will work until December 31, 2019.  The bad news is this means the front office staff has to wade through this transition for 21 months!  Health care providers must use the new card numbers beginning January 2020.  Some practices may think they can put this off but this time the patients are likely to force the transition.

This change will undoubtedly result in some of your patients having questions and concerns   The Centers for Medicare & Medicaid Services is encouraging Medicare patients to bring their new card to their next visit.  They are informing seniors that the change in cards is to protect them from medical identity theft.  CMS is also informing patients that if they forget their card then their health care provider can look it up for them.  If patients are also in a Medicare Advantage plan then the Medicare Advantage card is the main card for Medicare.  However, it is better to be safe than sorry so make sure you add the new card to the patient’s record, as well.

Protect your Digital Information

Are you really protecting your digital information?  You’ve likely heard of an SSL certificate.  But do you know what it is or why it is important?  I’d venture a guess that like most people you rarely give it a thought.

Almost a year ago to the day, there was a post entitled, “The Cost of Public Wi-Fi“.  That post contained some tips on how to protect your data.  Most people understand the importance of protecting passwords and logins.  Many know not to use a public Wi-Fi but let’s face it many of us do.  Starbucks, airport lounges, and even your local grocery store all provide wi-fi and a public password.  Maybe you even think that your account will never be hacked.

Who actually remembers that your email is data and contains lots of information about you, your company, and your family?  It can be the gateway to your digital information.  The first post provided a few tips on how to reduce your risk when using a public Wi-Fi.  One of the tips said, “check your email application to make sure that is using SSL”.  SSL – what’s that?  Where is it?  Do you have it?  How do you know?

What is an SSL Certificate and Why Should You Care” is an article written by Bill Hess, the founder of Pixel Privacy.  It provides some great information that answers all of those questions and more.  I hope you find the article both informative and useful.

Dealing with Unmet Deductibles

Unmet Deductible

Unmet deductibles challenge health care practices and interrupt cash flow.  Long gone are the days when collecting patient payables meant collecting $10 copays.  More and more patients have chosen a high deductible health plan to save on premiums and/or take advantage of health savings accounts (HSA).

Unmet Deductible This means that each patient must pay out of pocket for health care services until their deductible is met.  After that, their insurance will pay your claims.  The amount of the deductible varies from policy to policy.  However, the most common amounts range from $200 to $6,000.

Unfortunately, each new year finds patients, providers and clinic staff struggling to meet these deductibles.  Each must find an effective way to deal with the impact when deductibles reset.  Here are a few basics for improving your patient collections.

Tips to Improve Collecting Patient Deductibles

  1. Prior to the patient’s appointment verify eligibility and know what your patient will owe.  This is especially important because patients change insurances which results in changes to the deductibles.
  2. Always verify whether or not a deductible has been been met when you call to verify the patient’s insurance.
  3. Reduce front desk awkwardness and instead tell the patient why they will owe before the appointment.  Letting the patient know what they will owe is critical.  You can even do this when you place appointment reminder calls.  Patients don’t like surprises and they are being educated to understand that they will owe more than a $10 copay.
  4. Make it easy for them to pay and give them options.  Let them pay on a credit card, by cash, check, money order and even PayPal.  Make sure your staff offers to accept payment during the appointment reminder call or when they check-in or check-out.  Also, make sure that you have this payment expectations/information posted in several places in the office, including the waiting area and patient rooms.
  5. Implement a credit card on file policy whereby your patients agree to have all or some of the balance charged to their credit cards each month.  You do not want the liability of keeping their credit card information onsite, so use a certified and secure third party to retain the information.
  6. Promote your patient portal and if you don’t have one – get one.  Online payments are the way to go!  Some patients just want to go online and make a payment.
  7. Collect a flat amount in advance.  If you don’t know how much the patient will owe, then collect a flat amount.  Let the patient know that after the claim has been paid the balance will be billed to them.
  8. Inform your staff of how to collect money.  Your staff should be well-informed of all office and financial policies.  Consider providing staff with scripts to help them collect patient payments.

Time of service collections and lots of communications will help to make collecting deductibles easier and in the long run reduce everyone’s stress during ‘deductible season’.

Cloud or Server – What’s right for my practice?

Cloud based Server

Every private practice health care provider has had to weigh and measure whether a cloud-based or server-based software solution is right for their practice.  As your practice grows, it is good business to assess whether your initial decision is still the right one.

A few months ago, one of our clients found themselves in the path of a raging fire.  Fortunately, they had made the decision to be cloud-based.  Initially, they had to access patient notes via a tablet and then utilized a temporary office to see patients.  They never missed a beat.  All of the patient care data was completely backed-up and accessible from anywhere they were.

Cloud-based servers can be an attractive solution for many reasons.

  1. They provide on-going and instantaneous back-up systems;
  2. The back-up sites are in multiple locations throughout the United States so redundancy is in place;
  3. The responsibility and cost to maintain the cloud-based servers are not an expense the practice must bear;
  4. You do not have to worry about upgrading or maintaining the servers; and
  5. You save money because you do not need IT staff/contractors to manage, maintain or troubleshoot the servers.

Yet, there are those who feel a server-based solution is best for them because:

  1. They maintain direct control;
  2. They feel that troubleshooting response time is faster with in-house servers and contracted IT staff; and
  3. Despite the associated costs there is a level of trust in server-based over cloud-based.

Regardless of the solution you choose or have chosen for your practice it is important that you have a technology disaster plan.  No one plans on a disaster.  Most of us have never and will never experience one.  But, if there is one will you be able to access your patients’ records, refill prescriptions and DME orders and keep your practice going?  So, whether it is an extended power outage, hurricane, fire, earthquake, tornado or a flood you need to be prepared.  Is your data backed up off-site and out of your geographic area?  Will you be able to access the patient data if you have to practice in another location?  Could you function if all you had was an iPad or tablet?

Assess your situation and make changes as you deem appropriate.  Don’t wait until it is too late.
Server based


Is Your Practice Ready for MIPS?

The Merit-based Incentive Payment System (MIPS) program is a key component of the MACRA Quality Payment Program (QPP) and is expected to be the more popular path for 2017, the first performance year.  Under MIPS, the Meanighful Use (MU) Medicare incentive program, Physician Quality Reporting System (PQRS) and the Value-Based Modifier (VBM) program will be consolidated into one program.

We’ve consolidated the key highlights for the 2017 transition year and compiled them into this concise overview.  It’s short and created for anyone in your practice wondering what to do next.


Is it too late to start?

  • You can start anytime between January 1 and October 2, 2017

Pick your pace

  • Test: submit a minimum amount of 2017 data to avoid downward payment adjustment.
  • Partial: submit 90 days of 2017 data for a neutral or positive payment adjustment.
  • Full: submit a full year of 2017 data and you may earn a positive payment adjustment
  • If you don’t submit any 2017 data you will receive a negative 4% payment adjustment.

Reporting process

  • The submission of data remains the same as in the past
  • Quality Measures via claims based reporting or registry
  • Advanced Care Information (ACI) and IA categories use the attestation process as you did with Meaningful Use

Requirements reduced

  • ACI measures reduced from 11 measures to 5 measures
  • Cost performance category (formerly VBM) – 0% weight in 2017
  • Quality cross-cutting measures and domains removed to avoid a penalty and not earn an incentive, need only report on 1 patient.


MIPS eligible clinicians billing Medicare Part B listed as Physicians, Pas, NPs, Clinical Nurse Specialists, CRNAs.

Exempt eligible clinicians

  1. Physicians in their first year of Medicare Part B participation
  2. Membership in an advanced APM
  3. Physicians with less than $30,000 in annual Medicare revenue/or have less than 100 Medicare patients

MIPS Performance Categories for 2017

Quality (formerly PQRS) = 60%

  1. Submission: Claims Based, Qualified Registry or EHR
  2. Report: 6 measures
  3. Resource:

Advanced Care Information (ACI) Formerly MU = 25%

  1. Submission: Attestation based on your health technology.  Attest to 5 required measures for a minimum of 90 days.
    1. Security Risk Analysis
    2. ePrescribing
    3. Provide Patient Access
    4. Send Summary of Care
    5. Request/Accept Summary of Care (bonus credits available)
  2. Resource

Improvement Activities – IA  (aka from proposed rule CPIA) = 15%

  1. Submission: Attestation based on your health technology.  Complete 2 – 4 improvement activities for a minimum of 90 days
  2. Resource:


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