Mario P. Fucinari DC, CPCO, CPPM, CIC, Author at Illinois Chiropractic Society

Congress Kicks the Can Down the Road; Delays ICD-10 for One Year

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 18, 2014 | Billing and Collections, Documentation, ICS Message, Insurance, Practice Management, zall | 0 |

Congress voted to institute a 1-year “doc fix” preventing a 24% pay cut for physicians who treat Medicare patients. This is the 17th patch in 11 years whereby Congress delayed the “doc fix.” Although there was strong bipartisan support in both the House and Senate to repeal the Sustainable Growth Rate (SGR) formula responsible for the problem, the doc fix was enacted again. President Obama signed into law the Protecting Access to Medicare Act of 2014 on April 1, 2014.

Get, Ready, Audits are on the Rise

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 17, 2014 | Insurance, Medicare and Medicaid, zall | 0 |

The Department for Health and Human Services (HHS) and the Centers for Medicare and Medicaid Services (CMS) have the responsibility to make sure that the funds are properly protected. To this end, they have contractors who audit charts to prevent fraud and abuse. Among them are the Zone Program Integrity Contractors (ZPICS), who audit Medicare A and B, hospice home health, and durable medical equipment programs.

Stick to the Rules in ICD-10

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Mar 28, 2014 | Coding, Insurance, zall | 0 |

As the ICD-10 deadline looms closer and closer to the October 1, 2014 implementation date, it is important that every provider and his or her staff learn the rules pertaining to the ICD-10 codes.

ICD-10: The Devil is in the Details

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Dec 2, 2013 | Coding, Compliance, zall | 0 |

It is hard to believe that the deadline for mandatory implementation for ICD-10 is less than one year away. On October 1, 2014, the United States will implement the World Health Organization’s (WHO) mandate for the clinical modification of diseases and morbidity classification. This is known as ICD-10-CM

Can You Opt out of Medicare

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Dec 2, 2013 | Insurance, Medicare and Medicaid, zall | 0 |

The recent changes in health care have prompted talk of doctors choosing to opt out of the Medicare program. Is this a viable option for you as a chiropractor? Ignorance of the law is no excuse as they say.

NGS Takes Over Medicare in Illinois: More of the Same?

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Oct 18, 2013 | ICS Message, Insurance, Medicare and Medicaid, zall | 0 |

On September 7, 2013, National Government Services (NGS) took over the contract as a carrier for processing claims and adjudication of Medicare in Illinois, Wisconsin, and Minnesota. Wisconsin Physician Services (WPS) was our former carrier for as long as I can remember. It is just a change in carriers, right? After all, it is still Medicare. Or is it?

HIPAA Security Rule Compliance

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Jun 7, 2013 | Compliance, HIPAA, zall | 0 |

The Health Insurance Portability and Accountability Act of 1996 (HIPAA) was implemented in four different phases to ensure compliance. The latest portion of HIPAA is the SECURITY RULE, which went into effect on April 21, 2005. All providers, except for small health plans, should have been in compliance by April 20, 2005. The exception for small health plans mandates that they must be compliant no later than April 20 of 2006.

New 1500 Health Insurance Claim Form Released [Updated]

Posted by Mario P. Fucinari DC, CPCO, CPPM, CIC | Apr 1, 2013 | Insurance, Medicare and Medicaid, zall | 0 |

The National Uniform Claim Committee (NUCC) announced on February 15, 2013, the implementation of the newest version of the health insurance claim form, which is to be denoted as 02/12.