And what, Socrates, is the food of the soul? Surely, I said, knowledge is the food of the soul.
Plato
PECOS Revalidation extended to 2015

Most optometric physicians have received letters that they are required to revalidate their enrollment through the online PECOS system and have already done it.  The deadline for all physicians to revalidate has been extended to March 2015.  If you haven't received your letter to do it, then there is nothing to worry about.  It will be coming.

If you did receieve your letter, revalidation is very simple.  Log into the PECOS system using the User ID and password for your individual NPI and select the active enrollment for the Optometrist.  Revalidate enrollment is one of the options available and by reviewing your enrollment data, printing and signing the certification statements, and mailing them in, you have revalidated your enrollment. 

PVG Connect 2012 and beyond

The secret to healthy, long-term practice growth is a heart-felt and steadfast commitment to quality people, products and services.  The experts of PVG have stayed true to that belief, and for more than 20 years we have been blessed to be a part of the growth of some of the best practices in the country.

On Saturday, January 21st in Greensboro, members of PVG will gather again for a day filled with fun, inspiration, and energy.  In combination with other like-minded private practitioners, the group will start 2012 by swinging for the fences.

For the past few years, economic news, government compliance, automation, and price-point marketing have served as a distraction from the fundamentals for many small businesses in America. 

We take our hats off to the private practices of Professional Vision Group.  They have persevered in the storm and we are proud to be associated with every one of them.  We can't wait for PVG Connect 2012.  Better yet, we are looking forward to a great year!

Important 2012 Info for Medicare Providers

Medicare carriers will hold claims for the first 10 days of 2012 as in the past few years.  Medicare carriers currently have at least 14 days to pay clean electronic claims.

Deep cuts to Medicare providers were avoided as the US House and Senate agreed to delay cuts for two months.  If there is no action, as much as 27% is expected to be trimmed from reimbursements for physicians.

We are waiting for the new fee schedules to be posted and will get the schedules out as soon as possible.

The 2012 Part B deductible is $140 and the copayment is still 20% unless the enrollee has a Medicare Advantage Plan.

 

OM/EW PQRS Report on Communication with PCP in Diabetic Retinopathy

Meaningful Use Update
In order for the OfficeMate/ExamWriter version 10.5 CMS Quality Reporting (PQRS codes) to work right on Communication with PCP (5010F) the exam record must have Dx code 362.01-362.06 and PQRS 2021F - presence or absence of macular edema in the exam record.  Most docs have been using the Dx codes 250.50 or 250.51.

Information Coming in About How to File NC HealthChoice

Getting information about the transition of NC SCHIP NC HealthChoice to Medicaid from Blue Cross Blue Shield has been a challenge.  Members are starting to understand the process and this is what we know so far:

NCHC will no longer cover contact lenses or CL services.  They will pay for a refraction however if filed along with the comprehensive exam code and “NC HealthChoice” appears in the plan name field.

Eyeglasses go to Nash Optical now and use a special form HC-017 (9/2011) that has the NC HealthChoice logo on it.  The normal NC Medicaid frame selection is used and plastic lenses are paid for.  Providers may request poly for kids and high index for spherocylinder powers >+/- 8 D but there is no guarantee you’ll get it.

The form is mailed to an address different from the traditional NC Medicaid glasses:

HP Enterprises/Prior Approval

PO Box 322490

Raleigh, NC 27622

 

Jobs take the usual amount of time from Nash and patient elected upgrades are not available.

 

Get SC Medicaid Eligibility Online Only Now

 

Effective December 31, 2011, the South Carolina Department of Health and Human Services’ (SCDHHS) toll free eligibility verification line (1-888-809-3040) will no longer be available. This system is currently used by a small number of providers to validate member eligibility and/or to check the status of the most recent payment from SCDHHS. Providers may access this same information via the free SCDHHS Web Tool.

HIPAA 5010 For Offices using Clearinghouses

Action Requiredby January 1st! The new HIPAA 5010 format requires two changes to the claim Billing Address (box 33) when using a clearinghouse.

·      You must include a full 9-digit ZIP code instead of the previous 5-digit format.

·      You must use a physical mailing address; post office boxes are no longer allowed for a billing address.

Private Practice Teams Rock!

 

According to the July issue of Consumer Reports, in the last 12 months 64% of people surveyed left a business because of bad service and 71% were tremendously annoyed by not reaching a human on the phone.  65% felt that way about rude sales people and 56% of the people felt that way about phone menus, too.

 

The good news is that in the category of eyewear, private practices ranked the best in customer service and a large national retailer ranked last.

 

This proves once again that the key to good customer service starts with relationships.  Empathetic and proactive care keeps private practices thriving.

 

Our experienced and loyal teams once again show why they have the edge.

Last Days Left for 2011 EHR Incentive

 

Registration is open for providers wishing to qualify for meaningful use of EHR in 2011.  You must have 3 months of meaninful use to hit the deadline.  If you have not yet registered, then visit and register for the MEDICARE incentive.  This must be done for EACH provider and PECOS has to be up-to-date for it to work.

Also keep in mind that providers getting e-Rx and PQRI incentive money can’t get EHR incentives at the same time.  If you are getting other incentives, you will want to wait until next year.

Visit https://ehrincentives.cms.gov/hitech/login.action to get signed up.

You will need to have a CCHIT ID number for your practice management/EHR software to completely register and be ready to attest.

You can get your certified EHR software ID number by visiting this site (for ambulatory practice types) and searching for your software by name or vendor:

http://onc-chpl.force.com/ehrcert/EHRProductSearch?setting=Ambulatory

You add the product you have to your shopping cart and click on the button that says “Get CMS EHR certification ID.”

The site will generate an ID number that you enter into your Registration site.

All 15 Core Measures must be met (or excluded from) and 5 of the 10 Menu Set Measures must be met or excluded from to have Meaningful Use (MU) of EHR during the 90-day period.

You have until February 29, 2012 (Leap Day) to attest to MU in 2011 for a 90-day period.

Incentive money is capped at $44,000 per provider or no more than five years of the incentive.  The last money will be paid in 2016.

 2014 is the last year to register and start participating in the EHR incentive.  In 2015 Medicare payment adjustments (reductions) begin for hospitals and providers who are not meeting MU of EHR.

According to Centers for Medicare and Medicaid Services:

For the first year for which an EP applies for and receives an incentive payment, the EHR Reporting Period is 90 days for any continuous period beginning and ending within the year. For every year after the first payment year, the EHR reporting period is the entire year.

·     A Payment Year equals a Calendar Year (CY). Incentive payments for this program end after 2016. 

·     A qualifying EP will receive an incentive payment equal to 75 percent of Medicare allowable charges for covered professional services furnished by the EP in a payment year, subject to maximum payments.

·     In general, a qualifying EP can receive an annual incentive payment as high as $18,000 if their first payment year is 2011 or 2012. Otherwise, the annual incentive payment limits in the first, second, third, fourth, and fifth years are $15,000, $12,000, $8,000, $4000, and $2,000 respectively.  In general, the maximum amount of total incentive payments that an EP can receive under the Medicare program is $44,000. 

 

What is your practice mantra?

A mantra is a word, group of sounds or words that create a “transformation” or put thoughts into action.  Common in Hindu and Buddhist cultures, the mantra cuts through the “static and noise” and focuses the thoughts into action.  Some practitioners even cut their mantra into rock as a form of expression and meditation.

Before you say I’ve spent too much time in Asheville, give some thought to your mantra or vision statement:

What do you do?  In a practical and simple term, what is your purpose?

Second, How do you do it?  What makes your practice different and specifically what steps do you take to accomplish the what?

Last but not least, why do you do what you do?  What are your hopes and dreams?  What do you hope to accomplish from all this hard work?

Write it down with help from your team.  Formulate a vision statement that captures the heart of your care and is easy to understand and convey.  Share it with patients and new team members.  Incorporate your vision into your goals and resolution. 

Remember the old adage, “if you don’t know where you are going, any road will take you there.”