Since the inception of the Medicare program in 1965, beneficiaries have been identified by a Social Security number-based identifier known as the Health Insurance Claim (HIC) number. This unique identifier has been used to determine the beneficiary for all Medicare transactions such as eligibility, billing and claim status inquiries.As a means to help fight identity theft, The Medicare Access and CHIP Reauthorization Act (MACRA) of 2015 requires the Centers for Medicare and Medicaid Services (CMS) to remove the beneficiary’s Social Security number from all Medicare cards by April 2019 and replace it with an identifier that will help to secure the integrity of the beneficiary health data. This new number will be known as the Medicare Beneficiary Identifier (MBI).
It’s that time of year again! If your Fiscal Year ends on December 31, you’ve probably been asked to start compiling your data in preparation for your 2017 operating budget. There is no doubt that the budget process can be grueling, but with a good strategy and some preparatory “leg work”, you can see the process through and produce some valid numbers that you can rely on for next year. The last thing that any manager wants to see is a budget that is not based on given, reliable history.
capitation: a payment method for health care services. The physician, hospital, or other health care provider is paid a contracted rate for each member assigned, referred to as “per-member-per-month” rate, regardless of the number of nature of services provided.
I’m not sure about you, but I never had plans to get old. I still rock out to The Who singing “My Generation…hope I die before I get old.” I’m a part of the generation that decided that 40 is the new 30, and then 50 is the new 40. Next year I will plant my feet firmly on age 60, and will hope that it’s the new 50! As much as we may try to stay young, the truth is that we can’t stop the clock, and time does march on, and those of us in the Baby Boomer generation (born Post-World War II between 1946 – 1964) are sliding head-first into retirement.
Topics: Financial Consulting
The Merriam-Webster Dictionary defines innovation as “the act or process of introducing new ideas, devices, or methods”. BusinessDictionary.com defines innovation as “the process of translating an idea or invention into a good or service that creates value or for which customers will pay.”
Topics: Revenue Cycle Management
Work as a trainer has some inherent obstacles – especially when that training is done remotely via an online meeting center. The first challenge, of course, is that it’s hard to capture and keep the attention of trainees without them being able to see me move about or wave my arms to indicate the importance of a significant piece of Medicare compliance. Then, there is the chance that the trainee may have limited or outdated computer experience – or just may be new to the job or industry.
Topics: Clinical Consulting
Sometimes, in order to grasp a new concept, you have to put it in terms that are personal and relatable. For example, when I was in college, two semesters of a world history class were mandatory. I heard about a professor who had a really unique style of teaching. Professor Dober’s shtick was to write on the blackboard backwards. So if you wanted to be able to take notes and understand the material, you had to learn how to read his cursive writing backwards. His style was catchy and memorable, and his classes were packed.
The Long Term Care Post-Acute world has functioned for decades in a fee-for-service environment. In the 1980’s, billing Medicare for resident care was pretty easy: add up all of your expenses for the billing period, type them on a claim, and mail it to the intermediary. You were paid your actual costs for your room and board, pharmacy charges, medical supplies and other patient care related costs. The annual cost report process allowed you to report facility operating expenses such as food costs and laundry services so that an adjusted reimbursement rate could be calculated. Facilities were even compensated through a settlement for their prior year charges in excess of payments received! Imagine that…