Validator 5.15 released for Palmetto Medicare
Validator version 5.15 has been released for the transition to Palmetto Medicare for both northern and southern California. Many of you may recall that you MUST transition to the new system by September 2nd, or you risk delaying your claim payments. If you are currently submitting Medicare claims to NHIC for California, and have not already done so, you are urged to fill out the paperwork found in our June Newsletter. Those who have already filled out the paperwork and received your password for the new BBS, please follow the instructions in our article here to download the latest patch and start submitting to Palmetto Medicare. NOTE: This patch is a one-way patch. Once you have installed it, you may still download mail from NHIC, but you must submit claims to the new BBS. Do not install the patch unless you already have your paperwork back from Palmetto.
In addition to changes specifically for Medicare, we have added the following important changes to the Validator program:
- The provider unique identifier has been moved from the legacy ID to the NPI number. This allows files without a legacy ID to be re-processed.
- The NPI field for the facility has been marked as optional (all other NPI fields were marked as required in version 5.14).
- If there is no Facility attached to a claim, we will send no facility. This change, made to the forms, replaces the older system which would send the practice information in box 32 if a facility was not attached.
- Also in the newest forms, we have made the determination for if you are billing as a group depend on the Group NPI number rather than the legacy Group ID.
- We added compressed (Zip) file handling to the reports and mail screen.
- We added the Place of Service Code 13 to over 35 carriers.
- We suppressed the patient’s group number in Medicare carriers to handle when clients put the word “NONE” in the group number field in Lytec.
Medicare wants to give you a pay raise for saving costs!
| According to CMS, “E-prescribing - a prescriber's ability to electronically send an accurate, error-free and understandable prescription directly to a pharmacy from the point-of-care - is an important element in improving the quality of patient care.” According to a July 20th, 2006 report released by the Institute of Medicine, over $1.5 Million patients annually are victims of medication errors, costing providers, patients, and American taxpayers an estimated $3.5 Billion annually. This is to say nothing of the increase in physician labor costs for filling, refilling, and maintaining a practice’s medication dispensation needs. |
"Doctors at a hospital in Brooklyn, New York have gone on strike. Hospital officials say they will find out what the Doctors' demands are as soon as they can get a pharmacist over there to read the picket signs!"
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Well, our government believes it has very simple solutions to this problem. We here at Stephens & Associates know that government ideas are not always good ones, but this one seems to have some serious merit. The plan, as reported by this Washington Post article, is for Medicare to give you a pay raise for adopting e-prescribing in your office, which has been proven to reduce your office’s labor costs, and vastly reduce medication errors anyways. The plan lays out a 2% bonus on Medicare reimbursements for those providers who e-prescribe starting January 1st of 2009 through December 31st of 2010. In 2011 and 2012, the bonus will drop to 1%, then in 2013, down to ½ a percent. By 2014, those who are NOT e-prescribing will start to see their reimbursements cut.
This means that even if you assumed no labor cost savings for using e-prescribing, an office which gets reimbursed just $2,500 from Medicare monthly will have an e-prescribing solution (which is only $50 a month) pay for itself. Any office that makes more than that (which most do) will be PAID to e-prescribe. An average small office grossing just $50,000 a month will make $1,000 a month.
McKesson (Lytec’s parent company) has a $50 offering which works specifically with Lytec to pull patient demographics, has automatic formulary, allergy, and contraindication checking, as well as many other advanced features, and is just $50 a month. Your Lytec reseller can help you determine how much you could get paid for this, set you up with e-prescribing, and make sure the proper forms are filled out in time for the pay raise to take effect.
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