http://www.trigram.com/blog/ Trigram Blog en support@trigram.com Copyright 2010 2010-01-04T20:22:00-08:00 http://www.trigram.com/blog/post/resources-for-california-workers-compensation-billing/ http://www.trigram.com/blog/post/resources-for-california-workers-compensation-billing/#When:19:22:00Z In a recent post, I put out a link to a document by the California Academy of Family Physicians with great guidelines for how to get paid for medical billing.  (Click here for that.)   We also have many users in California who are looking for guidelines and/or resources to bill within the California Worker’s Compensation system.  While there are an abundance of online resources, as well as classes on the subject, the most common questions we get relate to which codes to use and how much they will pay.  While we would normally just refer you to the California Department of Industrial Relations website for practitioners (click here), the documents most asked for are the General Information and Instructions on how/what to bill (see here), and the procedural (CPT code) fee schedule for services you have provided.  This fee schedule is updated every so often, and the one we refer to is here.  The fee schedule is listed by section (what type of procedure--surgery, general medicine, anesthesiology, etc.), then CPT code, description, with the maximum payment amount at the end of each line.  Before the maximum payment amount is the reduction percentage, which is taken when a given procedure is used/billed along with others on the same day of service.  That’s about the most info we can provide on the ‘how tos’ of billiing, especially as it relates to California Worker’s Compensation.  For more information, go to the California Department of Industrial Relations website.   Practice Management 2010-01-04T19:22:00-08:00 http://www.trigram.com/blog/post/a-great-free-resource-for-medical-billingfor-everyone/ http://www.trigram.com/blog/post/a-great-free-resource-for-medical-billingfor-everyone/#When:19:14:00Z Hi all.  We often get calls from users asking us questions about how to do their billing, e.g., which codes to use for which procedures, how often to bill, etc.  We used to answer these questions, but prefer not to, as the way you use AcuBase, how you bill, and what you bill for is up to you.  We are more in the business of providing you with the tools to have you do your billing rather than teaching people how to do medical billing.  But most of us here at Trigram are also users of AcuBase as well as practitioners ourselves, and occasionally we find great resources.  I recently found one that I wanted to share:  A guide from the California Academy of Family Physicians called, "Strategies for Coding, Billing, and Getting Paid Appropriately."  It’s an excellent, free guide in PDF format, and it’s over 50 pages of "How Tos" on billing.  Check it out--I’ve posted it here. Practice Management 2009-12-31T19:14:00-08:00 http://www.trigram.com/blog/post/spending-on-your-medical-practice-at-year-end/ http://www.trigram.com/blog/post/spending-on-your-medical-practice-at-year-end/#When:18:16:00Z As the year draws to a close, there are many different tasks that await, from helping your patients to get their year-end receipts in order, to your own tax-prep and marketing.  In previous blog posts, I have covered how important this time of year is for sending out marketing materials, and helping your patients get organized for their own year-end needs.  Here, I’d like to briefly suggest another potential preparation you can make before the year is over:  spending money!  As anyone with any experience in tax preparation knows, when a business has made money in a given year and will owe tax, it may be an opportune time to spend a little on capital investments for your business to have more write-offs.  Planning to get a new table, perhaps some new wall hangings?  Heat lamps getting a little rusty?  Computer getting a bit old?  If you’ve made money in your practice this year, you have some money in the bank, and you have calculated that you will owe taxes, why not make some of those purchases before January 1st?  If you are an AcuBase user, and you’ve been entering payments faithfully into the program all year, run a simple report to get your gross earnings.  Go to the Reports tab in AcuBase, and select the Invoices:  Deposit Slip report.  Enter the dates from 1/1/2009 to 12/31/2009, and then go to the last page of the preview when it comes up (or print it out) to see the final tally of what you’ve made this year (gross).  If you use Quicken or another bookkeeping software package, use their reporting tools to tally up your expenses for the year.  If you made a lot more than you spent, and still have money in your practice’s account, perhaps this is the time to make some purchases.That said, note that I am not a tax professional, and do not wish to be your primary source for tax or spending advice.  On my end, I get my estimated taxes done by my accountant in the Fall before making these decisions, and you should as well.  AcuBase and Trigram Stuff, Practice Management 2009-12-21T18:16:00-08:00 http://www.trigram.com/blog/post/year-end-summaries-using-acubase-pro/ http://www.trigram.com/blog/post/year-end-summaries-using-acubase-pro/#When:18:30:00Z As the year rapidly comes to an end, many of your patients who paid you directly will be wanting a summary printout of their visits for the year for tax purposes and/or to get reimbursement from their insurance company or flex account.  Rather than waiting for them to ask, why not offer this service up to them as you finish your last appointment of the year with them?  Doing so is easy in AcuBase.  Simply go to the Reports tab, choose the report titled, "Invoices:  Patient Balances Detailed," and click on the "Run Selected Report" button on the bottom of the screen.  When you get to the Search/Find screen, go to the "Invoice Date" field, and enter "1/1/2009...12/31/2009" (without quotes) to choose all of the year’s invoices.  Then click on the "Patient ID" field, which pops up an alphabetical list of your patients.  Choose the patient you would like to summarize, then click the "Continue" button on the left side of the screen to get a preview and print.  A summary with diagnosis and patient information will be provided for the year. Often times when we print these reports, we may see a payment that was missed, or perhaps  other issues with individual invoices.  To fix these, go back to the patient’s name from the Patients tab on top of the screen, then choose the "Billing" subtab, find the invoice date in question, click it, and edit it as necessary.  If the information on the top of the report (such as diagnosis, or patient info) is incorrect or missing, go back to the first invoice for that report and fix it there.  Then, when you print the report, that information will be fixed.For other questions or issues related to year-end processes, please feel free to contact our excellent, responsive technical support team at support@trigram.com, through the contact page on our website at http://www.trigram.com/about_us/contact/, or call us toll-free at (888) 4ACUBASE. AcuBase and Trigram Stuff, Practice Management 2009-12-14T18:30:00-08:00 http://www.trigram.com/blog/post/tis-the-season-for-marketing-your-practice/ http://www.trigram.com/blog/post/tis-the-season-for-marketing-your-practice/#When:16:27:00Z By Jason Luban, L.Ac.Founder, Trigram Software LLCAs the holidays fast approach, many of us notice that our practices may begin to thin out.  Children get out of school, friends and family show up, vacations are taken, and medical appointments become a distant priority.  Rather than slink about waiting for the action to return, why not take action?  The holidays are a perfect time to hone your marketing skills by using some time-honored techniques to build the momentum of your practice into the new year. Those of us who have been in practice for some time now know the 80/20 rule well:  80% of your business will come from 20%...of your existing or past, satisfied patients.  Mining the resources of your database full of past and current patients is an excellent way to get more people coming in to see you, and during the holidays, there is no better, and lower maintenance, way to do so than with holiday cards.  In the recent past, holiday and birthday cards, and nearly any communication with patients through the mail, were a less-than-palatable experience.  We’d have to buy the generic cards en mass, print out labels or hand-write addresses on each, sign each card, and stamp and send it.  At the very minimum, an all-day process.  And while the Internet now allows us to collect patient email addresses and send mass emails or newsletters online, snail mail is still the best way to truly reach out and touch someone.  Fortunately, you can do so with custom cards, mass mail, and do it all with the click of a mouse in under an hour.  Photo sites like Kodak and Shutterfly.com, among others, allow you to upload your own pictures, easily create your own cards from their templates, import your names and addresses, and have the cards addressed and sent out in the mail.  Use AcuBase to go to your list of patients, then go  to File/Export, and choose the fields First Name, Last Name, Address, City, State, and Zip, and save the file to your desktop.  Then upload (import) the list to your favorite card-making website, and you’re all set.At the time of writing this, my research has found that ordering over 100 custom-made cards and having each addressed and sent by mail costs about $2/card.  By picking only your ‘favorite’ referral sources and patients who are still active or recently active, you will reduce costs by targeting your market, and tickle their brains when they get your card.  If even just a few of them remember you and send themselves or someone else your way, the exercise will have more than paid for itself. AcuBase and Trigram Stuff, Practice Management 2009-12-11T16:27:00-08:00 http://www.trigram.com/blog/post/finding-good-practice-management-marketing-resources-online/ http://www.trigram.com/blog/post/finding-good-practice-management-marketing-resources-online/#When:18:04:00Z By Jason Luban, L.Ac. With so much focus on treating patients and billing insurance companies, it’s easy to overlook the fact that we must continue to market our practices.  If you’re like me, associating the words ‘marketing’ and ‘your practice’ may give you a pit in your stomach.  Nevertheless, few practiices market themselves.  I’m not going to write a big blog post on this.  You all know marketing is necessary, and you also know that there are a bunch of ways to do it, from newsletters to birthday and referral thank you cards, email marketing, and more.  With the holidays fast approaching, it may be a good time to bring this subject up again (holiday cards, anyone?).Much as I dislike having to market, there are good, FREE resources available to you which may cut down the time and effort necessary to get it done.  I’ll review some of my favorites over time, as I find them, and if you have any good links, please send them along as comments (below).  For now, I’d highly suggest checking out The Supply Center’s freebies (at http://www.thesupplycenter.com).  This website for medical supplies also supplies many free resources for marketing and managing your practice, from marketing plans to newletters and brochures.   Again, if you have any other links or suggestions, let us know.  And remember, AcuBase can help by printing out mailing lists, labels, and more related to your patients, referral sources, insurance company contacts, and more. Practice Management 2009-11-09T18:04:00-08:00 http://www.trigram.com/blog/post/are-you-ready-for-medicares-recovery-audit-contractor-rac/ http://www.trigram.com/blog/post/are-you-ready-for-medicares-recovery-audit-contractor-rac/#When:18:29:00Z  By Sue Kay As a practice manager, you have so many responsibilities critical to the efficient, effective AND profitable running of your medical practice. Add to the mix the tough economic times we are facing (unlike any other in recent memory), and your job can be downright overwhelming. And on top of it all - here comes RAC!What is RAC? It stands for Recovery Audit Contractor program, and if it’s not having an effect on your practice yet - just wait; it will.The Recovery Audit Contractor (RAC) program was authorized by Congress as part of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). As part of the legislation, Congress directed the Centers for Medicare and Medicaid Services (CMS) to conduct a three-year recovery audit demonstration program in a small number of states.The goal of the RAC program is to detect and correct improper Medicare payments and to collect those over payments from providers.From March 2006 through March 2008, the Medicare Recovery Audit (RAC) demonstration project identified more than $1 Billion in incorrect Medicare payments - including some $900 Million in over payments to facilities and providers.The obvious success of this demonstration program led to the RAC program being made permanent as part of The Tax Relief and Health Care Act of 2006. This authorized CMS to expand the program in all 50 states. This national rollout is currently underway, with RACS scheduled to be engaged in each of the 50 states no later than January 2010.The question is… Are you ready?According to the CMS website, the demonstration program identified overpayments most often in the following 4 situations:Payment for services that were "not medically necessary." (40 percent);Payment for claims that were coded incorrectly or were paid using an outdated fee schedule (35 percent);Payment for services without adequate documentation to support the claim (8 percent); andPayment for services in which duplicate claims were filed and paid for the same service (17 percent).As you prepare for a potential RAC Request, keep the above four overpayment situations in mind and put the following preparation steps in place:Identify a RAC point of contact/leader. In most 3-5 physician private practices, this point of contact will most likely be you (the practice manager/office manager). In larger, multi-specialty practices, you may appoint another staff member such as the Medical Records manager or your Billing Supervisor to be the RAC point of contact. You can now ask the RAC to route all requests to this one individual in order to make sure that all RAC requests are handled the same way and in a timely manner.Conduct an internal audit of a sampling of past claims. Pull the medical record and make sure that the record contains appropriate documentation to support your claim. Remember that the documentation within the medical record must support the diagnosis information included on the claim for reimbursement. Based on the fact that 40 percent of the overpayments identified in the demonstration program were due to services provided that were deemed to be "not medically necessary," you must make certain that your documentation supports and provides evidence that the service was indeed necessary.Review your existing compliance programs to make sure that you are using the most current Medicare regulations. Keep in mind that RACs are not permitted to select claims to review through random selection; they are required to use data analysis to identify and select claims for review. The best way to reduce your RAC risk is to make sure that you are up-to-date on current Medicare rules and regulations and that you have a process in place for incorporating those rules and regulations into your practice workflow.Consider some outside/external help to review your current practice policies and procedures. External reviews are not only helpful in regard to the RAC program, but can also help identify key areas that will help your practice reduce its risk and run more smoothly and efficiently. [Visit our resource page at www.efficiencyinpractice.com for a listing of possible external audit sources.](c) 2009 Efficiency in PracticeSue Kay, Senior Consultant at InHealth, is the editor of Efficiency in Practice, the free eNewsletter for medical practice managers who want to save time, money and reduce risk. For more information and to access your FREE report, The 8 Things You MUST Know About CMS’ RAC Program, visit http://www.efficiencyinpractice.com Practice Management 2009-09-28T18:29:00-08:00 http://www.trigram.com/blog/post/more-on-new-fda-supplement-dispensary-guidelines-and-procedures/ http://www.trigram.com/blog/post/more-on-new-fda-supplement-dispensary-guidelines-and-procedures/#When:17:30:00Z By Jason Luban, L.Ac.A few days ago I posted a question about whether or not anyone knew of new FDA Good Manufacturing Process (GMP) guidelines that may apply to practitioners selling herbal supplements.  I’ve since gotten some more information from Bill Egloff at Crane Herbs (Craneherb.com).  Apparently, new FDA guidelines are going into effect that create and maintain standards, primarily for those who combine herbs or herbal medicines ("compounding" formulas).  These regulations will primarily affect schools, herbal formula manufacturers, and larger clinics that do compounding, but a new course by Marilyn Allen (see below) is aimed at practitioners.  The thinking is that, if you have been through a course where you have learned the basics of GMP guidelines, and you keep records and attempt to adhere to the GMP standards, as well as using GMP-certified herbal sources, you should have a better defense in case a patient or customer complains that the formula you gave them caused them undue harm.I don’t know much more than this, and would welcome any comments from those who may know more.  In the mean time, I’m posting Marilyn Allen’s course flyer below, which includes contact information: FDA Good Manufacturing Procedures:   Dispensary Guidelines and Procedures Information You Need to Know to be in Regulatory Compliance Saturday, August 29, 2009   Whittier, CA Southern California University of Health Sciences Presented by American Acupuncture Council, the Consortium for Oriental Medicine Research and Education in coordination with Marilyn Allen There are new FDA regulations regarding good manufacturing procedures.  Schools and practitioners must be able to comply through dispensary guidelines and procedures.  It is important for you to understand these regulations to be in compliance and to keep your practice growing and thriving through your increased knowledge.  The upcoming seminars will present the necessary information and provide you with the following additional benefits: Continuing Education Credit Certificate A disc containing all forms you need to be compliant A handout to put in your Policies and Procedures notebook Information on the Adverse Reaction Database Lunch Vendor interactions and coupons A raffle Topics to be discussed include: introduction to the FDA ruling, processing and product information, sanitation, equipment and utensils, record keeping, and more! Come learn the ins and outs for your office’s dispensary in this one day seminar.  This is information you absolutely must know and incorporate.  You must be in the loop. Just $199 for 8 CEUs (California Board) and 7 PDAs (NCCAOM)! AND…all proceeds from this seminar will go back into building the acupuncture profession through research and legislation. For more information and registration contact Alice at AAC Network (800) 562-3335 Don’t be left behind!  Reserve your spot today! _______________________________________________________________ Additional Dates and Locations August 29, 2009                  Southern California University of Health Sciences (Whittier, CA) October 3, 2009                   Texas College of Traditional Chinese Medicine (Austin, TX) October 10, 2009                 Five Branches Institute (San Jose, CA) November 1, 2009               American Academy of Acupuncture & Oriental Medicine (Minneapolis/St. Paul, MN) November 7, 2009               Acupuncture and Massage College (Miami, FL) November 21, 2009            Phoenix Institute of Herbal Medicine & Acupuncture                                                             (Phoenix, AZ) December 5, 2009               Pacific College of Oriental Medicine (San Diego, CA) December 13, 2009            Pacific College of Oriental Medicine (New York, NY) January 30, 2010                Northwestern Health Sciences University                                                             (Minneapolis/St. Paul, MN) February 6, 2010                 Arizona School of Acupuncture and Oriental Medicine                                                             (Tucson, AZ) February 20, 2010               University of East-West Medicine (Sunnyvale, CA)                                                           *This seminar will be conducted in Chinese March 21, 2010                    Institute of Clinical Acupuncture and Oriental Medicine                                                            (Honolulu, HI) March 27, 2010                    Traditional Chinese Medical College of Hawaii (Kamuela, HI) April 3, 2010                         Five Branches Institute (Santa Cruz, CA) April 4, 2010                         American College of Acupuncture (Houston, TX)                                                           *Seminars in both Chinese and English this day at                                                                  this location May 1, 2010                         Emperor’s College of Traditional Chinese Medicine                                                             (Santa Monica, CA) May 15, 2010                       Southwest Acupuncture College (Santa Fe, NM) June 26, 2010                     Dragon Rises College of Oriental Medicine (Gainesville, FL) Dates pending at several additional locations including   Practice Management 2009-09-21T17:30:00-08:00 http://www.trigram.com/blog/post/do-new-gmp-good-manufacturing-practices-standards-apply-to-your-supplements/ http://www.trigram.com/blog/post/do-new-gmp-good-manufacturing-practices-standards-apply-to-your-supplements/#When:16:59:00Z By Jason Luban, L.Ac. I was recently at a Chinese medicine seminar with Giovanni Maciocia in San Francisco, and got to talking to a few other colleagues, one of whom was Bill Helm of Crane Herbs (http://www.craneherb.com).  Bill alluded to the fact that all practitioners would soon need to be in compliance with Good Manufacturing Practices (GMP); that their herbal medicines would need to meet GMP standards.  I’ve since done a little bit of Web sleuthing and haven’t found much, save this article from another herb company (Pacherbs.com).  If anyone out there knows of what I speak, please email us at support@trigram.com, or, better yet, leave us a comment below.  Practice Management 2009-09-18T16:59:00-08:00 http://www.trigram.com/blog/post/coding-resources-anyone/ http://www.trigram.com/blog/post/coding-resources-anyone/#When:17:47:00Z Our support team gets a lot of calls from individual practitioners looking for resources on how to do their CMS form billing--which codes to use and the like.  AcuBase Pro gives users the ability to do billing, just as Microsoft Word gives one the platform to do word processing.  But what you put on that page depends upon your own training, your own situation, your own needs.  It follows that we cannot tell you how to bill, which codes to use, or even where to put what on the CMS form.  However, we’d very much like to be able to recommend paid and (preferably) free resources in this area.  AcuBase Pro staff and users highly recommend Flashcode, a free web-based coding database (http://www.icd9coding1.com).  For more detailed courses for those doing billing and coding, you may want to check out paid courses, such as those offered at Audioeducator.com (http://www.audioeducator.com/industry.php?id=11 for courses on medical billing and coding). A Google search for billing and coding information will surely provide much more, but we’re most interested in knowing what you use or recommend.  So if you have any further recommendations for where to go, on the web or otherwise, please let us know by commenting below. Practice Management 2009-09-04T17:47:00-08:00