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Highmark recently released a new policy requiring G-codes/severity modifiers be included on outpatient therapy claims for Medicare Advantage Patients. Highmark will begin requiring therapists to include these codes on claim submissions as they bill for outpatient therapy (physical, occupational, and speech), specifically for Medicare Advantage Patients, as of January 1st, 2014. Please click on the file below for more information.
New G-Code Requirements
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Keeping track of the various incentive programs and deadlines currently being rolled out by CMS is oftentimes daunting. Recently, CMS published some new tools that assist healthcare professionals, organizations, and insurance carriers with applicable deadlines, and also offers helpful resources in meeting them.

                                      Please click on the below images to access these helpful tools:
Feeling overwhelmed by the Meaningful Use Attestation Process? We can help! Check out our provider solution, MBSS...Let's Attest! We want all of our eligible providers to qualify for and acheive Meaningful Use. Contact us today to see how we can begin assisting you in meeting this goal!
Interested in learning more? Click here. You can also find a description of this program under our "Services" tab on this website.
We look forward to working with you!

MBSS has been accredited by the Better Business Bureau!

Please join us in congratulating Dr. Bonnie Tatar for successfully attesting and receiving her Meaningful Use Incentive reward! Congratulations, Dr. Tatar!

Building and Maintaining Loyal Client Relationships November 1, 2012 By Leave a Comment Danielle Taimuty

By Elizabeth Pagel-Hogan

Danielle Taimuty, CEO and President of Medical Billing Solution Services, Inc. (MBSS), has a knack for building loyal relationships. This knack has helped her grow MBSS from a small consulting service run out of her home to a national business that benefits her clients and her community.

“MBSS got started by accident,” Taimuty laughed. “I have a clinical background but started working for an insurance company. I was married and then we had a son and I wanted to stay at home. For a financial boost, I did some consulting for a practice to help with their billing. They were my first client and are still my client today.”

Taimuty is originally from Pittsburgh and lives in her hometown of McMurray but the business is in now based in Canonsburg near Southpointe. Word of mouth, passed from one satisfied customer to the next, at first caused Taimuty some consternation.

“When I initially took on this first client, I was immediately referred to another client and I was completely overwhelmed,” she recalled.

But now the business thrives from the consistently positive client recommendations.

“9 out of 10 times our out-of-state clients are referred by an existing client. We live for those referrals. Other than my children, there’s nothing that makes me happier than that,” Taimuty explained. “I always try to stay in personal contact with all of my providers, even though we are growing. That way if there is a problem we can address it and give them a resolution quickly.”

MBSS started with small practices but now serves larger groups too. The largest practice, including 27 primary care physicians, is based in Chicago. MBSS also serves urgent care, podiatry, surgery, and physical therapy among other specialities.

Taimuty originally hoped to be a physician herself but after a first-hand experience at Mercy Hospital, she took a different approach.

“I decided I wanted to help physicians. The idea that all physicians are very wealthy and work 8-4 was squashed for me. Great providers work so hard to take care of us and somebody has to take care of them.”

Billing is the core of MBSS but it also offers electronic medial records, practice management, credentialing, helps providers with meaningful use and attestation. MBSS also provides support and training on all products and sends staff to practice locations. In addition, MBSS helps providers connect with attorneys and helps them determine realistic expectations of revenue.

Taimuty could identify so many things from the insurance standpoint that providers weren’t billing where they could be.

“We had one client that was a group practice but the husband and wife got a divorce. She didn’t get anything, so we set her up with her billing, set her up with EMR, and quadrupled her income from the time she was in a group practice,” Taimuty said. “We helped her through a tough time. We taught her how to bill—she just didn’t know. We find that a lot.”

MBSS doesn’t always take over the billing for providers.

“I want what’s in their best interest because that’s in my best interest,” Taimuty explained. “If I go into their office and they have a great staff, I will tell them they don’t need to outsource. We want them to find solutions that meet their needs and in their best interest.”

But that situation doesn’t happen often.

“Most of the time, the best physicians are not business people,” explained Taimuty. “They really want to help people and treat the patients, but they put the business needs on the back burner. In today’s industry, business can’t be. Their profit margins have decreased so much. Physicians need a business sense or surround themselves with someone who can make sure they are billing correctly while following guidelines and regulations.”

Taimuty felt governmental changes are the biggest challenges that providers face right now.

“We’re going through a paradigm shift,” she said. “The smaller providers have really struggled to implement the changes and it’s difficult being the bearer of bad news when we have to explain the changes and the often negative effects. Also, I hate to see a really good provider decide to retire because they can’t take the logistics any more.”

Despite these obstacles, Taimuty sees a light at the end of the tunnel.

“I’d like to see providers get over the hump of adopting the technical aspect of medicine. It will get better!” she said. “Look at banking now—that will be healthcare in the future. They will be able to access the information they need to provide better care and carriers are going to pay providers for healthier populations. Our great providers will get paid what they deserve.”

Taimuty’s combined clinical and insurance background gave her the perfect foundation to begin MBSS but she gives most of the credit to her team.

“I’m very aware that I am where I am today because of the people around me,” Taimuty stressed. “I have a fantastic team that has helped this company grow and continues to help it grow. Many years we put the brakes on and worked on a solid foundation.”

She explained that customer service and a respect of the family are two core values.

“My team is like family, I have so many people who’ve worked with me for so many years,” she said. “Customer service is what sets us apart. Customer service is our number one concern. We don’t outsource anything. Most of our employees come to the office everyday, but all 47 of our employees are women right now and a lot of us are mothers. If their children are sick, we have allowed them to work from home. Our IT department has set everything up securely and we are compliant with HIPAA and HPI. We are also compassionate. We understand that family comes first and wouldn’t want it any other way.”

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Recently, HITECHAnswers published an article describing the findings of a case study exploring the physician use of the EHR and the quality of healthcare. This case study found that physicians utilizing an EHR scored signaificantly higher in quality healthcare than those physicians not using an EHR.
Follow the link below to read the rest of the article, and let us know what your thoughts are!
Join us in congratulating Dr. Bonnie Tatar and Dr. Weldon Lovely in successfully attesting to Meaningful Use Stage One. Both Dr. Lovely and Dr. Tatar participated in MBSS' Let's Attest Program to assist them in achieving this goal.

Congratulations Dr. Tatar and Dr. Lovely on this wonderful accomplishment!

Novitas Medicare patients received EOBs stating they received pneumonia vaccine when they really received a flu vaccine. This is causing confusion with the patients.

The EOB error, which began Oct. 1, 2012, affected all Medicare patients in Pennsylvania and several neighboring states. It did not affect Medicare Advantage patients. Novitas Solutions has notified all of its business partners. The error did not cause any issues with physician reimbursement.

If you receive a call from a patient about this error, you can get a revised EOB by contacting Novitas Solutions at 1-800-MEDICARE. Patients and physicians will only receive a corrected EOB upon request.