FOS

California Supreme Court Rules Physicians Cannot Balance Bill HMO Patients

According to the San Francisco Chronicle, the California Supreme Court has ruled that physicians cannot "balance bill" patients whose health maintenance organizations (HMOs) have underpaid for care, and that the physicians can only seek redress from the insurer. The decision was praised by consumer groups, but a spokesperson for the California Medical Association stated that a ban on billing patients would shift costs from HMOs to physicians, some of whom might end their affiliations with emergency departments.

Overview of E-Prescribing Program Initiated by CMS

The BSOF has attached a series of educational documents to our Blog that provide some background and instructions on the E-prescribing program initiated by the Centers for Medicare & Medicaid Services.  The documentation includes a series of helpful documents from the AAOS as well as links to the CMS E-prescribing website. 

Here is the link to the CMS E-prescribing site:  http://www.cms.hhs.gov/EPrescribing/

As a quick reference tool, below are the appropriate codes for reporting the use of e-prescribing technology.

The current “G” codes are as follows:

• G8443 – the prescriptions generated during the patient encounter were generated using a qualified system.

• G8445 – you have a qualified system but no prescriptions were generated during the patient visit.

• G8446 – you have a qualified system, but some or all of the prescriptions during the encounter were handwritten or phoned in due to one of the following: required by state law (such as narcotics), patient request ( such as patient going away for winter), or your system is currently inoperable.

Download Nuts and Bolts of E Prescribing

Download 2009 E Prescribing Fact Sheet AAOS

Protect your Medicare provider enrollment data by enrolling/updating information online.

The U.S. Centers for Medicare & Medicaid Services (CMS) has set up an Internet-based system, designed to make it easier for physicians and nonphysician providers enrolled in Medicare to protect their enrollment records. The Provider Enrollment, Chair and Ownership System (PECOS), will help providers reduce the risk of having their personal and financial identification numbers (e.g., birth date, Social Security Number, Tax ID Numbers) being stolen and used to commit fraud. PECOS is currently available in more than 30 states and will be expanded to all states by the end of January.
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