Here we go again with money owed to physicians and the big job of calculating the differences on claims already paid.  Again, I hope some folks soon come out of denial and come to understand he money and time involved here.  Certainly I would like to see the process work for the doctors, but again when underlying data systems are involved, resets and programming needs to occur and this is both expensive and time consuming. 

Do Some Think That Health IT Costs and Systems Grow On Trees-Certainly Starting To Give That Impression of Late

I was caught up myself with the little billing I do from the Congressional stall over the extension granted in June when the 10 day limit expired and had to re-submit all the claims as there as an “unidentified technical error” reported by the Medicare contractor, a wholly owned subsidiary of Blue Cross, and had to re-submit, so a bit of extra work on my part and several others on Twitter reported the same.  This is real life folks and the money and time that others had to incur due to Congressional delay so now we have this mess to figure out.  Is this a re-do of all claims for the year 2010 for each provider?  It seems like that is the answer and a lot of data work and expense so will that part of it be funded here or from a separate area to make this happen for the doctors? 

When it comes to top level management with CIOs and CTOs in time, there are going to be very few that want the pressure cooker as this is a tough place to be today and somewhat thankless too as politicians who are the big “non participants” in general digital IT literacy drive a lot of this and sometime they don’t look very smart when knowledge is needed and we end up with open mount and insert foot.

So what is the deal here for physicians to collect?  Resubmit claims again and cross fingers?  If it is not substantial enough then they won’t have time but the contractor no doubt will see additional transaction revenue from all of this so I’m sure they are ready to go for it as the bills resubmitted will again need to be analyzed for potential fraud and the rest of the processes that go along with it, so they will be securing additional money through this process and will this expense be greater than what is owed to the doctors?  Good question I think, but only the algorithms used to forecast will know for sure.  BD 

The American Medical Association (AMA), along with medical societies representing all 50 states and the District of Columbia and 57 national medical specialty societies, called on the Centers for Medicare and Medicaid Services (CMS) to use the $200 million allocated by Congress to provide physicians with long-overdue Medicare reimbursements for payments they should have received in 2010.  The funds were part of the Medicare & Medicaid Extenders Act of 2010, which was passed this week by Congress.

“After weathering a year filled with uncertainties from continuous threats of cuts to Medicare payments, many physicians are not in a position to rely on IOUs from the government,” said Cecil B. Wilson, M.D., AMA President.  “This week Congress allocated $200 million to help CMS comply with the new health reform law by reimbursing physicians for payments they should have received this year under the Affordable Care Act.  We urge CMS to provide physicians with prompt information about how these claims will be handled, and to make the reimbursement process as quick and simple as possible.

AMA and Others Urge CMS to Pay Overdue Reimbursements to Docs | Physicians News


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