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It seems like keeping up with the changes in the
Medicare rules and regulations is a full time job. This
month has been no exception. In addition to
several 'in-house' issues, such as billing 'Medicare
Secondary' claims electronically, there are several
items which may have an impact on your revenue
stream. In several of the articles below, we have
included links to other sources of additional materials.
Most are great for late night insomnia problems!
| Payment for services to undocumented aliens |
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As part of the Medicare Modernization Act, Section
1011 allows for registered providers to be reimbursed
for emergency health services provided to
undocumented aliens. CMS will provide additional
funding of $250 million dollars a year through fiscal
year 2008 effective for dates of service from May 5,
2005. Eligible ambulance services include the
medically necessary air and/or ground transport of
the patient to the first hospital at which they are
seen for a medical emergency. Section 1011 does
not cover transport once the emergency care has
been provided and is always the payor of last resort.
Systems Design will begin to register our clients with
the CMS designated contractor Trailblazer and some
of you will begin to see paperwork to sign cross
your "IN" baskets. It is important that we
pre-register you because of the relatively short filing
period for these claims. If you have any question
regarding Section 1011 please do not hesitate to
contact us.
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| Medicare Advantage Program |
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Major changes are in the works involving your
Medicare patients. CMS has infused $14 billion
dollars in to the Medicare Advantage program in order
to reach their stated goal of 35% enrollment for all
subscribers into Medicare HMOs. What it means to
your patients is lower premiums, prescription
coverage, preventive care and, in some cases, even
dental and vision coverage. For you it means that
establishing medical necessity and what constitutes
an emergency will most likely be easier with the
Medicare Advantage HMOs. However, with all this
good news comes a note of caution. All
non-emergent, scheduled trips will require
preauthorization. Furthermore, if you do not obtain
the authorization you may not bill the patient. Please
make sure to pass this on to your intake personnel.
Remember emergent transports do not need to be
authorized.
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| Ambulance Inflation Factor |
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In the November 25, 2005, the
Centers for Medicare and Medicaid Services (CMS)
announced the 2006 inflation factor for ambulance
services will be 2.5%. As your actual Medicare
allowances become available, we will notify you.
[Federal Register: November 25, 2005 (Volume 70,
Number 226)]
[Notices]
[Page 71163-71165]
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| Employee Profile |
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Sue Schmitt
- Account Manager
Wedding Bells! That's right, two weeks ago Sue tied
the knot. Although Sue has been with us for just
under one year, she comes with a tremendous
amount of medical billing experience. Finding the work
at Systems Design NW was not challenging enough,
she decided to take on the additional role of wife!
Most of the staff joined Sue and her new husband
Leland for a great wedding reception - we are always
on the lookout for a reason to celebrate! We wish
Sue and Leland many years of happiness!
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| On the Lighter Side |
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An eccentric philosophy professor gave a one
question final exam after a semester dealing with a
broad array of topics.
The class was already seated and ready to go when
the professor picked up his chair, plopped it on his
desk and wrote on the board: "Using everything we
have learned this semester, prove that this chair
does not exist."
Fingers flew, erasers erased, notebooks were filled in
furious fashion. Some students wrote over 30 pages
in one hour attempting to refute the existence of the
chair. One member of the class however, was up and
finished in less than a minute.
Weeks later when the grades were posted, the rest
of the group wondered how he could have gotten an
A when he had barely written anything at all.
His answer consisted of two words: "What chair?"
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| Staff E-Mail Addresses |
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Although we always welcome your phone calls, there
are times you may wish to contact us via e-mail.
| Lori Christenbury |
LoriC@SystemsDesignNW.com |
| Shelley Brewington |
ShelleyB@SystemsDesignNW.com |
| Cris Connors |
CrisC@SystemsDesignNW.com |
| Judy Dunn |
JudyD@SystemsDesignNW.com |
| Tammy Flanagan |
TammyF@SystemsDesignNW.com |
| Carol Green |
CarolG@SystemsDesignNW.com |
| Laurel Hoch |
LaurelH@SystemsDesignNW.com |
| Sue Schmitt (Holler) |
SueS@SystemsDesignNW.com |
| Kim Mayes |
KimM@SystemsDesignNW.com |
| Lois Pierce |
LoisP@SystemsDesignNW.com |
| Lisa Rogalsky |
LisaR@SystemsDesignNW.com |
| Juls Smith |
JulsS@SystemsDesignNW.com |
| Cindy Tomeo |
CindyT@SystemsDesignNW.com |
| Susan Wytko |
SusanW@SystemsDesignNW.com |
| Roger Zegers |
RogerZ@SystemsDesignNW.com |
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| Holiday Schedule |
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December
23rd Christmas - Close at noon
26th Christmas - Closed
January
2nd New Years - Closed
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Roger A. Zegers, President
As 2005 quickly comes to an end, it's time to
look back at the year that was. It has been a great
year for business, as we have been able to add many
new clients. It has also been a great year as we
have added several wonderful new employees to our
team. We have all of you to thank for our continued
success!
On behalf of the entire staff at Systems Design
Northwest, I want to extend our warmest wishes for
a blessed Holiday season and a happy new year!
http://www.systemsdesignnw.com
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