Changes In The Medical Billing World for July 2005

Changes In The Medical Billing World for July 2005

In July 2005, for many states, there was a 2% rate increase in Physical Therapy, Occupational Therapy and Speech/Language Pathology. As of July 1, 2005 the provider is responsible for submitting the correct charges for dates of service on or after July 1, 2005. If you have submitted medical billing claims before notification of this increase (if it applies in your state),you must submit an adjusted medical billing claim to receive the new rate.

Additionally, Colorado Home Health and Home and Community Based Services Providers as of July 1, 2005, may no longer submit claims for HCBS services under their Home Health provider number. All medical billing claims must be under the one provider number. These providers should have applied for a new HCBS provider number prior to May 2005. Failure to do so can now seriously delay any medical billing claims for services rendered after July 2005.

In Colorado, a 10 day rule has been established for medical billing that requires PARs (Prior Authorization Requests). The provider has 10 business days from the PAR start date to submit a complete PAR. If the PAR is incomplete, has missing or invalid information, the 10 days does not re-start from the date the provider submits the missing information. Your PARS must be complete the first time the are submitted and include all of the required information. Should your completed PAR be received later than the 10 working days deadline, units of service will be reduced accordingly and that means less revenue for your practice.

Keeping up with these fast paced changes is the job of your medical billing partner, if you outsourced your medical billing, none of these headaches would be yours!

View all Articles by: Melissa Clark, CCS-P