Tag Archives: Issues

Billing Specialists to Look After Major Billing Issues Likely to Be Faced By Radiologists in 2013

Radiologists, who have been striving to maintain a balance between diagnostic priorities and operational compliance, may well find pulled further into a host of billing and compliance issues throughout 2013:

To begin with, they will have to discern the vital connect between diagnosis coding and procedural coding systems and the systems that have evolved to provide a common method of describing diseases, diagnoses, and procedures.

Second, like in other disciplines, they may be bound by the medical necessity clause while diagnosing high-cost tests. In fact, Medicare requires that the medical necessity of high-cost diagnostic radiology tests be proved and the extent to which they may be prescribed for beneficiaries by either primary care physicians or physician specialists. Therefore, radiologists need to be aware of both the medical necessity as well as the extent to which beneficiaries are entitled for radiology reimbursement under Medicare, Medicaid, or commercial health insurance plans.

Third, admissible radiologic expenses for Part B imaging services may be rationalized on par with industry standards. As a result, radiologists may see their reimbursements dropping or appreciation depending on where they stand vis-à-vis industry standards.

More importantly, radiologists may be under increased monitoring for billing errors, and irregularities. It could even lead to being black-listed for repeated history of billing malfunction. Therefore, it may require a concerted effort to stay clear of being guilty under Medicare, Medicaid, and other HHS programs or commercial health insurance plans.

These ensuing operational issues may prompt radiologists to:

Screen medical necessity and ask for advanced beneficiary notices (ABNs) on Medicare patients. This could require radiologists to function in tandem with the facility staff at the patient’s hospital to ensure the ABNs are accompanied by component fee as well.
Be prepared for Recovery Audit Contractors (RACs) and Comprehensive Error Rate Testing (CERTs), which are integral to standard scrutinizing. This would call for tactical and shrewd documentation and explanation of the radiologic services billed for claiming.
Evaluate templates and exam titles in accordance with the prevailing standard of equipment, technique or procedure, and the admissible CPT codes as amended from time to time.
Establish smooth communication with billing processes during revision to equipment, techniques or procedures. This would ensure that the modifications are adequately reflected in coding and billing, and claims are devoid of either under-coding or up-coding.
Make provision for reporting discrepancies, such as number of views or extent of technical complexity. This could help radiologists recover maximum claims as well as minimize the chance of denials and auditing issues

Even as radiologists seek to implement tactical moves to counter the impact of billing issues, they may find themselves swayed more towards clinical focus. That is why it makes sense to hire Radiology Billingspecialists for the purpose. Medicalbillersandcoders.com – having nation-wide affiliation with a chosen pool of radiology billing specialists – offers to deploy billing resources that are competent and experienced to address and maneuver radiologists through the billing issues likely to surface in 2013.

Medical Billers and coders (MBC) is one of the leading Medical Billing Companies in USA & help doctors to shortlist Medical Billing Companies, Medical Billing Services according to their preferences of specialty, city, software and services performed.

About NFL investigates, issues guideline

The NFL sent representatives to the Jets’ practice facility Friday as part of its investigation into Sunday’s tripping incident involving the team’s strength and conditioning coach and a Miami player.

In light of the incident – in which Sal Alosi, a Massapequa native and former Hofstra player, was suspended indefinitely for tripping special-teamer Nolan Carroll during the Jets’ 10-6 loss to the Dolphins – the league issued a reminder of sideline guidelines to all 32 teams, where to buy Discount NFL Jerseys? maybe ujersy is a good choice.

According to the rules, each organization must appoint a “get-back coach” – which, in the Jets’ case, was Alosi – who must be aware of the rules and enforce them. Only the game officials and chain crew are permitted in the “first border,” or white stripe along the sideline.

In the “second border,” which extends 6 feet to the solid yellow line within the bench area, only the head coach, assistants in charge of calling signals or substitutions and small groups of substitution players are permitted. All others must remain in the bench area behind the second border.

Violations of these rules by the team or individuals could lead to in-game penalties or other disciplinary action, including fines or suspensions.

Jets coach Rex Ryan said that having received the memo, he is confident that his team won’t incur any infractions. “Our team will be way back, you know?” he said playfully. “That’s pretty safe to say; we will be the leaders in that.”

Ryan reiterated that he had no prior knowledge that Alosi ordered players to create a wall on the sideline during punt returns. He also dismissed the comments of former Ravens coach Brian Billick, now an NFL analyst, who said on ESPN radio Thursday: “Of course Rex knew about this, if you want to buy New England Patriots Jerseys, please go to ujersy.”

“I wish he would have asked me,” Ryan said. “I would have told him the truth.”

Though the Jets insist Alosi acted alone, there’s growing …

More information please views: About NFL investigates, issues guideline

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Performance Issues – Missed Deadlines

Anyone can miss a deadline, it’s happened to us all but when you have a team member who consistently misses deadlines, you have a problem that you need to address. Be sure that the team member has the same understanding of their deadline as you before taking action; a work assignment and deadline for the assignment constitute a contract between you and your team member and the contract must be agreed upon. The deadline must be clearly stated and the team member must agree that they can and will meet it. It’s time for action if you’ve clearly stated the deadlines and your team member has agreed to meet them.
 
The first question to ask is: is my team member capable of meeting the timelines you’ve given them? The answer to this question will guide your actions. One way of measuring your team member’s ability to meet the deadline is to have a consultant, either on the team or external to it, assess the work package to determine the effort necessary to complete it. An estimate of the effort required will allow you to determine whether the duration allowed was reasonable. Be sure the consultant has all the information they need, both about the work and about the resource assigned to it. You’ll get different estimates for junior, intermediate, and senior resources.
 
If the time you’ve allowed your resource to do the work is less than reasonable, you may need to re-visit all your estimates. At the least, you’ll need to re-visit all the estimates for that resource. If the resource is identified as a senior performer and performance indicates a more junior one, you may need to consider training for the resource to improve their performance. The training might be formal such as courses, or informal such mentoring or coaching.

Remember that when a senior resource is engaged in mentoring a more junior one, their productivity will be severely impaired so make allowances. Consider replacing the resource with a senior resource if that’s possible. At the very least, you’ll need to move this resource from the critical path or partner them with a senior resource capable of meeting the deadlines and mentoring your poor performer. If you were told a contract resource performed at a senior level and they actually perform at an intermediate or junior level, you have a problem with your source which should be addressed. Remember that your goal is to be influential and achieving this goal has a down side: no-one wants to disappoint you so they may agree to an unreasonably short deadline.
 
You may be dealing with a lack of experience in a particular skill set, that is the team member may be a senior programmer but have very little experience in data query languages. Your project should have provisions for training and now may be the time to utilize them. It’s always better to have training occur before the skill is actually required, but if the need for training is only discovered when it’s needed, and the team member is otherwise a valuable asset, you may be left with no other choice than to provide the needed training. Consider replacing the resource with one with the required skill set if tight timelines don’t permit training time. Consider going back to the source for a contractor, and demand that they replace the resource with one having the required skills (providing you identified the required skill in the first place).
 
The extreme case is where you’re dealing with a resource with all the skills and experience required to meet your deadlines, but is either too lazy to meet them or is actively trying to sabotage your project! Observe the behavior of the team member. Are they spending an unreasonable amount of time socializing? Are they constantly visiting other members of the team (or other teams) and chatting with them? Have you received complaints from other team members that your problem child is constantly pestering them and interrupting their work? If you encounter any of these symptoms, it’s time for a one-on-one meeting with the resource. Once again, you need to tread carefully here. Consult your Human Resources organization’s policies, guidelines, and standards; you may even want to ask for help from an HR representative. Take the team member aside and clearly articulate the impact of the missed deadlines on the project. Be polite but firm. You’re not asking to engage in a debate here, the conversation should be one sided, you talking and the poor performer listening. Now move on to the behavior you’ve observed and relate the behavior to the missed deadlines (e.g. “I’ve observed you over the past few days and you’ve spent at least 20% of your time chatting with other team members. I believe that’s the reason for the missed deadlines”).
 
Outline how the team member is to improve their performance next. The outline should emphasize the importance of meeting deadlines. You are much less concerned with behavior than results. You’ll need to address the behavior where you have received complaints from other team members or from people external to the team. Be clear that the behavior change must succeed in eliminating future complaints without identifying those who complained. Identify the next work package (or the one the poor performer is currently working on) as the pilot. They need to succeed at delivering that package on time, or identify any impediments that would prevent them from meeting their deadline. Ensure that the team member agrees to the actions you identify and schedule a follow up to ensure their corrective action is on track. Lastly, you should record this meeting so that the poor performance and the agreed upon corrective actions are documented.
 
Not all poor performers are interested in improving their performance. Where you are dealing with a team member with a hidden agenda, or someone who simply cannot take direction, escalate the problem to your project’s sponsors and let them help you deal with the problem. It’s always a good idea to identify what you’d like to see them do before escalating. Do you want the resource replaced with a better one? Have you identified the resource you’d like to add to the team? Can the sponsor succeed in affecting a performance/attitude improvement where you’ve failed? You should also be prepared to articulate the risk to the project if this resource is allowed to continue sabotaging the project. The ultimate tool in the Human Resource management tool kit is firing. This should only be used as a last resort and, if you are dealing with a permanent employee, you’ll need to engage the Human Resources department. Only when the HR department approve of a firing will you be allowed to go ahead with this. Usually, HR departments have a strict set of criteria for firing an employee and you’ll need to meet those criteria. The exception to this rule is when you’re dealing with a contract resource. Your agreement with the personnel agency should provide you with the authority to dismiss the resource if their performance doesn’t meet requirements.

The PMBOK® describes best practices in the Human Resource Management area. Take the Project Management Professional (PMP®) to demonstrate you’ve mastered all the best practices described in the PMBOK®. You can learn more about the certification process and get PMP® Exam Preparation training on our website at: http://www.threeo.ca

Dwight Howard's father says son, Kobe Bryant should hash out issues

Dwight Howard's father says son, Kobe Bryant should hash out issues
MIAMI — The dust certainly didn't settle after the Lakers eked out a victory against the lowly Charlotte Bobcats, not when Dwight Howard's father injected himself into his son's awkward relationship with Kobe Bryant. The elder Howard said his son …
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Los Angeles Angels History Shines Light On Modern Baseball Issues

Los Angeles Angels History Shines Light On Modern Baseball Issues
Inter-League play. Baseball fans think of these as modern concerns, and at least in the case of Inter-League it's considered a mark against Bud Selig's tenure as commissioner. However, a 1964 article in Sports Illustrated reveals just how old these …
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LSU Football: 10 Issues the Tigers Must Resolve Before Alabama Showdown

LSU Football: 10 Issues the Tigers Must Resolve Before Alabama Showdown
LSU has some explosive athletes at the wide receiver position, but the average college football fan wouldn't know that because they haven't been involved heavily in the offense up to this point. Of course, the wide receivers haven't been needed much, …
Read more on Bleacher Report