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New Care Management Services Billing Guidelines for Behavioral Health Providers

AAFCPAs would like to make behavioral health provider clients aware that, effective January 1, 2018, there are new billing guidelines for care management services. Billing changes for care management affect the following services: Cognitive-assessment services Psychiatric collaborative care model (CoCM) General behavioral health integration (BHI) Note: These changes do NOT affect Federal Qualified Health Centers (FQHCs) or Rural Health Centers (RHCs). Effective January 1, 2018, there are five new evaluation... continue reading

New Care Management Services Billing Guidelines for Health Centers

AAFCPAs would like to make Federal Qualified Health Center (FQHC) clients aware that effective January 1, 2018, there are new billing guidelines for care management services. Care management services include the following four services: Transitional Care Management (TCM) Chronic Care Management (CCM) General Behavioral Health Integration (BHI) Psychiatric Collaborative Care Model (CoCM) FQHCs may be reimbursed for Chronic Care Management, Psychiatric Collaborative Care Model or Behavioral Health Integration services using... continue reading

AAFCPAs to Lead Medicare and Medicaid Cost Report Trainings in MA and RI Providing Coveted Guidance

AAFCPAs’ Matt Hutt, CPA, CGMA and Courtney McFarland, CPA, MSA, in collaboration with the Massachusetts League of Community Health Centers (The League) and the Rhode Island Health Center Association (RIHCA), will again present Medicare and Medicaid Cost Report Training sessions for MA and RI community health centers. Medicare and Medicaid Cost Report Training, for Members of the RIHCA When: September 28th | 9:00am – 1:00pm Where: Thundermist Health Center | West Warwick, RI Matt... continue reading

Denials Management: Best Practices in Improving Revenue Cycle Processes & Monitoring Third-Party Payer Denials

The complexities surrounding third-party revenue cycle management, patient eligibility, and systems capabilities to support process design changes continue to increase, as do third-party claim denials across virtually all payers. Denials can affect the bottom line of healthcare organizations, leading to lost revenue and productivity; however, in many cases, denials are preventable. In order to prevent denials, it is critical that healthcare organizations develop & implement an effective denials management process, including:... continue reading

Best Practices for Complying with HIPAA & Safeguarding Patient PHI Accessible to Your Business Associates

Healthcare is predicted to be the most targeted industry for cyberattacks in 2017, according to the 2017 Data Breach Industry Forecast from Experian.   “Electronic health records remain likely to be a top target for hackers,” Experian found. To further heighten & complicate these risks, providers’ responsibilities for protecting personal health information (PHI) under the Health Insurance Portability and Accountability Act (HIPAA) extend to certain vendors, referred to as “business... continue reading

AAFCPAs Advises Healthcare Providers to Position Themselves for Change

We may not be able to fully predict how future changes to the Affordable Care Act (ACA) will affect the healthcare system, but AAFCPAs advises healthcare clients to position themselves for change.  AAFCPAs’ Matt Hutt reflects on last week’s healthcare reform news, and shares insight into what providers may expect: Healthcare providers must position themselves for change, and focus on short and long-term Strategic Planning.  Providers should now: assess the profitability... continue reading

Medicare PPS Base Rate & G-Codes for 2017: What FQHCs Need to Know

AAFCPAs would like to make health center clients aware that the Centers for Medicare & Medicaid Services (CMS) recently updated the federally qualified health centers (FQHC) prospective payment system (PPS) base payment rate and the geographic adjustment factors (GAF) for 2017. AAFCPAs advises clients that now is the time to re-evaluate the charges that were established for the 5 payment codes known as G-codes, and to revisit the FQHC’s regular... continue reading

Healthcare reimbursement questions to ask during a time of uncertainty

According to a March 2016 report by the Department of Health and Human Services, an estimated 20 million more Americans have health insurance coverage as a direct result of changes driven by the Affordable Care Act (ACA).   The influx has payors scrambling to meet coverage demands, while providers and provider organizations simultaneously navigate the murky waters of reimbursement codes. As the healthcare industry morphs from the traditional fee-for-service to the... continue reading

HRSA Operational Site Visits: Considerations, Risks and Common Trouble Spots

Does your Health Center have its Health Resources & Services Administration (HRSA) site visit looming?   If so, or if your Center has been through a recent HRSA Operational Site Visit (OSV), you know what a daunting, stressful and time consuming process this may be.  HRSA is continually refining and clarifying the 330 program compliance requirements as most recently demonstrated through the issuance of the new Draft Health Center Program Compliance... continue reading