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The FIRM provides professional claims billing services for individual providers, clinics and facilities. We service all disciplines of practice, i.e., medical, dental, diagnostic testing, chiropractic, physical therapy, optometry/ophthalmology, mental health, chemical dependency, and durable medical equipment.

We offer specialty services such as consultation, collections and appeals, contracting and credentialing, verification and preauthorization and personal injury settlement negotiating. We offer form development and revision services, office reorganization and personnel training.

We have extensive experience in all areas of commercial insurance, Workers Compensation, personal injury, Third Party Administrators, Medicare, Medicaid, and other state and federally funded programs. We offer personalized services designed specifically to meet your needs.

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Come out and hear our owner Tia Aspra speak at 11th edition of Larry Laurent’s Chiropractic Law Seminar

Come out and hear our owner Tia Aspra speak at 11th edition of Larry Laurent’s Chiropractic Law Seminar series on Saturday, September 8, 2018. This fall’s event will be held in Austin, at the Granduca Hotel – 320 South Capital of Texas Hwy, Bldg B, Austin, Texas, 78746 from 8:00 a.m. to approximately 5:30 p.m. Ms. Tia Aspra of Financial Investigation & Reimbursement Management and Ms. Kathy Jones of NACA - Texas, will be providing tips on risk management, coding, credentialing, documentation and office compliance practices to ensure that your new practice complies with all state and federal laws, as well as our Board’s regulatory programs. This Chiropractic Law seminar has been approved for 8 hours of CE credit, including the 4 hours of Ethics, Documentation and Jurisprudence required by the Texas Board of Chiropractic Examiners. We have kept the cost low - $198.00 for doctors, $79.00 for staff accompanying a doctor and $98 for CA/staff attending without a doctor. You will have the opportunity to obtain thousands of dollars worth of free legal information, consulting services and information on office procedures for a very low registration fee. To register give Larry Laurent a call at (512) 996-8844 or send an email to (larry@larrylaurent.com) if you have any questions. We hope to see you in Austin on Saturday, September 8, 2018.

By |September 4th, 2018|Chiropractic, doctor, doctor Credentialing, Health Insurance, Healthcare Changes, Healthcare Professionals, Medical, Medical Billing, Medical Coding, Medical Compliance, Medical Credentialing, Medical Insurance, Medicare, medicare claims, Multi-Specialty, Obamacare, Physician Credentialing, Specialties, Staff Training|Comments Off on Come out and hear our owner Tia Aspra speak at 11th edition of Larry Laurent’s Chiropractic Law Seminar

New Medicare Advantage rules hold big potential for pop health

Healthcare Dive- Meg Bryant- June 13, 2018 The push toward valued-based care and population health management has raised visibility around nonmedical conditions that impact health outcomes. Improving health outcomes using population health strategies could get a major boost with a new Medicare Advantage rule taking effect this week. Payers will now be able to work with companies like Uber or Lyft to provide transportation, for example, as part of a more complete set of benefits for the quickly growing MA population. CMS issued a final rule in May giving MA plans more flexibility in determining the types of supplemental benefits they can offer chronically ill enrollees, including nonmedical benefits. The new policy, part of a broad 2019 Medicare payment rule, means plans like UnitedHealthcare and Humana aren't harnessed to a set palette of supplemental benefits for members with chronic conditions, but can tailor them to the specific needs of individuals. The rule could see an array of new benefits aimed at improving health outcomes by addressing issues such as housing and food insecurity, transportation and social isolation. Potential benefits include ride-hailing services, home visits, nutritional support, air conditioners for people with asthma, home renovations like grab bars and other accommodations to prevent falls, and home health aides. Providers have praised the expansion of benefits. “We now have a funding stream effectively within Medicare Advantage around social services,” Don Crane, president and CEO of America’s Physician Groups (APG), told Healthcare Dive in an interview. He called the change a “necessary and appropriate step” in managing chronic diseases. The focus on social determinants of health and population health management is part of the broader shift to value-based care and reimbursement. Some providers, payers and employers already offer wellness and prevention programs or [...]

House Passes Measure to Repeal and Replace the Affordable Care Act

NY Times- By THOMAS KAPLAN and ROBERT PEAR MAY 4, 2017 WASHINGTON — The House on Thursday narrowly approved legislation to repeal and replace major parts of the Affordable Care Act, as Republicans recovered from their earlier failures and moved a step closer to delivering on their promise to reshape American health care without mandated insurance coverage. The vote, 217 to 213, held on President Trump’s 105th day in office, is a significant step on what could be a long legislative road. Twenty Republicans bolted from their leadership to vote no. But the win keeps alive the party’s dream of unwinding President Barack Obama’s signature domestic achievement. The House measure faces profound uncertainty in the Senate, where a handful of Republican senators immediately rejected it, signaling that they would start work on a new version of the bill virtually from scratch. “To the extent that the House solves problems, we might borrow ideas,” said Senator Lamar Alexander of Tennessee, chairman of the Senate health committee. “We can go to conference with the House, or they can pass our bill.” Even before the vote, some Republican senators had expressed deep reservations about one of the most important provisions of the House bill, which would roll back the expansion of Medicaid under the Affordable Care Act. With $8 Billion Deal on Health Bill, House G.O.P. Leader Says ‘We Have Enough Votes’ MAY 3, 2017 But a softening of the House bill, which could help it get through the Senate, would present new problems. For any repeal measure to become law, the House and the Senate would have to agree on the language, a formidable challenge. The House voted on Thursday on a revised health care bill that would [...]

Major Changes May Be Coming to Medicare

Confused about Medicare / Medicaid issues? Ask the experts at The Firm Services Published: Thursday, April 13, 2017 11:19 p.m. CDT • Updated: Thursday, April 13, 2017 11:19 p.m. CDT By Trudy Lieberman, Rural Health News Service What’s going to happen to Medicare? That’s not an insignificant question given the political shift in Washington. Now, with Republicans controlling the presidency and both houses of Congress, some ideas they’ve been pushing for years have a chance of passing. Those ideas would drastically change the way Medicare works for those already on it and those joining in the next few years. Medicare is wildly popular, but that popularity doesn’t necessarily translate into understanding of a very complex program, what’s happened to it, and what may happen. Writing about Medicare for nearly 30 years and watching it evolve, I’ve seen how easily Congress has already made big changes with hardly a peep from the press or the public. The same could happen again. In this column, I discuss a few of those possible changes gleaned from my decades of experience covering the program. Since the election, there’s been talk of “voucherizing” or privatizing Medicare, an idea Republicans have been pushing for 20 years. Under a fully privatized arrangement, Medicare would no longer be social insurance like Social Security but more like Obamacare with everyone eventually buying their coverage from private insurance companies. Beneficiaries would receive a sum of money, likely to be called “premium support” instead of the more dire-sounding “voucher,” to help buy their coverage. The amount of support and how well it would keep pace with medical inflation would be buried in the details Congress would hash out. Today, the government provides the benefits [...]

One in four U.S. consumers have had their personal medical information stolen

The Accenture study also finds that half of these victims were subject to medical identity theft and on average had to pay $2,500 in out-of-pocket costs per incident. Healthcare IT News - By Bill Siwicki February 20, 201708:23 AM Twenty-six percent of U.S. consumers have had their personal medical information stolen from healthcare information systems, according to results of a new study from Accenture released today at HIMSS17 in Orlando. The findings show that 50 percent of those who experienced a breach were victims of medical identity theft and had to pay approximately $2,500 in out-of-pocket costs per incident, on average. In addition, the survey of 2,000 U.S. consumers found that the breaches were most likely to occur in hospitals (the location cited by 36 percent of respondents who experienced a breach), followed by urgent-care clinics (22 percent), pharmacies (22 percent), physicians’ offices (21 percent) and health insurers (21 percent). 50 percent of consumers who experienced a breach found out about it themselves, through noting an error on their credit card statement or benefits explanation, whereas only 33 percent were alerted to the breach by the organization where it occurred, and only 15 percent were alerted by a government agency, according to the survey. Among those who experienced a breach, 50 percent were victims of medical identity theft, the survey found. Most often, the stolen identity was used to purchase items (cited by 37 percent of data-breached respondents) or used for fraudulent activities, such as billing for care (37 percent) or filling prescriptions (26 percent). Nearly one-third of consumers had their social security number (31 percent), contact information (31 percent) or medical data (31 percent) compromised, according to the survey. Unlike credit card identity theft, where [...]

Modernizing Medicare with the QPP

Let the Experts at The Firm Services assist your practice. HBMA- Dr. Kate Goodrich- 03/13/2017 Modernizing Medicare with the QPP Keeping Medicare’s Promise to Families Today and Tomorrow By Kate Goodrich, Centers for Medicare & Medicare Services (CMS), US Department of Health and Human Services (HHS) Billing managers are uniquely positioned to support clinicians in succeeding under the new program. For example, you can assist physician and other clinical practices in: Determining whether they need to participate in the Quality Payment Program (QPP); Verifying whether they meet desired thresholds in terms of Medicare fee-for-service (FFS) patient counts and billing amounts; Examining the potential impact of various participation options on revenue; and Analyzing CMS feedback on cost performance measures. And, for clinicians who don’t believe they’re prepared to participate, you can help them understand that CMS offers flexible options. We understand that resources and technology vary widely across practices, and we want the broadest participation possible among eligible clinicians. I look forward to continuing to work with the entire healthcare community as we embark on the implementation of the QPP. Background In October 2016, HHS launched the QPP with a final rule with comment period implementing certain provisions of MACRA – the Medicare Access and CHIP Reauthorization Act of 2015. A bipartisan solution, MACRA ended the flawed Sustainable Growth Rate (SGR) formula for Physician Fee Schedule payments, and streamlined existing Medicare quality reporting programs. MACRA was enacted to strengthen Medicare. Clinicians who participate in Medicare are part of a dedicated team that serves 55 million of our country’s most vulnerable Americans. As a result of the SGR formula, physicians and other clinical practices faced payment cliffs for 13 years. The QPP improves Medicare by [...]

Donald Trump’s promises are taking a beating in the GOP’s Obamacare replacement

Questions? Call the Professionals at The Firm Services. Washington Post - By Aaron Blake March 10 at 10:29 AM Two big stories on the Republicans' Obamacare replacement bill broke late Thursday. And both point to major broken promises for President Trump. The Washington Post's Katie Zezima and Christopher Ingraham report that the bill would cut a mental-health and addiction treatment mandate covering 1.3 million Americans — counter to a Trump promise to expand treatment: The Republican proposal to replace the Affordable Care Act would strip away what advocates say is essential coverage for drug addiction treatment as the number of people dying from opiate overdoses is skyrocketing nationwide. Beginning in 2020, the plan would eliminate an Affordable Care Act requirement that Medicaid cover basic mental-health and addiction services in states that expanded it, allowing them to decide whether to include those benefits in Medicaid plans. CNN, meanwhile, is reporting that the Trump White House is negotiating to possibly roll back the Medicaid expansion earlier to appeal to conservatives — counter to Trump's promise to leave Medicaid alone: White House officials are beginning to urge House GOP leadership to include an earlier sunset of the Medicaid expansion funds authorized under Obamacare than the 2020 date set by the current bill. The change comes just days after the bill was unveiled and follows a blitz of activism aimed squarely at the White House and President Donald Trump, who has met with conservative leaders in recent days. Here's what Trump said last year: “I’m not going to cut Social Security like every other Republican, and I’m not going to cut Medicare or Medicaid.” After House Republicans released a proposal to transform the Affordable Care Act, members of [...]

The Advantages and Disadvantages of Electronic Medical Records

Credentialing, Revalidation Services professionals at The Firm Services Crystal Lombardo- The Next Galaxy  The advancement of technology has changed the way the entire world functions. One big change that has happened has to do with the medical world. Electronic medical records, or EMR’s, are used in just about every single hospital and doctor’s office in the United States. Electronic medical record means that a patient’s paper chart, which is what contains all of their medical history, information on medical conditions, treatments, and other types of information, are all stored electronically. It has been a great asset to the medical community, but has brought some pretty hefty issues right along with it. Advantages of Electronic Medical Records 1. Instant Access is an Advantage EMR give medical professionals quick and simple access to all of the patient information that they may need in order to provide an accurate and speedy diagnosis. Much of the confusion, and bureaucratic characteristics of the medical world are eliminated with the use of electronic medical records. 2. Doctor’s Have Bad Handwriting It is no secret that the majority of doctors have pretty illegible penmanship. This has been a problem that has haunted the medical world for decades. Electronic medical records have solved this problem! Doctors no longer have to scribble notes that may not be able to be read, instead they type them into the electronic medical record database, so there is never anymore confusion about if that is an “r” or a “z”. 3. Record Keeping Has Been Cleaned Up Keeping a physical record for each patient can begin to take up a pretty intense amount of space. Boxes and boxes of records are filed in order to be [...]

Showing panic over Obamacare repeal, GOP senators release replacement plan that (almost) makes sense

Will Obamacare survive? LA Times - Michael Hiltzik - January 24,2017 2;25pm If you’re following the health insurance debate—and since the coverage of more than 20 million Americans is under threat from the Trump White House and the Republican congressional majority, you should be—you’re going to be hearing a lot in the coming weeks about Cassidy-Collins. That’s an Obamacare replacement plan just introduced by Sens. Bill Cassidy (R-La.) and Susan Collins (R-Maine). Dubbed the Patient Freedom Act, It’s the first such proposal that indicates that the GOP is becoming increasingly panicked about the political price of repealing the Affordable Care Act outright, and increasingly desperate to reassure voters that the provisions of Obamacare they actually value can be retained without a break. These include Obamacare’s protection of coverage for pre-existing conditions, its ban on lifetime and annual limits for benefits, and coverage of certain preventive services without co-pays. It also keeps coverage of mental health services and guarantees black-lung benefits for coal miners. The federal exchange, healthcare.gov, will continue to operate. Dependents still will be permitted to stay on their parents’ employer-sponsored plans until age 26. The measure kills the employer mandate and individual mandate, though it substitutes a “continuous coverage” system for the latter, which we’ll explain in a bit. The other [Republican] bills have said, Let’s just get rid of Obamacare. This one seems to be offering options. — Karen Pollitz, Kaiser Family Foundation The goal of Cassidy-Collins is to shift the the decision of whether to keep Obamacare, dump it entirely, or come up with an alternative system to the states. (A three-page section-by-section summary is here.) “When you speak to Americans,” Cassidy said Monday on the Senate floor, “they [...]

ICD-10’s Impact to the Worker’s Compensation Industry

The Firm Services has the latest information regarding ICD-10 and its implementation. Written by Sherry Wilson and Tina Greene | Monday, 28 March 2016 04:00 A general assumption had been that states would be aligning their worker’s compensation regulations with the rest of those of the healthcare industry in order to adopt the ICD-10 regulations. As of Oct. 1, 2015, there were only 21 states that had aligned with the Centers for Medicare & Medicaid Services (CMS) ICD-10 requirement, according to the WEDI Property and Casualty ICD-10 State Readiness Resource Center and the International Association of Industrial Accident Boards and Commissions (IAIABC) ICD-10 State Survey results. The states that had aligned with the CMS ICD-10 regulations included Alabama, California, Delaware, Florida, Georgia, Idaho, Illinois, Louisiana, Maryland, Massachusetts, Minnesota, North Carolina, New Hampshire, Nevada, New York, Ohio, Oregon, Pennsylvania, South Dakota, Texas, Washington, and the U.S. Department of Labor. So, what has been the impact to stakeholders post-ICD-10 in the other 29 states? The following is a summary profile of the ICD-10 status of the other 29 states and reported stakeholder impact: Three states with pending ICD-10 regulations post-Oct. 1, 2015 included Alaska, Wyoming, and Tennessee. The following is the reported ICD-10 post-implementation impact: Wyoming is allowing providers to submit ICD-9 and ICD-10 for one year as a transition plan and will adopt ICD-10 when their rulemaking becomes effective. Alaska and Tennessee have encouraged stakeholders to move forward with ICD-10 while their rulemaking process remains pending. Payer Impact: Payers that do business in these states are required to support ICD-10 and ICD-9 codes during the regulatory transition period. Provider Impact: Providers that are submitting ICD-10 claims have reported no impact to their revenue cycle [...]