Do you ever look at your collections per previous month’s rvus? Why would you look at that? Well there are several good reasons.
1. Most physician fee schedules are based on some multiple of the Medicare RVU fee schedule
2. Tracking payment per RVU can quickly tell you how well your staff are doing at collecting the expected payment RVU.
What is a good number? The exact number depends on your location in the country. In general, Medicare is paying $34.0376 per RVU. If your practice is collecting less than that amount and is not heavily Medicaid, you should be aware that you need to look at your managed care contracts to see if you can get them to pay at least Medicare’s rate. Otherwise, your commercial insurances are being subsidized by your Medicare patients or you need to have someone look at your billing service or department.
It was recently brought to our attention that using scribes to document on Medicare patients just became a bit more difficult.
Cigna Government Services just indicated in their latest bulletin that scribes must document the following “written by (Jane Doe), acting as scribe for Dr. (Smith).” Then, Dr. (Smith) should co-sign, and indicate the note accurately reflects work and decisions made by the physician. The scribe is functioning as a “living recorder,” documenting in real time the actions and words of the physician as they are done. If this is done in any other way, it is inappropriate. The real time transcription must be clearly documented as noted, by both the scribe and the physician. Failure to comply with these instructions may result in denial of claims.”
So your idea of having your Medical Assistant document everything and then typing “what she said” isnt going to work.
They just keep making it tougher to see patients. Options to offset the productivity losses from this requirement include optimizing your EMR and eliminating other non-essential functions. Look at every activity of your practice and staff and see what can be eliminated without impacting care or the patient quality experience.