New health care codes released mid-year in unprecedented move

Washington, D.C. – The American Medical Association CPT committee recently released a new set of medical codes for Applied Behavioral Analysis (ABA). In an interview at the APA Convention, Antonio Puente, Ph.D., professor of psychology at the University of North Carolina and voting member of the AMA CPT committee, said in his 25-year involvement with […]

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  • Commercial Insurers Actively Reviewing Patient Records for Healthcare ‘Waste’

    Psychologists who think that not participating in Medicare can avoid audits of patient files need to think again. Commercial payers such as Aetna, Anthem and Humana have in-house special investigation units that are becoming aggressive in reviewing clinical records. According to health care attorney and psychologist, James Georgoulakis, Ph.D., JD, federal audits focus on fraud […]

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  • Larger bonuses & penalties coming for Medicare

    Medicare’s current emphasis on pay-for-reporting will likely shift to pay-for-performance in which providers could earn bonuses or penalties of 4 percent in 2018 and up to 12 percent in 2021 and beyond. In order to abolish the sustainable growth rate (SGR) formula and avert a 23.7 percent rate reduction in Medicare reimbursement, bipartisan companion bills […]

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  • Meet the Exchange-Based Patient

    It’s Jan. 2, and the phone rings with a potential new patient. If the caller carries insurance through your state’s new Health Insurance Exchange (HIX), it will be important to determine the unique coverage details. What are HIX plans? To be in the HIX, insurance must be government-certified as a Qualified Health Plan. Most fall […]

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  • Medicaid Expansion, Insurance Exchanges Face Hurdles

    A slate of new provisions of the Patient Protection and Affordable Care Act (ACA) will arrive Jan. 1. Along with significant insurance reform, the act promises to extend health insurance to millions by providing affordable options through Medicaid and new health insurance exchanges. Will the practicing psychologist see an influx of patients in 2014? The answer […]

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  • What Malpractice Insurance Isn’t

    A brief discussion with psychologists at any risk management seminar quickly reveals that few of them have ever read their malpractice insurance policy and those few who have gained a poor understanding of what is written in it. This is not because psychologists are easily confused, but because these policies are written in a rather […]

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  • ACA likely to create more large care provider groups

    Less than six months after passage of the Affordable Care Act (ACA), the administration’s health czar and two colleagues wrote in the Annals of Internal Medicine that “the economic forces put in motion by the Act are likely to lead to vertical organization of providers and accelerate physician employment by hospitals and aggregation into larger […]

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  • Psychology gets ready for Obamacare

    With the re-election of President Barack Obama and a U.S. Supreme Court decision upholding the Affordable Care Act (ACA), the groundwork has been set for the biggest changes in how health care is provided since the establishment of Medicare, delegates to this year’s State Leadership Conference (SLC) were told. Time is running short before the […]

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  • Medicare Payments to Psychologists Suddenly Reduced

    Despite an increase in work values for some psychological services in 2013, payments to psychologists under the Medicare system are being reduced overall by 2 percent as of mid-August because of errors made by the Center for Medicare and Medicaid (CMS) in previous calculations of practice expense. The Aug. 12, 2013 issue of The Federal […]

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  • Health Care Reform: An ACO/PCMH Primer for Psychologists

    Psychologists can share in the enormous opportunity health care reform offers many institutional providers that have invested millions of dollars in becoming, incentivizing, supporting and transforming Accountable Care Organizations (ACOs). The ACO movement has the confidence of sophisticated players across the system. They understand that value-based quality care is the standard of the future. Psychologists […]

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