WSMA Coding and Billing Assistance/Advocacy
WSMA Insurance Claim Assistance Request
Coding and Billing Advocacy A-Z
AMA Coding Online
The American Medical Association now offers a comprehensive set of new web-based solutions for coding and billing medical services. The new interactive website AMA Coding Online provides electronic access to authoritative coding and compliance resources. Highlights include:
The products sold through AMA Coding Online range from $185 to $800 for a one-user, one-year subscription. AMA members save 25 percent off the regular price for these products. Multi-year and multi-user discounts are also available. For additional information, please contact the AMA Unified Service Center at (800) 621-8335.
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AMA Discount Publications
All WSMA/WSMGA members can purchase AMA Publications at a discounted rate. Members have unique needs, and these AMA products offer resources to help meet these needs from Practice Management to Coding.
For more information, contact Jenelle C. Dalit at the WSMA's Health Care Economics Department at (206) 441-9762 or 1 (800) 552-0612, or via email.
To download the Order Form, click here [PDF].
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athenahealth, Inc.
The Washington State Medical Association has partnered with athenahealth, Inc. to offer our members the industry's leading billing and practice management solution, athenaCollectorSM. WSMA members may be eligible for a 6% discount on athenaCollector.
athenaCollector helps physician practices get paid more, faster, by optimizing billing, evaluating productivity and monitoring cash flow. It accomplishes this while taking on your paper and handling your most time-consuming work, including claim submission, insurance package management, electronic eligibility verification, payment posting, claim follow-up, denial management, and more. With athenaCollector, you’ll gain a clear view of your practice’s performance so you can better assess, plan and grow the way you want.
What makes athenahealth’s services different?
athenahealth helps physician practices to get paid more, faster, with less work and hassle by optimizing your workflow, evaluating productivity and monitoring cash flow.
athenahealth continuously researches and seeks out new insurance rules, builds them into their patented revenue cycle rules database, and makes them available to all clients on their network, esulting in fewer claim denials. athenahealth’s Intelligence Team also tracks new government and Pay-for-Performance (P4P) rules to help make sure you receive the incentive payments you’re eligible for. And while some vendors may send you software you need to update at your own time and expense, athenahealth constantly updates their software and rules database for you, giving you faster access to insurer coding changes—all free of charge.
View a video overview of athenahealth.
View a video overview of athenaCollector.
To learn more about athenahealth, visit, www.athenahealth.com/WSMA, or call 888.402.6942 and be sure to mention you’re a member of the WSMA.
For more information, contact the WSMA's Health Care Economics Department at (206) 441-9762 or 1 (800) 552-0612, or email Bob Perna at rjp@wsma.org.
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Chart Review Service
Physicians and their practices are at tremendous personal and financial risk as "audits" by government contractors and health insurers threaten to recoup past payments. Refund requests in the thousands of dollars are not uncommon! Defending yourself and your practice against allegations of coding errors and "inappropriate" payments becomes very difficult for audited claims dating back two, five and even ten years.
The Solution
Periodic expert review of your coding and documentation, as a component of your practice’s Compliance Program, to detect and correct errors, and ideally to prevent errors from occurring through ongoing monitoring and related education of physicians and staff.
The WSMA’s Chart Review Service can help you achieve those improvements in your coding and documentation activities.
How the Chart Review Service works
This service will provide your practice with a written report of our analysis of the coding and documentation of specific visit records and the services provided, drawn from selected charts as mutually agreed upon.
That analysis will review the accuracy of the codes—CPT and HCPCS service coding and ICD diagnostic coding—as selected by the practitioner, and the thoroughness of the chart documentation in support of those codes.
The report also will provide you with written recommendations for remedial actions where indicated. WSMA staff also will post-review discussion, conducted via telephone, to discuss those findings.
As an optional service WSMA staff can provide your practice with additional training on code selection and coding documentation, offered electronically via web-based means or on-site.
Get started today in protecting yourself and your practice against allegations of inappropriate payments and costly refunds of payments received.
Download an overview of the Chart Review Service [PDF]
For more information, contact the Bob Perna, MBA, FACMPE, senior director, Practice Resource Center at (206) 441-9762 or 1 (800) 552-0612, or rjp@wsma.org, or Michelle M. Lott, CPC, CPMA associate director, Practice Resource Center and health insurance coding specialist at (206) 441-9762 or 1 (800) 552-0612 or mml@wsma.org.
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DecisionHealth: Health Care Newsletters, Publications and Educational Tools
DecisionHealth delivers unbiased healthcare news as a completely independent source. Their flagship publications include Part B News, Medicare Compliance Alert, and Private Payer News.
In addition to these publications, DecisionHealth offers a variety of in-person conferences, audio conferences, and audio conference tapes and CDs. To keep WSMA members abreast of current issues directly affecting our profession, our patients and our organization, we have partnered with DecisionHealth to provide special member-only-discounts on offered by DecisionHealth.
If you are interested in signing up for one of DecisionHealth's conferences, please visit their site. Conference information is listed on the left. When registering online be sure to use discount code WSMADH in order to receive your 15% WSMA member discount.
Here is a list of the types of audioconferences that DecisionHealth produces annually:
- Billing, Reimbursement
- Pay for Performance
- Private Payer Contracting
- Managing Non-Physician Practitioners
- Medicare Provider Enrollment
- Specialty Coding and Billing
- ASC reimbursement and management
- Medicare Part D
- Managing Practice Expenses
- Preventative Medicine Billing
- E/M Coding
You'll benefit from their experienced team of journalists and professionals. If you have questions about your subscription, please contact DecisionHealth's customer relations staff at 877-397-1496 or via email at customer@decisionhealth.com . For more information on DecisionHealth, click www.decisionhealth.com.
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Insurance Claim/Assistance Request (ICAR)
The WSMA continues to hear from physicians and practice managers regarding unresolved claims problems with health plans. To better assist our members in addressing these concerns, the WSMA is pleased to offer this service, the WSMA Insurance Claim-Assistance Request (ICAR).
Use this form to advise the WSMA when you encounter problems with specific insurance claims. Here's how the process works: the WSMA will facilitate communication between the physician's practice and appropriate parties at the health plan. In compliance with the recently implemented HIPAA privacy regulations, WSMA has instituted policies to protect patients' "Health Information" we receive from WSMA members.
Important: Before a WSMA member sends us any "protected" health information, the WSMA will need to receive a signed Business Associate Agreement. Click here to download a copy of the WSMA's Business Associate Agreement [PDF].
Upon receipt of your completed ICAR form and a signed Business Associate Agreement, the WSMA will track each ICAR, and forward a copy to the relevant health plan. We'll ask the health plan to act upon that request to resolve the claim, and to advise the WSMA of their actions. We will forward a copy of the health plan's response to the inquiring physician.
This free service is available only to WSMA member physicians and their practice staff. For more information, contact the WSMA's Health Care Economics Department at (206) 441-9762 or 1(800) 552-0612, or via email.
To download a WSMA Insurance Claim-Assistance Request, click here. [PDF]
To download a WSMA Business Associate Agreement, click here. [PDF]
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WSMA Coding Hotline
For better or worse, codes determine your reimbursement. Correct coding also keeps the auditors away. Guidance on CPT, ICD-9 and HCPCS coding is now available from the WSMA's certified coders through the WSMA Coding Hotline.
The WSMA Coding Hotline is available by calling Michelle M. Lott, CPC at (206) 441-9762 or 1 (800) 552-0612 or mml@wsma.org.
This service is FREE to WSMA member physicians and WSMGMA member practice managers and staff. Non-members can access this service for a prepaid fee of $120 per month for three questions per practice per month.
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