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Compliance Deadlines for Doctors

Four key items for your “to do” list  By Professional Business Consultants

  1. Physicians who are participating in the Medicare EHR Incentive Program have until Feb. 28, 2014, to attest to meaningful use of their EHR to receive the 2013 payment year incentive. Medicare penalties begin in 2015 for physicians and other providers who are not meaningful users of EHR technology. You must successfully attest by 11:59 p.m. Eastern Standard Time.
  2. On Oct. 1, 2014, all services and discharges must be coded using the ICD-10 code set. ICD-9 diagnosis codes cannot be used for services provided on or after Oct. 1, and claims that do not use ICD-10 diagnosis codes cannot be processed for reimbursement. The necessary system and workflow changes need to be in place by the compliance date in order for you to send and receive the ICD-10 codes. But only half of health providers have conducted impact assessments and even fewer have begun testing. Key areas to focus on include training and education, payer collaboration, cross-mapping solutions, vendor readiness, systems remediation, as well as dual coding.
  3. Watch for revalidation letter requests from your Medicare contractor. You have 60 days from the date on the request to submit the revalidation. The Internet-based Provider Enrollment, Chain and Ownership System (PECOS) can be used in lieu of the Medicare enrollment application (i.e., paper CMS-855). This revalidation effort applies only to those providers who were enrolled prior to March 25, 2011. You must wait to submit the revalidation only after being asked by your MAC to do so. Revalidation notices are mailed to the provider’s primary payments address and to the correspondence address. Not receiving the revalidation request is not a valid reason for not completing the CMS 855 application. Be sure to periodically check the CMS website to find out if your revalidation request has been sent. To access PECOS, you must have an active National Provider Identifier (NPI) and a web user account established in NPPES. Physicians and non-physician practitioners will access PECOS with the same User ID and password they use for NPPES.
  4. July 31, 2014, is the license renewal deadline for Illinois physicians. If you haven’t taken the required 150 hours of continuing medical education, check out the Chicago Medical Society’s Calendar of Events page on 28 for upcoming CME programs. The Illinois Department of Financial and Professional Regulation will send automatic renewal notices to all physicians prior to the license expiration. IDFPR also conducts random audits of physicians for compliance with the CME requirements. Hours earned should consist of formal educational programs (40%) and a combination of formal and informal education (60%).

Professional Business Consultants, Inc., (PBC) is a practice management consulting firm in Oak Brook that specializes in health care. For more information on PBC, visit

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