Billing Solutions: Rapid Changes in Billing

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RESOURCE FOR MEDICARE ESRD GUIDELINES

The CMS ESRD Center website is a valuable resource that provides links to ESRD billing regulations, payment guidelines, and a host of other issues.

Of particular interest for billers is the “ESRD Payment” page found at http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/ESRDpayment/index.html. On the left side of the screen is a menu containing links to the following items:

  • ESRD Co-morbidity conditions, which contains the most current list of diagnoses that qualify for a payment adjustment
  • ESRD Consolidated Billing
  • ESRD Payment Regulations and Notices
  • Educational Resources
  • ESRD PPS Facility FAQ’s
  • ESRD PPS Outlier Services
  • CMS Sponsored Calls
  • Spotlight

The Payment page also gives an overview of Medicare regulations regarding ESRD billing and there are links at the bottom of the screen to helpful documents and links, such as the ESRD Pricer.

The main ESRD Center page is: http://www.cms.gov/Center/Special-Topic/End-Stage-Renal-Disease-ESRD-Center.html?redirect=/center/esrd.asp

NEGATIVITY BIAS IN E-MAILS

E-mail often seems to be a convenient and non-confrontational way to communicate with others. However, I often have wondered why some of my e-mail recipients react so negatively to my e-mails no matter how carefully I try to word them. All of us in medical billing use e-mail to contact co-workers, supervisors, clients, and patients, so writing an e-mail that will elicit the response we desire has become an important job skill.

Daniel Goleman, who wrote a best-selling book on emotional intelligence in the 1990s, wrote a follow-up book titled, “The Brain and Emotional Intelligence: New Insights.” He discusses e-mails in a chapter called, “The Social Brain Online.”

“There is a negativity bias in e-mail,” Goleman wrote. “When the sender thinks an e-mail was positive, the receiver tends to see it as neutral. When the sender thinks its neutral, the receiver intends to interpret it as somewhat negative.”

No wonder receivers respond negatively when we address a difficult matter with them via an e-mail.

Reminding a patient via e-mail to make a past due payment can sometimes elicit an angry call no matter how carefully we may have worded the reminder.

Goleman wrote that if the sender and receiver know each other well, the bond between them can overcome the negativity bias. Thus, a patient, physician, supervisor or co-worker with whom you have a good relationship, may tend to respond more positively than someone who does not know you well or at all.

Before addressing a matter through e-mail, each of us should take into account how well we know the recipient and whether or not a different form of communication may be a better approach. Goleman wrote that phone calls and especially video calls allow the recipient to consider additional emotional inputs, such as your tone of voice and for video calls, facial expressions and gestures. The recipient can also provide you with immediate feedback allowing you to adjust your approach during your call.

Do you have questions? Would you like to add your comments to a previously answered question? Do you have a funny experience with billing you would like to share? Please send your questions, comments and stories to me at rcollins@sceptremanagement.com.


Rick Collins is the chief operating officer of Sceptre Management Solutions, Inc., a company that specializes in billing for outpatient dialysis facilities and nephrology practices in the U.S.

NOTE: The information contained in this column is for informational purposes only and is not to be construed as payer policy or procedures. You should always verify information in this column with appropriate government or payer manuals and instructions and proceed as directed by your Medicare contractor or other appropriate payer representatives. 

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