Reimbursement

CMS Rule Change – May 12, 2014
By Kimberly Procaccino, RD, LDN, MBA, CMS Task Force Member & Sodexo Nutrition Director.

Click here for an update by the CMS PA Task Force on the CMS final rule change concerning diet orders

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Reimbursement Report: Let’s Work Together

By: Jennifer Doane, MS, RD, CSSD, LDN, ATC / LVDA, Reimbursement Chair

When we stand as individuals we can accomplish many great things. However, when individuals stand together the outcomes can be amazing! One area of our chosen field that would greatly benefit our entire profession through a pooling of resources is the area of reimbursement. If you have been successful with any type of reimbursement, especially third-party billings, then you know how difficult it can be to manage this maze of informational and logistical nightmares. As our ability to perform billable services increases, and our ability to receive reimbursements for a multitude of our services also increases, it is my hope that our area registered dietitians will remain on the forefront of this daunting aspect of our practice.

On a positive note, in the last 10 years, there have been great strides (some larger than others) that effect an RD’s reimbursement for services. Third party billing is definitely becoming much more of a necessity with our population. Also, staying on top of this area can definitely be a key point towards your overall personal income and/or the success of your department.

At this time I would like to ask that any LVDA members please take the time to touch base with me regarding their reimbursement stories. I will be starting to compile our very own database of reimbursement that can help to assist all LVDA members achieve the income they deserve for the services they deliver to their clients.

Thank you in advance for your time! Please contact me to provide me with your valuable information on the very pressing topic of reimbursement.

The Process And Getting Started

1. A National Provider Identifier or NPI is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
   You can apply for a NPI number by starting here: https://nppes.cms.hhs.gov/NPPES/StaticForward.do?forward=static.npistart
2. How much to charge / salary survey Information.
   1. ADA Compensation & Benefits Survey of the Dietetics Profession 2011
   2. Salary Tool
      
   3. Career Toolbox
   4. “The Entrepreneurial Nutritionist“, 4th edition.
      Kathy King, RD, editor and author with 10 contributing authors.
      Course Expiration Date: Jan-31-2013
      This classic tell-it-like-it-is book has helped thousands of dietitians create their own businesses or determine entrepreneurship was not an avenue they wanted to pursue. Includes data from Worldwide survey and 1,600+ dietitians who shared what made them successful.
   5. “Making Nutrition Your Business: Private Practice and Beyond”
      Faye Berger Mitchell, RD   and
      Ann M. Silver, MS, RD, CDE, CDN
      Are you thinking of starting your own business? This indispensable guide is packed with advice and tools to help you fulfill your dream. Whether your passion is private practice or consulting for a PR firm, this book provides the business basics you need to get started.
      A recent review on the book states: “The authors have covered the spectrum, from the personality required for success in private practice to the how-to steps to get started. This book is particularly useful for the sample forms and instructions on how to navigate third-party reimbursement systems for medical care.”
      
3. Academy of Nutrition and Dietetics Resources
   1. Coverage: http://www.eatright.org/coverage/
   2. Coding: http://www.eatright.org/Members/content.aspx?id=7495

Insurance Companies

1. Local coverage
2. Where to start:  Coding, Coverage and Compliance
   From AME 2012, Powerpoint for “Private Practice: Understanding Forms, Codes, and Insurances”
   Speaker: Amy Cartwright, MS, RD, LDN, Conyngham, PA
   This seminar is for registered dietitians who want to successfully become credentialed by insurance companies and get reimbursed for their services. In this seminar, we will examine how to properly fill out insurance claim forms and successfully be reimbursed for services. The goal of this seminar is to help registered dietitians increase reimbursable services offered.
3. Which companies
4. Tips on dealing with insurance companies
   CAQH, a nonprofit alliance of health plans and trade associations, is simplifying healthcare administration through industry initiatives.
   
   

Third-party billing options

1. Camille DeSimone / Medical billing is our family business
   We are medical billing professionals with over 20 years of experience in the field. Our goal is to provide seamless medical billing to give your practice the highest level of reimbursement. We offer full support and full service specializing in Registered Dietitian billing. We currently provide billing and support to Registered Dietitians in Pennsylvania, New York, New Jersey and Connecticut. http://www.dietitianbilling.com/

1. Camille Power Point from ADA presentation:   american-dietetic-association-billing-coding.pdf
2. Reimbursement Guide:   registered_dietitian_reimbursement_form.PDF
3. Links and Resources:   medical-billing-resources.pdf
4. Other Resources:   http://www.dietitianbilling.com/resources.html

• Athena
  We know how hard everyone works at a medical practice. Because we used to run one.  In 1997, Athenahealth’s co-founders Todd Park and Jonathan Bush purchased a birthing practice in California. Almost immediately, they were buried in paper and spent most of their time and energy trying to get paid. They looked for a solution, but couldn’t find one. So they built their own. http://www.athenahealth.com/

The Public Hearing held on April 9, 2012

1. An article describing the Public Hearing on Medical Nutrition Therapy has been submitted to the state newsletter. Click here to view the draft version.

2. House Democratic Policy Committee Hearing, Harrisburg, PA, April 9, 2012
   Testified using Written Testimonies	Submitted Written Testimonies
   Deborah Hutcheson, DCN, RD, LDN, CNS, CDE President, PADA; Assistant Professor, Program Director, Clinical Dietetics & Nutrition, University of Pittsburgh	Andrea Dillaway-Huber, PhD, LDN, RD Private Practice, Nutrition Counseling and Education, Wyomissing
   Ilona R. Dawson-Garrity, LDN, MBA, RD Reimbursement Chair, PADA	April E. Rudat, MS Ed, RD, LDN Private Practice, Moscow Faculty and Student Health Services Consultant Dietitian Marywood University, Scranton Author of two books
   James E. Kintzel, MD Founder and Medical Director, Fresenius Outpatient Dialysis Clinic, East Stroudsburg	Christina Brecht, MPH, RD, LDN Registered Dietitian, Monroe County Tenured faculty member, East Stroudsburg University
   Nancy Wagner, MBA, RD, LDN Public Policy Chair, LVDA Renal Dietitian, Fresenius Medical Care, Outpatient Dialysis	Cynthia M. Brylinsky, MS, LDN, RD Vice President, Financial and Decision Support Services, Geisinger Medical System, Danville
   Gale Maleskey, MS, RD, LDN Owner, Integrative Nutrition, Bethlehem	Jennifer A. Palauskas, LDN, RD Registered Dietitian, Scranton
   Jacqueline Jarrett, RD, LDN, CDE Co-Owner, Advantage Nutrition and Wellness, Bethlehem Jennifer Doane, MS, RD, CSSD, ATC Reimbursement Chair, LVDA Co-Owner, Advantage Nutrition and Wellness, Bethlehem	Kandi Perazzo, MA, RD, LDN Public Policy Co-Chair, LVDA Licensed Registered Dietitian, Allentown
   Carol Spicher, MS, RD, LDN, CDE General Internal Medicine of Lancaster Physicians’ Alliance, Ltd.	Karen Peterson, RD, LDN, CDE Registered Dietitian and Diabetes Educator, New Castle For 30 years, full time for Jameson Health System, the Diabetic Clinic and Jameson Care Center For 10 years, part time Fresenius Medical Care, a dialysis unit Starting private practice
   Julianne Hagan, MS, RD, RN, LDN, CDE Healthy Habits 4 Life Pediatric Weight Management Program Coordinator Children’s Community Pediatrics , Wexford, PA	Kathy P. Alfieri, RD, BS Clinical Nutrition Manager, Dunmore
   Cynthia Burke, MS, RD, LDN, FADA Delegate to Academy of Nutrition and Dietetics Owner, Private Practice, Bridgeville	Krista Y. Latortue, MPH, RD, LDN, CSP Founder and Executive Director, Family Food, LLC, Philadelphia
   	Liz Hill Ruder, PhD, MPH, RD Assistant Professor, Director of the Didactic Program in Dietetics, University of Pittsburgh
   	Michele L. Francis, MS, RD, CDE, LDN Manager, Diabetes and Nutrition Services Department, The Chester County Hospital and Health System, West Chester
   	Suzanne C. Ickes, LDN, RD Private Practice, Allentown

3. Agenda and all written testimonials in one document can be downloaded here.
4. Follow-up information is available here.
5. Write your own testimony. Click here for a template and instructions.

 

Additional Testimonies
Joseph G. Herman, MS, RD, LDN Regional Dietitian, Cura Hospitality, New Tripoli, PA
Rayshiang Lin, MS, RD Pennsylvania Department of Health, Harrisburg, PA (1985-present) Public Health Consultant, Public Health Nutritionist 2
Celena Romero RD, LDN, MBA, CNSC, CPHQ Career Guidance Chair, LVDA Clinical Quality Specialist, Lehigh Valley Health Network, Allentown, PA