Professional medical societies and organizations play a key role in assisting the government in shaping billing payment systems, codes and policies because medical professionals are the developers of peer-reviewed healthcare literature and practice guidelines and appropriate use criteria, and understand all aspects of clinical practice. This knowledge is critical for government agencies and private payers when they set coding, coverage and payment policy.
Additionally, your members look to your organization as a source of reliable coding and billing information for their own use.
Merlino Healthcare Consulting provides expert assistance to navigate the AMA CPT and RUC process, from submitting code applications to conducting and analyzing the AMA RUC survey process following the most current policies.
Reimbursement Policy Research, Monitoring and Content Development
Merlino Healthcare Consulting monitors important reimbursement web sites, government agencies and other professional organizations’ communications to keep your leaders and members informed of new or revised reimbursement policies, including coding, national and local coverage, and payments that are important to your organization’s specialty.
We work as staff or consultants for your society staff, committees or leadership providing guidance to foster and maintain reimbursement relationships with important government agencies and private payers. Merlino Healthcare Consulting provides assistance to facilitate your coding committee’s activities. We assist in the development of materials and provide analysis to support submission of code applications. We staff and prepare presenters, as well as provide summary and follow-up for code applications to the following organizations and committees:
- American Medical Association (AMA) Current Procedural Terminology (CPT®) codes
- CPT® Editorial Panel
- Relative Value Scale Update Committee (AMA-RUC)
- Practice Expense Committee (AMA-PE)
- Centers for Medicare and Medicaid Services (CMS) Healthcare Common Procedure Coding System (HCPCS Level II) codes
- American Hospital Association National Uniform Billing Committee (NUBC) Hospital Revenue Codes
Our staff monitors and reviews payment policies that are important to your members. We identify potential reimbursement activities for leader and member discussion. We also supply written summaries and data analysis and assist with the preparation of responses to the published proposed and final rules of U.S. government agencies, including Medicare, Medicaid, private payers and state and local payers.
Member Reimbursement Education
Merlino Healthcare Consulting researches, designs and provides content for educational seminars on coding and reimbursement, including PowerPoint presentations from basic to complex topics. We provide expert presenters or written materials and authoritative documentation for your leaders’ or members’ presentations, whether on site (face to face), via conference call, video or on the Web.
Working closely with your organization’s committees, our staff helps develop and coordinate responses to member coding and reimbursement questions, and we prepare frequently-asked-question content for web or other publications.
Merlino Healthcare Consulting identifies and obtains authoritative documentation. We develop reimbursement content and materials for all your organization’s publication needs. This could include material for Web sites, e-mail notification, fax alerts, peer-reviewed journals, newsletters, frequently-asked-questions, PowerPoint presentations, brochures, books, CDs, etc. (sample newsletter articles)
Do You Want to Know More?
If you are interested in finding out more about our services, contact us at Merlino Healthcare Consulting Corp. and we will provide you with a personalized quote for our services.