Hospital network and physician office managers in health professional shortage areas (HPSAs) usually like that their physicians could be receiving bonus payments from the government for primary care services.
While the bonus payments are almost free money for providers, there are still some bill coding and documentation elements to be aware of so office administrators can track bonuses consistently and accurately for the covered primary care services.
HPSA Acumen Chief Executive Marijka E. Lampard made explaining those details part of her third trip to Yuma, Arizona’s, Yuma Regional Medical Center in late March.
Marijka presented to medical billers, physicians, hospital administrators, recruiters, nurse and physician assistant trainers, as well as individuals from the University of Arizona the benefits of their renewed Geographic HPSA and how to obtain them.
She also discussed the new Primary Care Incentive Payment (PCIP) as well as the HPSA Surgical Incentive Payment Program (HSIP).
Even though Yuma County had already been designated, it still was extremely beneficial to review the benefits and how to best obtain them. Since Yuma County has a full-county Geographic HPSA, the primary care physicians, specialists, nurse practitioners, and physician assistants were receiving the 10-percent Medicare bonus automatically every quarter. It did not matter how much of their Zip Code was in the HPSA.
Also, concerning the ‘AQ’ modifier, since providers in the Yuma County designation were receiving the automatic payments, it was better that they not attach the AQ modifier when sending in their claims. Attaching the AQ modifier will often result in the Center for Medicare and Medicaid Services delaying a payment rather than processing and sending it through.
The remainder of the trip allowed Marijka to reconnect with Yuma’s executives and discuss with them the strategic planning considerations made possible with their active HPSA designation and HPSA Acumen research.