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December 1, 2017
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Dec. 1, 2017


Anthem Announces Changes to Modifier 25

Anthem announced that, as of Jan. 1, 2018, it will implement a policy in California, Connecticut, Kentucky, Maine, Nevada, New Hampshire, Ohio and Wisconsin that will reduce reimbursement for Modifier 25. This policy will affect claims processed Jan. 1, which could include claims made in 2017 that are processed on Jan. 1 or later. This will have major implications for those physicians enrolled in Anthem.

The payor will begin reducing reimbursement of evaluation and management (E/M) services, which are billed with Modifier 25 in relation to two circumstances:

  • When a minor surgical procedure code (0 or 10-day global period) is reported on the same day as an E/M code by the same physician, payment for the E/M code will be reduced by 50 percent.
  • When a preventative/wellness exam and a problem-oriented E/M are billed during the same encounter, payment for the problem-oriented E/M code will be reduced by 50 percent.

Practices are urged to thoroughly review and assess the impact that any proposed modifications would have on their practices.

AMA recently adopted a policy in response to Anthem's policy to “aggressively and immediately advocate through any legal means possible, including direct payer negotiations, regulations, legislation, or litigation, to ensure when an evaluation and management (E&M) code is appropriately reported with a modifier 25, that both the procedure and E&M codes are paid at the non-reduced, allowable payment rate.”

KMA has put together a resource guide for physicians on the Modifier 25 policy change.

It is suggested to call Anthem at 800-205-5870 to voice concerns about this change and how this will negatively impact your practice and your patients.


MIPS in 2018: AOA Needs Your Help!

Are you planning to go all in with MIPS in 2018? If so, the AOA needs your help for an article. We are looking for individuals who plan to go all in on MIPS next year to be interviewed on Monday or Tuesday (Dec. 4 or 5) of next week. Email Caitlin Price at the AOA Office if you are willing to be interviewed for this article. Thank you!


AOA Quick Survey: Drug Monitoring

Please answer a quick survey so we can determine drug monitoring based on your state! You can access the survey here. Results will be posted in next week’s AOA Now.




The AOA's Executive Partners work closely with the AOA year round to help the association provide members with resources and education in the unique specialty of otolaryngology practice management. This special edition of the AOA Now features educational content from our Partners. For more information and resources from our Partners, please visit the Partner page on the AOA website.


AllMeds RCM / Billing & Collections Services Will Dramatically Improve Your Bottom-Line!

AllMeds RCM provides cost-neutral Billing & Collections services in a supplemental, temporary or turnkey model that can provide immediate and dramatic revenue improvements:

  • Increase Collections
  • Reduce Days in A/R
  • Minimize Compliance Risk
  • Ensure Proper Documentation
  • Improve Net Collection Percentage
  • Focus on Self-Pay & Private-Pay
  • Enhance Customer Service

Find out how AllMeds RCMcan invigorate your bottom-line and make all the difference in your 2018! | 888.343.6337 |



The Art and Science of Building Remarkable ENT, Otology and Multispecialty Practices

With a focus on low-effort, high-impact strategies, Audigy Medical simplifies complex decision making for your practice through a comprehensive suite of services implemented by a dedicated team of in-house business experts.

Because there are crucial distinctions in a practice’s goals, size, needs, and culture, we tailor our recommendations to achieve your specific goals.

Our results-focused, data-driven methodology provides you a comprehensive snapshot of your business’s current health and its potential for increased efficiency and profitability, as well as a proven plan to achieve unprecedented patient care.


Invest Your Time in What Matters:

Transform Your Audiology Department

Audiology Management Group Networktm helps practice administrators put their time to good use. Many of our members tell us that they struggle with the day-to-day operations of their audiology ancillary. Our experienced business adviser team understands. Find out how to take advantage of the Network’s business services so you can invest your time on what really matters, the patients.

P.S. - Tired of managing the audiology ancillary?
Ask us about our Joint Venture Equity Partnerships!
Maximize Profits and Minimize Risk!

To Learn More Visit
Or Call 866.566.7705



Point-of-Care CT Imaging for Otolaryngology/Allergy Practices

CS 9300 System for Sinus and Temporal Bone Applications
For fast and accurate CT images, choose the CARESTREAM CS 9300: the point-of-care CT system that is easy to implement and afford. Featuring a range of fields of view and resolutions, the unit is ideal for visualizing temporal bone and sinus structures - and all with much less radiation than conventional multi-slice CT exams.

A complete solution you can count on.

The CARESTREAM CS 9300 System offers:

  • Immediate access to CT scans for faster diagnosis and treatment
  • Superb image quality at radiation doses up to 94% less than conventional CT systems
  • A new source of revenue and affordable way to expand services
  • Expert accreditation support at no additional cost





Reach Your Practice's Full Potential in 2018

Achieving your goals requires a functional plan and dedicated management resources. Fuel Medical’s strategic plan has both. What sets us apart is our individualized approach and ability to create tools customized to your practice needs outlined in your plan. Each tool created for your practice helps improve operational efficiency, allowing you more time to focus on the most important piece of the puzzle - patient care.


What a strategic plan does:

  • Considers all areas of your practice.
  • Maximizes budget by being flexible.
  • Encourages change based on real-time results.
  • Provides a functional roadmap to achieving your goals.


Contact Fuel Medical today and start planning for your best year yet.





Making Their Journey Our Journey
What’s good for our patients is good for our practices. The best business advice for a successful practice is to listen to your patients, as they will guide you toward success. Not only can your patients offer you key insights for how to improve general business procedures in your practice, but they can show you how to be more effective and efficient in providing hearing health services.

In terms of general business procedures, your patients are a great resource for ways to easily improve a multitude of items that can have both short- and long-term benefits all around for your practice. Such items include: scheduling appointments, new patient procedures, educational items and general ambiance. You can easily obtain information from patients via online surveys, a physical suggestion box at the front desk, online reviews and in follow-up conversations face-to-face or over the phone. By asking patients for their input, you will make them feel valued, appreciated and heard. And when positive suggestions are implemented, not only will your patients place a higher value of trust and loyalty in your business, but you’ll see greater efficiencies as well.

When it comes to providing better hearing health services, your patients should be your number-one indicator of success. Every patient’s ear is unique, and because of that, every patient’s perception of sound is different. Instead of relying on only charts and data to prescribe hearing health treatments, especially when it comes to hearing aid technologies, combine key audiological data with personalized patient perception and input. In doing so, you’re ensuring that the patient feels they have helped you choose their hearing health plan, that they are comfortable with and understand their chosen technologies, and you ensure a greater chance of long-term patient satisfaction.

Your patients can help you improve your practice, procedures, services and profits. All you have to do is listen and keep an open mind.


Making Their Journey Our Journey
What’s good for our patients is good for our practices. The best business advice for a successful practice is to listen to your patients, as they will guide you toward success. Not only can your patients offer you key insights for how to improve general business procedures in your practice, but they can show you how to be more effective and efficient in providing hearing health services.


Association of Otolaryngology Administrators
2400 Ardmore Blvd., Ste. 302
Pittsburgh, PA 15221
p: 412-243-5156 | e:

AOA Office

2400 Ardmore Blvd., Suite 302
Pittsburgh, PA 15221
Phone: 412-243-5156
Fax: 412-243-5160

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