Doctors of optometry
should be aware that the Centers for Medicare & Medicaid Services (CMS) has
contracted with eGlobalTech to provide comparative
billing reports (CBRs) to doctors of optometry. CBRs will be
sent to 6,500 doctors of optometry this week. The CBR will come directly from
eGlobalTech. The majority of doctors who have been selected to receive a CBR
will receive the report via fax. In some cases the report will be sent via mail
if a physician does not have a fax number listed in the CMS National Plan and Provider Enumeration System (NPPES) or
if more than 5 doctors in a practice were selected to receive a CBR. If you are
one of the 6,500 doctors of optometry that have received a CBR, here are the
top 5 things you need to know:
1. CBRs are educational reports that provide comparative data which demonstrates how you compare to your peers. These reports are not intended to be punitive in nature and are not intended to be used to make assumptions regarding how you practice. CBRs have been issued to many specialties and were issued to ophthalmologists in April focusing on many of the same services that are included in the optometry CBR.
1. CBRs are educational reports that provide comparative data which demonstrates how you compare to your peers. These reports are not intended to be punitive in nature and are not intended to be used to make assumptions regarding how you practice. CBRs have been issued to many specialties and were issued to ophthalmologists in April focusing on many of the same services that are included in the optometry CBR.
2. CBRs are not an
indication of fraudulent or inappropriate billing. Even if a report indicates that you are an
outlier compared to your peers, this is not an indication of fraudulent or
inappropriate billing. There are many reasons a doctor could be considered an
outlier compared to peers. If you received a CBR and are surprised regarding
how your practice compares to peers, this is a great opportunity to conduct a
self-audit. Additionally, if the data reported from CMS differs greatly from
your billing records, the report provides an opportunity to correct any billing
information transmission problems between your practice and CMS.
3. A number of factors
were considered when selecting which doctors of optometry would receive a CBR. First, the universe of doctors of optometry
enrolled in the Medicare program was identified. Then the codes that were
reported most frequently by doctors of optometry were identified. eGlobalTech
then selected measures to evaluate doctors of optometry based on most
frequently billed services. Any doctor who was an outlier based on one of the
measures selected was placed into a pool of physicians that could potentially
receive a CBR. Out of that pool of physicians, any doctor who treated fewer
than 115 Medicare beneficiaries and billed less than $15,000 from July 1, 2014,
to June 30, 2015 was eliminated from the pool of potential CBR recipients. Out
of that remaining group, 6,500 doctors of optometry were selected to receive a
CBR.
4.Attend the CBR
Webinar. On Wednesday,
November 18, 2015 from 3:00 p.m. – 4:30 p.m. Eastern
Time a webinar will be held to review the CBRs. There will be a question and
answer session following the presentation. Register for the webinar at:
https://www.anymeeting.com/PIID=EC51DD85854E38
If you are unable to attend the webinar, a recording will be available 5 days
following the presentation.
5. AOA is here to help. If you have questions regarding your CBR,
please contact Rodney Peele rpeele@aoa.org or Kara Webb kcwebb@aoa.org.
eGlobalTech
can also be contacted through their CBR Support Help Desk: 1-800-771-4430 or
via email at: cbrsupport@eglobaltech.com.
