A guide to finding the latest reimbursement news

For outpatient rehab providers-whether they work in private practice, hospital outpatient, or skilled nursing facility settings-certain scenarios become routine.

For instance, it's the start of the calendar year, and CMS launched a slew of new program memoranda (PM) pertaining to the Medicare Physician Fee Schedule or other fee screens critical to your practice. Or maybe outpatient rehab providers find themselves waiting for the fee schedule to update their charges as CMS continues to issue notices citing unforeseeable delays.

Many outpatient rehab providers, who already find themselves without enough hours in the day to complete tasks, are groaning under the burden of keeping up with the latest instruction changes.

Practices rely on consultants to keep them abreast of changes, but the question remains: Would you know how to find updated fee schedules and other PM essentials for your practice?

Many providers count on their consultants and rehab directors to find the most up-to-date information available on fee screens. But there may be times when your informant is not around, or the information may come too late to be useful. This uncertainty has led some business managers and other billers who work for outpatient rehab providers to look for the information on their own.

"I like to be self-sufficient here and not depend on our consultant to fax or e-mail me those rates," says Cindy Shaske, director of business services at Cedar Community in West Bend, WI.

"I feel in my position I should be able to simply know when to look for [fee schedules] and also be able to go out there and find them."

But for all Shaske's intentions, she still has trouble knowing when and where to find the right information, especially through "pages and pages" on the Web. "How do we know that a screen has changed?" she asks.

According to consultant Lee Heinbaugh controller of PMGO Inc. in Cleveland, the information that providers need as far as fee schedules go is readily available, although it takes some time to sort it out. "I go to the CMS Web site," she says. "[Fee screens] are available at the beginning of the year, generally. And then there is always a transmittal if there are any changes. I watch all the transmittals on the CMS Web site, so there's really no magic."

Even the CMS site has its ups and downs. Heinbaugh says it is a good idea to bookmark the pages you find useful, but also be aware that things could change at any time. Some of the resources that you may want to check regularly include the following:

1. Public use file downloads. Heinbaugh conducted a Web search, recovered the information and found an updated version of what formerly was called the "public use files." By directing your Web browser to www.cms.hhs.gov/providers/pufdownload you'll have one-click access to any piece of reimbursement information you'll ever need.

2. CMS manuals and publications. One good thing about the CMS public use files page is that it includes any updates to fee schedules and code files. However, if you'd like more general links to the necessary reimbursement issues, visit www.cms.hhs.gov/manuals to view any CMS manual in published or electronic form and all program memoranda or transmittals from 2000 to the present.

3. Free e-mail updates. Another helpful feature of the CMS Web site (the main site can be accessed at www.cms.hhs.gov) is its quarterly provider update section. By pointing your browser to www.cms.hhs.gov/providerupdate you get access to an archive of provider updates. The real beauty of this section, however, is the top of the page where you can sign up for a free e-mail service that sends up-to-date provider information directly to your inbox.

Although CMS may be your best bet since it is the organization that is making coverage and reimbursement decisions, it is not your only potential source for information.

If your fiscal intermediary or carrier has a Web site, that is a good place to start if you feel the CMS site is too cumbersome. Also, go to your state Medicaid Web sites or get in touch with provider associations.

And of course, you can always tune in to www.rehabregs.com for the latest outpatient rehab provider and updates.