Tag: medical billing

EHRmedical billingMedical Billing and CodingRevenue Cycle ManagementTelehealth

Understand How To Code Telehealth, Telemedicine

Hint: The terms aren’t interchangeable.

Providers are increasing patients’ access to healthcare services through virtual communications. If providing services to patients without an in-person, face-to-face interaction makes sense for your practice, it’s important for you to know how to code the services correctly.

TelehealthWhile you may hear telehealth and telemedicine used interchangeably, from a coding perspective, the words refer to different services and situations.

Definitions:  A good place to start is by outlining the difference between telehealth (defined as any health service provided by telecommunications) and telemedicine (defined as any clinical service provided by telecommunications). Additionally, you’ll want to consider the array of nuanced guidelines and constantly changing code sets.

Have a look at three key areas to cover some of your most pressing telemedicine and telehealth services’ coding needs:

 

  1. Keep an Eye on Changes

“One of the greatest challenges facing telemedicine coding is that changes in technology typically occur faster than changes in coding,” says Kent Moore, senior strategist for physician payment at the American Academy of Family Physicians.

“CPT® code change proposals are often generated and acted upon more than a year before the changes/new codes appear in CPT®, and CPT®itself is only published once a year. So, it’s easy to see how technology moves faster, leaving coders to wonder if a new telemedicine service fits an existing code or needs to be reported using an unlisted code,” Moore adds.

As an example of this rapid change, theCenters for Medicare and Medicaid Services(CMS) introduced two new HCPCS codes for 2019: G2012 (Brief communication technology-based service, e.g. virtual check-in…) and G2010 (Remote evaluation of recorded video and/or images submitted by an established patient…), which you can use when a provider is evaluating information to determine if a patient needs to be seen in the office.

Additionally, CMS added two prolonged service codes, G0513 (Prolonged preventive service(s) … first 30 minutes…) and G0514 (…each additional 30 minutes…), to the telehealth services’ list.

One means of staying current with telemedicine codes is consulting Appendix P in your CPT® manual. Documenting any service listed there when provided via telemedicine is as easy as appending modifier 95 (Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system). You will also need to add place of service (POS) code 02 (Telehealth) to your claim to indicate that the provider is at the distant site (as opposed to the originating site where the patient is located).

GT no longer needed: Unless you are billing claims from a critical access hospital (CAH) under method II for institutional claims, you no longer need to apply modifier GT (Via interactive audio and video telecommunication systems) to a Medicare telehealth claim. But modifier GQ (Via asynchronous telecommunications system) is still required for asynchronous communication when appropriate, says Mary I. Falbo, MBA, CPC, CEO of Millennium Healthcare Consulting Inc. in Lansdale, Pennsylvania.

2. Know What Qualifies as Telemedicine

While telemedicine can involve the use of telephone communication, two groups of telephone evaluation and management (E/M) codes are not regarded as telemedicine.

Codes 99441 through 99443 (Telephone evaluation and management service by a physician or other qualified healthcare professional … provided to an established patient, parent, or guardian …) and 98966 through 98968 (Telephone assessment and management service provided by a qualified nonphysician health care professional to an established patient, parent, or guardian …) are not regarded as telemedicine because CPT®does not regard them as being “face-to-face” services.

Medicare Advantage Now Features Telehealth Expansion

In the past, telehealth was only an option offered through Medicare Advantage beneficiaries’ supplemental benefits, but the Centers for Medicare and Medicaid Services (CMS) wants to change that.

Now: Bolstered by provisions outlined in the Bipartisan Budget Act of 2018 (BBA 2018), CMS updated telehealth services for Medicare Advantage (MA) plans starting in the contract year 2020, notes a two-part final rule, published in the Federal Register last month.

“Under this final rule, MA enrollees may have great opportunities to receive healthcare services from places like their homes, rather than being required to go to a healthcare facility,” CMS advises. “MA plans will now have broader flexibility than is currently available in how they pay for coverage of telehealth benefits to meet the needs of their enrollees.”

The final rule allows MA plans the option to offer telehealth benefits to MA patients beyond their supplemental benefits in both rural and urban environments, aligning with BBA 2018 legislation, indicate attorneys Matthew M. Shatzkes and Susan Ingargiola of the national law firm Sheppard, Mullin, Richter & Hampton LLP, in the Sheppard Mullin Healthcare Law Blog.

However, “MA Plans will continue to be able to offer MA supplemental benefits (that is, benefits not covered by fee-for-service Medicare) via remote access technologies and/or telemonitoring for those services that do not meet the requirements for coverage under fee-for-service Medicare or the requirements for MA additional telehealth benefits (such as the requirement of being covered by Medicare Part B when provided in-person),” Shatzkes and Ingargiola explain.

The same is true for 99444 (Online evaluation and management service provided by a physician or other qualified healthcare professional … using the Internet or similar electronic communications network), which is also regarded as non-face-to-face and would also not be defined as telemedicine by virtue of its asynchronous nature.

3. Don’t Forget Difference Between State and Federal Rules

Depending on the nature of the telehealth service and the clinical care administered telemedically, CMS may not cover the outcomes.

“The key to compliance with Medicare rules is to evaluate the Medicare billing requirements for a bona fide telehealth encounter with the proposed arrangement from the telehealth company,” says John E. Morrone, a partner at Frier Levitt Attorneys at Law in New York City. “It is very common for healthcare services to comport with applicable state law but not be reimbursable by Medicare.”

He adds, “A telehealth encounter may be perfectly acceptable under state law, and even billable to commercial carriers, but not be billable to Medicare.”

Resource: For a more in-depth look at CMS’s telehealth services, visit https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/downloads/TelehealthSrvcsfctsht.pdf?utm_campaign=2a178f351b-EMAIL_CAMPAIGN_2019_04_19_08_59&utm_term=0_ae00b0e89a-2a178f351b-353229765&utm_content=90024810&utm_medium=social&utm_source=facebook&hss_channel=fbp-372451882894317.

 

Originally published Published on Thu Jun 06, 2019, TCI

Revenue Cycle Management

Reporting Cardiac Stress Tests

Interpretation only, or supervision, too? The answer affects your coding.

If coding for cardiac stress tests makes you want to pull your hair out, you are not alone. Understanding the nuances of the appropriate stress test codes can be tricky. Here’s how to avoid the confusion so you can seamlessly report stress tests.

Notice What Happens During Stress Tests

Cardiologists use stress tests, also known as treadmill or exercise tests, to see how well a patient’s heart deals with work.

When a patient takes a stress test, the cardiologist (or tech) hooks up the patient to heart monitoring equipment, and the patient walks slowly on a treadmill. Next, the treadmill’s speed increases and tilts to simulate the patient going up a small hill. During the test, the cardiologist monitors the patient’s heart rate, breathing, blood pressure, and level of tiredness.

Stress tests allow the cardiologist to diagnose coronary artery disease, determine a safe level of exercise for the patient, and diagnose a possible heart-related cause of symptoms such as chest pain, shortness of breath, or light-headedness.

stress test

Grasp 93015 — Several Codes in One

When it comes to reporting stress tests, the CPT® manual gives you the following options:

  • 93015, Cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous electrocardiographic monitoring, and/or pharma­cological stress; with supervision, interpretation and report
  • 93016, … supervision only, without interpretation and report
  • 93017, … tracing only, without interpretation and report
  • 93018, … interpretation and report only.

Problem: The way that the CPT® manual lists the above codes could suggest that they work together. This interpretation isn’t correct, but the manual does not offer any extra explanation beyond the descriptor language for the codes’ appropriate usage.

Solution: You can look to an article in the January 2010 CPT® Assistant to see the close connection between the stress test codes.

According to CPT® Assistant, 93015 represents a complete cardiac stress test procedure, which includes the technical and professional components of the service — 93016, 93017, and 93018. To correctly report 93015, one cardiologist must perform all three components in a nonfacility setting like an office, clinic, or diagnostic testing center.

If the cardiologist does not perform a complete 93015, he should report just the code or codes that best represent the service he did perform (93016-93018).

Reporting stress tests in the hospital: If the cardiologist reports stress tests in a facility setting like the hospital, the facility would report the technical component (93017), and the cardiologist would report the service he performed (93016, 93018, or both).

Bonus tip: The PC/TC indicators for these codes in the Medicare Physician Fee Schedule also can help you use these codes correctly:

  • Code 93015 has indicator 4, meaning it’s a global test code that describes selected diagnostic tests where there are associated codes that indicate (a) the professional component only and (b) the technical component only.
  • Codes 93016 and 93018 have indicator 2, meaning they are professional components only. Codes 93016 and 93018 describe the physician work portion of selected diagnostic tests where there is an associated code that describes the global test.
  • Code 93017 has indicator 3, meaning it is the technical component only. Code 93017 indicates the staff and equipment costs of selected diagnostic tests where there is an associated code that describes the professional component of the diagnostic test only.

Understand the Individual Component Codes of 93015

Let’s dig deeper into each component of 93015 — 93016, 93017, and 93018 — to see what it means when a cardiologist reports these codes.

1. Code 93016 is a professional component you report for the physician’s supervision only, without the interpretation and report. Medicare’s diagnostic test supervision guidelines require this component.

Expert tip: Report 93016 only if the physician provides direct supervision of the stress test. Physicians should document they supervised in order to use this code.

2. Code 93017 represents the service’s technical component such as technicians, providing the equipment, paying for rental space, utilities, supplies, etc. You use 93017 for tracing only, without the interpretation and report.

Expert tip: For tests performed in a facility setting, only the facility reports 93017.

3. Code 93018 is a professional component.

Expert tip: Report 93018 if the provider provides an interpretation and a written report.

Learn more-

Cardiac Stress Test 

Cardiac Health

~Excerpt taken from the 2018 Cardiovascular Survival Guide

Revenue Cycle Management

Clear up EOB Confusion

Remember: An EOB is not a bill.

Working in the healthcare field, you know that acronyms are a part of your daily life. From the Health Insurance Portability and Accountability Act (HIPAA); to local coverage determinations (LCDs); to relative value units (RVUs) — as a coder, you are constantly bombarded by acronyms.

It’s common for one such acronym, explanation of benefits (EOB), to cause confusion among patients. Read on to learn more about EOBs, as well as remittance advice (RA).

Delve Into How EOBs Work

Insurance companies send EOBs to patients two to three weeks after their initial appointment.

“EOBs are insurers way of explaining their reimbursement, based on the CPT® codes and ICD-10 codes submitted,” says Catherine Brink, BS, CMM, CPC, president of Healthcare Resource Management in Spring Lake, New Jersey. “EOBs usually list the service provided was approved or not approved, the amount a provider charged, the amount approved by the insurer, the amount paid by the insurer, the amount you may be billed, then a code that indicates how the claim was paid, denied, or partially paid based on the patient’s policy. This is explained in detail on the EOB.”

Don’t miss: Although patients often mistake an EOB for a bill, an EOB is not a bill.

“Most patients do not understand EOBs or the definition of the acronym ‘explanation of benefits,’ which means what the insurer will pay based on your particular policy,” Brink says.

Check out this example from Brink: A participating provider charges $200 for a service. Medicare’s approved amount for this service is $160. Medicare pays 80 percent of $160-$128. The 20 percent difference, $32, is the patient’s responsibility to pay. If the patient has a Medigap insurance plan, then that $32 is usually paid by insurer depending on the insurance plan. The $40 difference from what the par provider charged and the Medicare approved amount must be written off by the par provider since it is part of the par contract with Medicare. Biller and coders must understand this and adjudicate the remittance advise, which is sent to the provider, correctly.

Note: An EOB is sent to the patient and an RA is sent to the provider. The patient needs to understand the EOB since he is responsible for the 20 percent.

Helpful tip: When asked how practices can help ease the confusion patients often have about EOBs, Brink says practices should explain to patients what the EOB will tell them and try to help them interpret it.

Practices could let their patients bring in EOBs and explain them. Practices could post this on their websites as a helpful service they provide, Brink adds.

Some practices offer education classes for patients to teach them about EOBs, and the patients like these classes, Brink says. “I see this in bigger practices who have the personnel to do this, for instance, education sessions, such as breakfast seminars.”

Practices Should Utilize RAs to Ensure Maximum Reimbursement

While an EOB is sent to the patient, a RA is sent to the provider who billed the service, according to Melanie Witt, RN, MA, an independent coding expert based in Guadalupita, New Mexico.

“Both types of statements provide an explanation of benefits, however,” Witt says. “The content of the RA and the EOB is nearly identical with the exception of a few minor items.”

Both RAs and EOBs contain the following information, according to Witt:

  • Information regarding the patient
  • The service provider
  • Any adjustments made to the claim
  • The type of procedure performed
  • The date the procedure was performed
  • The cost of the procedure
  • An explanation if the payment was denied

“Additional information regarding the patient’s benefits is often included as well, including the particulars of the plan, such as co-payments and deductibles,” Witt adds.

The major difference between RAs and EOBs is that an EOB contains a disclaimer stating the EOB is not a bill, according to Witt.

Example: For example, at the top of an EOB for Cigna, you will find the statement: “THIS IS NOT A BILL. Your health care professional may bill you directly for any amount you owe.”

Practices should utilize their RAs to streamline their processes.

“All billing staff should spend time studying the reasons cited for adjustments or denials from the RA they received,” Witt says. “Each RA message should be tracked to ensure that any patterns of inappropriate adjustments (incorrect use of a modifier, bundling issue, reduction for secondary procedure, etc.) or denials (code not covered, code bundled, demographics incorrect, not medically necessary, etc.) are addressed to ensure maximum reimbursement.”

Billers should also use RAs to compare what was paid to the published fee schedule from the insurer, Witt adds.

-originally posted from TCI Supercoder June 26, 2018

New Patient Image
MDSuitemedical billingMedical Billing and CodingMedisoft

What Makes A New Patient “New”?

A patient makes an appointment at your clinic and “has never been seen before”, you bill a new patient visit only to have the payer reject the claim, stating, “New patient qualifications have not been met”.

So, what went wrong?  Not all Evaluation and Management (E/M) codes fall under the new (versus established) categories.  For example, if the patient presents through the Emergency Department, the patient is always new, and the provider is always expected to get the patient’s history to diagnose a problem.  However, in the office setting, the patient sees their primary provider routinely.  The provider knows- or can quickly access- the patient’s history to manage their chronic conditions, as well as make decisions on recent problems.

The definition of a new patient in the CPT code book is: “one who has not received any professional services from the physician/qualified health care professional or another physician/qualified health care professional of the exact same specialty and subspecialty who belongs to the same group practice, within the past three years.”  In addition to this definition, CMS adds “an interpretation of a diagnostic test, reading an X-ray or EKG etc., in the absence of an E/M service or other face to face service with the patient does not affect the designation of a new patient.”[i]

Three key components that make up a new patient are:

  1. Professional Service (not modifier 26)– If the provider has never seen the patient face to face, a new patient code should be billed.
  2. Three-year rule- the general rule to determine if a patient is “new” is to check to see if that patient has been seen in the past three years. Check your dates on this-if the patient was seen the last time in May of 2015 and its March of 2018, it hasn’t been three years, according to the payer.
  3. Different specialty/subspecialty within the same group is possibly the most confusing. For Medicare patients, use the NPI registry to see what specialty the physician’s taxonomy is registered under.  The credentialing process is of upmost importance in ensuring no denials happen due to improper credentialing.

What happens when doctors switch practices?

If a doctor changes practices and takes his patients with him, the provider cannot bill for the patient as a new patient based on the “new” tax ID.  The tax ID doesn’t matter because the provider has already seen these patients and has established a history.  Just because the patient is being seen in a new facility, that patient is still seeing the same provider.

What happens when a provider sends the patient to mid-level provider?

When an MD or DO sends a patient to a mid-level provider (Nurse Practitioner or Physicians Assistant) and the visit is not an incident-to, the mid-level provider could bill a new patient code if they are a different specialty with different taxonomy codes.  An example would be a family practitioner and the mid-level sees hematology patients.  Since the specialty is different, the mid-level could bill as a new patient visit.  However, if the mid-level is also considered family practice, then a new patient visit code could not be used.

Of course, in billing there are always exceptions to the rules.

For example:

  • For some Medicaid plans, obstetric providers need to bill an initial prenatal visit with a new patient code, even if they have seen the patient for years prior to the patient’s pregnancy. Make sure you check your own local rules and Medicaid plans if you are billing obstetrics.
  • Hospitalists and Internal Medicine providers are the same specialty according to Medicare, even though each has a different taxonomy code.

If a new patient claim is denied, look to the medical record to see if the patient has been seen in the past three years by your group.  If so, check to see if the patient was seen by the same provider or a provider of the same specialty by checking the NPI registry website.  It’s always helpful to know how the provider is registered with the payer denying the claim.  If in researching all of this, there isn’t any substantiating evidence to support the denial, appeal the claim.

 

[i] Medicare Claims processing manual, chapter 12-Physican/Nonphysician Practitioners (30.6.7)

medical billingMedisoft

Can your current payment system store a card on file?

Most everyone likes the convenience of paying bills online.  It’s definitely my preference, since it seems most of the time I’m not home.  I am from the generation that is use to writing a check every month, and trying to remember to buy enough stamps, so I enjoy the convenience of going online and pay a bill with my credit card or setting up an auto payment to pull funds right from my checking account.  I like that I am emailed or sent a text of said funds have left my account-it’s just more convenient.  With my  Health Savings Account (HSA), I can also keep track of all my families medical expenses too and (again the word) conveniently pay with a debit card.

From a revenue standpoint in medical office, wouldn’t it be nice to give this convenience to your patients?  Especially for families like mine where there is college student making their own medical appointments (no way I am going to give him my debit card), or a spouse who can never remember to grab the HSA card from my wallet.

For medical practices using BillFlash,there is a way to now set up auto draft payments for patients.  There are two ways to do this-with StoredPay and with PlanPay.

StoredPay

With StoredPay, you’re able to make the authorized payment and email a receipt rather than just sending another bill and waiting to get paid. Securely store a payment method that you can use later as agreed with your patient.

PlanPay

PlanPay payments are not associated with any single bill/statement but are simply part of a plan to pay off an established liability like a car loan payment would do. Create and automate payments for payment plans/agreements you make with your patients (ex, payoff $2,400 liability by making a $100/mo. payment on the 15th of each month for 24 months).

Best thing of all-it’s easy to get started!  

Simply give us a call or email at(502) 538-4665 or sales@sunrize.com

Don’t currently use BillFlash and want to learn more?  Visit our website to view product information and see a video on how BillFlash works or give us a call!

electronic patient recordICD-10MACRAmedical billingMedical Billing and Coding

New PT CPT Codes for 2017

pt-with-patient

CPT® 2017 has a few expanded codes for physical therapy evaluations and follow-up exams.  These codes are in effect for dates of service starting January 1, 2017.

97001 to be replaced by three codes in 2017:

These new codes will add more specificity and details regarding the scope of the evaluation and states that it involves clinical decision-making of low/moderate/high complexity. The evaluation includes history to identify any factors that impact the plan of care; using standardized tests and measures to assess body structures and functions that may limit activity or restrict participation; and evaluation of the patient’s current status on presentation. The evaluation typically includes face-to-face time with the patient and/or family.

97161 Physical therapy evaluation: low complexity, requiring these components: A history with no personal factors and/or comorbidities that impact the plan of care; An examination of body system(s) using standardized tests and measures addressing 1-2 elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with stable and/or uncomplicated characteristics; and Clinical decision making of low complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 20 minutes are spent face-to-face with the patient and/or family.
97162 Physical therapy evaluation: moderate complexity, requiring these components: A history of present problem with 1-2 personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures in addressing a total of 3 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; An evolving clinical presentation with changing characteristics; and Clinical decision making of moderate complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 30 minutes are spent face-to-face with the patient and/or family.
97163 Physical therapy evaluation: high complexity, requiring these components: A history of present problem with 3 or more personal factors and/or comorbidities that impact the plan of care; An examination of body systems using standardized tests and measures addressing a total of 4 or more elements from any of the following: body structures and functions, activity limitations, and/or participation restrictions; A clinical presentation with unstable and unpredictable characteristics; and Clinical decision making of high complexity using standardized patient assessment instrument and/or measurable assessment of functional outcome. Typically, 45 minutes are spent face-to-face with the patient and/or family.

CPT® 2017 adds 97164 to replace 97002 (Physical therapy re-evaluation).

The new code adds more specificity and details regarding the scope of the evaluation, which includes history review and standardized tests (criteria established and agreed upon by a group of experts) and measures to assess body structure and function; a revised plan of care using standardized instrument and measurable functional outcome assessment tool; and typically involves 20 minutes of face-to-face time with patient and/or family.

Consider these to be the equivalent of E&M codes (99000) for Physical Therapy.  You should now consider these elements when coding for services:

  • Patient’s history
  • Examination results
  • Clinical decision-making
  • Development of the care plan

The level of the PT evaluation performed depends on the clinical decision-making and the patient’s severity, according to CPT® instruction. For reporting, PTs must demonstrate review of these body regions and body systems:

  • Defined body regions such as the head, neck, back, lower extremities, upper extremities, and trunk
  • Musculoskeletal systems, which include gross symmetry, range of motion, strength, height, and weight
  • Neuromuscular systems, which includes gross coordinated movement and motor function
  • Cardiovascular and pulmonary systems, which include heart and respiratory rates, blood pressure, and edema
  • Integumentary system, which means assessing the pliability, scar formation, color, and integrity of the skin

One other thing-make sure to sequence these codes before your modality CPT codes (those starting at 97010).

OT and AT have similar changes.  Look for those in a future post.

References:
CPT® 2017 Professional Edition, American Medical Association, pages 664-668
Federal Register, Vol. 81, No. 136, Pat. 46162, July 15, 2016, “Medicare Program; Revisions to Payment Policies Under the Physician Fee Schedule and Other revisions to Part B for CY 2017; Medicare Advantage Pricing Data Release: Medicare Advantage and Part D Medicare Advantage Provider Network Requirements’; Expansion of Medicare Diabetes Prevention Program Model”
AAPC Healthcare Business Monthly, November 2016

 

Integrated Cloud Based Solutions

ICD-10 Walking Through the Workflow

With less than a year to go until the ICD-10 code set implementation deadline, physician practices should be pursuing a comprehensive plan designed to ensure a smooth coding transition with minimal cash flow disruption.

A key step in any ICD-10-CM transition strategy is to conduct a detailed assessment of existing workflows and processes to determine which elements will require modification, according to Bess Ann Bredemeyer, a consulting director with McKesson Business Performance Services (BPS).

By identifying each point in the claims lifecycle that ICD-10- CM will touch, appropriate adjustments can be made and simulations conducted to test the new processes against real-world conditions.

“The best way to proceed with an assessment is to begin at the patient encounter and then move through to the claim drop and denial management,” Bredemeyer said. “That way you won’t miss anything.”

Clinical Documentation  Whether the clinical documentation is sent directly to a coder or to data entry personnel, it is also important to ensure that any changes in National Coverage Determinations (NCDs) and payer’s Local Carrier Determinations (LCDs) are incorporated and reflected in the claim. A good approach includes:

  • Identifying the top 50 most utilized diagnoses codes
  • Evaluating where additional documentation will be required
  • Mapping out modifications to support appropriate reimbursement
  • Updating charge tickets, super-bills and other revenue cycle tools

This is a Test  With all the elements theoretically in place, it is critical to begin testing your new workflow to determine if it can handle ICD-10-CM. Code audits can assess both clinical documentation and coding to determine whether the claims should come through clean or not. A real-world testing process may also reveal previously unknown problems that would otherwise remain hidden until the ICD-10 go-live.

Don’t Be Denied  Because of the complexity of ICD-10-CM and the sheer magnitude of the change, it’s reasonable to assume that even the best-laid plans may encounter some unexpected problems. For that reason, it makes sense to be prepared for a rise in denials. For physician practices, that means ensuring that staffing is adequate to manage an increase in volume, and that problems will be quickly identified and remediated.

“There is no denying that the transition to the new code set will require planning and resources to mitigate the burden of change,” Bredemeyer said. “That’s why you should get started now on developing a workflow analysis impact assessment that will help you develop a detailed ICD-10 timeline and budget.”

Article Resource:

ReveNEWS, Industry Spotlight, “Walking Through the Workflow- An Important First Step,” November 2013 edition located on the McKesson ReveNEWS website

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