In This Issue: CMS: Avoid Duplicate Payments for Medical Services Authorized by the Veterans Health Administration CMS: Expanded Diabetes Screening Claims for 82947 Returned in Error CMS: Discarded Drugs & Biologicals List Update 2025 Medicare Parts A & B Deductibles Humana Military Mandatory Enrollment in Electronic Funds Transfer (EFT) by January 1, 2025 United Healthcare…Read More
In This Issue: CMS CY 2025 Physician Fee Schedule Final Rule Reminder Medicare Beneficiary Eligibility Not Offered on the IVR Digital-only authorization case status for Wellpoint New Jersey Excellus BlueCross BlueShield Update to Telemedicine and Telehealth United Healthcare Update on Prior Authorization Resources for Outpatient Therapy and Chiropractic Services Coding Resources from United Healthcare Read…Read More
In This Issue: Influenza Vaccine: CMS Holding Claims for CPT Code 90658 Billing Errors on 2024/2025 Influenza Season Claims Updated COVID-19 Vaccines for 2024-2025 Season Reminder from Excellus BlueCross BlueShield- Annual Well-Woman Exam Billing Requirement New Medicare Advantage PPO Plans in Maryland Effective 1/1/2025 CDPHP Issuing Official Explanation of Payments ICD-10 Code Set Update Effective…Read More
In This Issue: Annual Flu Vaccine Pricing from CMS Revisions to Medicare Part B Coverage of Pneumococcal Vaccinations Policy United Healthcare Community Plan Prior Authorization Updates New GA modifier Requirement for United Healthcare Commercial Plans Excellus BCBS Tips for Using CPT Code +99459 Excellus BCBS Mandatory Code Submissions for Pre/Postpartum Services Optum Implementing New Protocol…Read More
In This Issue: Medicare Physician Fee Schedule Proposed Rule for CY 2025 Highmark’s Provider Portal- Availity Excellus BCBS August News CareFirst Updated Requirements for Inpatient and Observation Admissions CIGNA Digital Precertification Correspondence United Healthcare Community Plan of New York NPI and Taxonomy Code Requirements AmeriHealth commercial NY Access and National Access New ID Cards Excellus…Read More
In This Issue: CMS to Close Program that Addressed Medicare Funding Issues Resulting from Change Healthcare Cyber-Attack Aetna: Non-Physician Provider Types for E&M Denials United Healthcare: Claims & Eligibility Services are now in UHC Provider Portal Cigna Healthcare: Digital Claim Correspondence on CignaforHCP.com Highmark Blue Shield Provider News- Correcting Claims No Surprises Act - June…Read More
In This Issue: CPT 99459 Pelvic Examination Billing for Medicare Providers Accepting CHAMPVA: Enroll in Direct Deposit Now Aetna: Check Authorization Requirements on our Provider Portal on Availity Aetna: Missing Modifier 54 Expansion to POS 20 and 49 CareFirst Partnering with EviCore for UM Services for Cardiology and Radiology Imaging Fidelis Care Remittance Advice CARC/RARC…Read More
In This Issue: New Codes for Covid-19 Monoclonal Antibody Availity Portal for Horizon BCBS of NJ, Braven Health, and Horizon NJ Health NYS Essential Plan United Healthcare Claims Reconsiderations and Appeals Process United Healthcare: Florida Medicaid - 2024 Taxonomy Rule Changes Timely Filing Waivers for State Medicaid due to Change Healthcare Breach Compliance Corner –…Read More
In This Issue: Waystar Clearinghouse Medicare Conversion Factor Increase Prolonged Services Timetable 2024 UHC: Prior Authorization Crosswalk UHC: New Jersey Medicaid - CPT Code Change for Breast Milk Storage Bags UHC: Update your One Healthcare ID to Maintain Portal Access NYS Reimbursement for Adverse Childhood Experiences Screening Read more online hereRead More
In This Issue: CMS Suspends Appropriate Use Criteria for Advanced Diagnostic Imaging (AUC) Program Medicare Preventive Services Updates Medicare POS 10 Mass Claim Adjustment Complex & Chronic Care Code G2211 Usage Guidelines from NGS United Healthcare Diagnosis Requirement for Molecular Tests Availity Portal for Horizon BCBS of NJ, Braven Health, and Horizon NJ Health NYS…Read More