In This Issue: NYS Workers Compensation CMS-1500 Mandate Medicare Providers & Suppliers: Report Managing Employees Update - CMS Delay of Skin Substitutes Effective Date NGS Spring 2025 Virtual Conference NGS Written Inquiries Process Martin’s Point Referral Requirements / ProAuth System Implementation Excellus BCBS: Understanding Subrogation Claim Indicator OA-20 Aetna Changes to Coverage for Specialty Medications…Read More
In This Issue: Telehealth Flexibilities Extended Aetna: Psychiatric Diagnostic Evaluation Update Aetna: FIT/FOBT Code Update Aetna: New Credentialing Requirement for Physician Assistants (PAs) Aetna: Claim and Code Review Program (CCRP) Highmark Updated Reimbursement Policies Fidelis Care New York Claim Status Letters Fidelis Care New York Authorization Grids NYS Medicaid Over-The-Counter Changes Read more online hereRead More
In This Issue: Medicare Telehealth Flexibilities CMS Global Period Services - HCPCS Code G0559 Important Update for Part B Providers – New NCCI Lookup Tool New Medicare Part B Redetermination Notice Initiative - Implementation Delayed United Healthcare - Claim Denials and Rejections United Healthcare - Electronic Reconsideration and Appeal Submissions Requirement Highmark BCBS - Electronic…Read More
In This Issue: United Healthcare Provider Portal Authentication Action Needed by March 6, 2025 United Healthcare- New York Medicaid Compliance United Healthcare - Medicare Advantage: Update to Prior Authorization Requirement for Outpatient Therapy and Chiropractic Services CMS Policy Update for Visit Complexity Add-On Code G2211 National Government Services: Medicare Contractor New Redetermination Notice Initiative Aetna…Read More
In This Issue: Best Practices for the New Year Congress Extends Telehealth Waivers Telehealth Coding Changes Aetna Reimbursement for Modifiers SA and SB Excellus Blue Cross Blue Shield News NYS Medicaid: Lump Sum Payments for 1% Across-The-Board Increase Coding and Billing Guidance from NGS Medicare for Allergen Immunotherapy CPT 95165 Medicare Global Surgery Important Information…Read More
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