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
In This Issue: Excellus BCBS Updated NDC/HCPCS Codes When Billing for Depo-Provera® Excellus BCBS: Preauthorization Removed for Additional Procedure Codes Effective February 1, 2024 How to Use the Office & Outpatient E/M Visit Complexity Add-On Code G2211 Telehealth Modifier 95 & Place of Service Codes CMS Policy Update- Surgical Dressings for Lymphedema KX Modifier on…Read More
In This Issue: Humana Military Referral Change Excellus BCBS Tips for Claim Adjustment Submissions CareFirst BCBS Authorization Edit Update Upcoming changes to certain transactions within PEAR PM Aetna Senior Supplemental Insurance to Use New Payment Processor Global Surgery Billing Federal Independent Dispute Resolution (IDR) Process Administrative Fee and Certified IDR Entity Fee Ranges Final Rule…Read More