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HealthCare News

Tuesday, October 3, 2017
  New Prior Authorization Program Effective 10/1/2017 at Fidelis Care   Fidelis Care has engaged eviCore Healthcare (eviCore) to implement a new prior authorization program effective October 1, 2017.   Prior authorization will be required for the following services: Outpatient high-tech Radiology services Outpatient Non-Obstetrical Ultrasounds Outpatient diagnostic Cardiology services ...
Friday, August 18, 2017
Prolonged Services Without Face-to-Face Contact Now Separately Payable   Beginning January 1, 2017, prolonged services without face-to-face contact are now separately payable under the Medicare Physician Fee Schedule. Prolonged services without face-to-face contact do not require face-to-face time with the patient, and may be rendered in an office, outpatient, hospital and nursing facility setti...
Friday, August 18, 2017
2017 Quality Payment Program Hardship Exception Now Available   The Quality Payment Program Hardship Exception Application for the 2017 Merit-Based Incentive Payment System (MIPS) transition year is now available. Certified electronic health record technology (CEHRT) is required to participate in the advancing care information performance category. MIPS-eligible clinicians and groups may qualif...
Thursday, July 20, 2017
Increase in Documentation Submitted Without a Valid Provider Signature Affects Payments   National Government Services (NGS) is reporting an increase in documentation submitted without valid provider signature identification. This leads to claim denials that require time-consuming appeals. All medical records must have either a written or electronically entered provider signature. When that sig...
All Providers Must Revalidate Medicare Enrollment Information under Affordable Care Act Criteria Every Five Years; WCH Can Help With Provider Enrollment Revalidation – Cycle 2   In order to maintain Medicare billing privileges, all enrolled providers and suppliers must resubmit and recertify the accuracy of their enrollment information every five years under new enrollment screening criteria re...
Thursday, July 20, 2017
Evaluation and Management: Correct Coding Crucial for Compliance   In a study report about how “Improper Payments for Evaluation and Management Services Cost Medicare Billions in 2010,” the Office of the Inspector General (OIG) noted 42 percent of claims for Evaluation and Management (E/M) services were incorrectly coded and 19 percent lacked documentation. This included both upcoding, with a ...
Thursday, July 20, 2017
Modernized National Plan and Provider Enumeration System More Responsive and Secure   The Centers for Medicare & Medicaid Services (CMS) has modernized the National Plan and Provider Enumeration System (NPPES) with a unified login for type 1 and type 2 providers which increases security, provides new surrogacy functionality, has a more responsive user interface (UI) and a streamlined NPI applic...
Wednesday, June 28, 2017
Differentiated Coding for Expanded Problem Focused, and Detailed Levels of Evaluation and Management, No Longer Mandatory as of July 1 Differentiation in examination requirements for Expanded Problem Focused (EPF, 2-5) and Detailed (6-7) levels of service developed by the National Government Services (NGS) will no longer be considered mandatory as of 7/1/2017. This delineation of levels, initiate...
Wednesday, June 28, 2017
New Medicare Cards Offer Greater Protection to More than 57.7 Million Americans New Medicare cards, which will begin mailing in April 2018, will no longer include Social Security numbers. This Centers for Medicare & Medicaid Services (CMS) fraud prevention initiative will help combat identity theft and safeguard taxpayer dollars.The new cards will use a unique, randomly-assigned number called a Me...
Wednesday, June 28, 2017
Providers Must Report Enrollment Information Changes By Dictated Deadlines All providers must report enrollment information changes to their Medicare Administrative Contractor (MAC) within 30 days for a change in ownership, an adverse legal action, or a change in practice location, or 90 days for all other changes. Failure to do so could result in the revocation of your Medicare billing privileges...

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  New Prior Authorization Program Effective 10/1/2017 at Fidelis Care   Fidelis Care has engaged ...

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