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HealthCare News

Medicare Deductible, Coinsurance, Premium Rates and Therapy Cap Values for Calendar Year 2018    Background Beneficiaries who use covered Part A services may be subject to deductible and coinsurance requirements. A beneficiary is responsible for an inpatient hospital deductible amount, which is deducted from the amount payable by the Medicare program to the hospital, for inpatient hospital ser...
Tuesday, January 9, 2018
MIPS Reporting Countdown: Act Now to Avoid Penalties   Merit Based Incentive Payment System (MIPS) eligible providers who fail to collect and report a minimum amount of 2017 performance data by March 31, 2018, could face a four percent negative payment adjustment on Medicare reimbursements in 2019 — with increasing penalties in the future. You can check MIPS eligibility by entering your indivi...
  New York State Workers’ Compensation Board: New Registration Requirement   Recently, health care providers have started receiving letters from the New York State Workers’ Compensation Board. Workers’ Compensation Board has initiated a registration process to update and maintain a list of medical providers who are authorized to treat injured workers.  Authorized providers are required to regis...
Tuesday, December 5, 2017
  The Merit-based Incentive Payment System (MIPS) Updates for 2018 Have Been Released   Patients Over Paperwork  CMS has recently launched the “Patients Over Paperwork” Initiative, a cross-cutting, collaborative process that evaluates and streamlines regulations with a goal to reduce unnecessary burden, increase efficiencies, and improve the beneficiary experience. This effort emphasizes a com...
Wednesday, November 1, 2017
  Attention Managed Care Network Providers! New York State now requires all Healthcare providers to enroll with Medicaid.   Effective January 1, 2018, Federal law requires that all Medicaid Managed Care and Children´s Health Insurance Program network providers to be enrolled with State Medicaid program. Enrollment applications must be submitted to the Medicaid by December 1, 2017. Providers hav...
Wednesday, November 1, 2017
  Important reminder for Physicians who bill Certification and Recertification of Home Health Services to Medicare   Physician’s services involved in physician certification (and recertification) of Medicare-covered home health services may be separately coded and reimbursed.  It is important to understand that the services are only covered for patients who receive Medicare-covered home health ...
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...

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