HEALTHCARE NEWS
Stay Informed: Latest Updates and Insights in Healthcare!
Medicare Part C Reimbursement Reminder
5/28/2017
Retroactive to July 1, 2016, Medicaid will no longer reimburse the full Medicare Part C copay or coinsurance amount.Pursuant to 2016 changes to Social Services Law, the New York State Department of Health has revised the Medicaid reimbursement methodology for claims containing Medicare Part C (Medic...
2017 Eligible Professionals Transitioning to MIPS May Submit Hardship Form by October 1
4/28/2017
An eligible professional who has never successfully attested to meaningful use under the EHR Incentive Program, and is transitioning to the MIPS in Program Year 2017, may submit this Click here for instructions.
Medicare EHR Incentive Program Hardship Exception Application due July 1
4/28/2017
Eligible professionals (EP) who are not meaningful users of certified electronic health record (EHR) technology under the Medicare EHR Incentive Program may be exempt from Medicare penalties if they can show meaningful use would result in a significant hardship.To be considered for an exemption and ...
New Cognitive Assessment Code Likely to Become Permanent in 2018
4/28/2017
In January 2017, the Centers for Medicare & Medicaid Services (CMS) approved payment for a new G-code, G0505, which describes assessment and care plan services for patients with cognitive impairment. This code will likely be converted to a permanent CPT code, approved by the CPT Editorial Panel,...
All Providers Must Revalidate Enrollment with State Medicaid Agencies Every Five Years to Ensure Payment of Claims
4/28/2017
The New York State Department of Health has determined that many providers are at risk for not being paid for their services because the ordering/prescribing/referring (OPR) provider has not complied with a federal regulation which requires state Medicaid agencies to revalidate enrollment of all pro...
Medicare Covers an Annual Wellness Visit. Are you seeing patients for Wellness visit in January 2015?
10/19/2014
Medicare covers an Annual Wellness Visit (AWV) providing Personalized Prevention Plan Services (PPPS). Medicare covers the AWV for beneficiaries who are not within the first 12 months of their first Part B coverage period and have not received an Initial Preventive Physical Examination (IPPE) or AWV...
Obama Care for Your Patients
1/21/2014
Health insurance was always a major issue in the US. As of January 1, 2014 more than 1million people, that never had insurance before, are now covered by health insurance plans.
The Affordable Care Act, also known as Obamacare allows everyone to enroll into a health insurance plan of their choic...
2013 CPT Coding Changes for Psychiatrists and Behavioral Health Providers
10/28/2012
2013 brings big coding changes for prescribers and non-prescribers alike. On the psychiatry front, perhaps the most notable change is the elimination of the med-management code 90862. The 908XX psychiatric code series (90807 and 90817, for example) which covered therapy with ...
Major Therapy Reimbursment Changes Starting October 1st, 2012!
7/30/2012
Starting October 1, 2012, claims for patients who meet or exceed $3,700 in therapy expenditures will be subject to a manual medical review. For outpatient therapy services that exceed $3700 there will be an advanced approval process that will be implemented in three distinct phases. Providers will b...
Service-Specific Prepay Audit Being Conducted for Physical and Occupational Therapy Services Billed by Physicians
5/6/2012
INTERNET - 9/8/2011National Government Services, Inc. is currently conducting a service-specific prepayment review for Physical Therapy and Occupational Therapy Services being performed by specialties other than Specialty 65 (Physical Therapist billing independent) and 67 (Occupational Therapist bil...
Electronic Funds Transfer
5/6/2012
Horizon Blue Cross Blue Shield. January 24, 2012
In 2012, Horizon Blue Cross Blue Shield of New Jersey will require the use of Electronic Funds Transfer (EFT). In the first quarter of 2012, we will begin to require the use of EFT for newly credentialed group practices and solo physicians and oth...
Non-Specific Procedure Code Description Requirement for HIPAA Version 5010 Claims
5/6/2012
The Office of E-Health Standards and Services (OESS) announced on November 17,
2011, that although the 5010/D.0 compliance date of January 1, 2012 will not change,
HIPAA enforcement of compliance with the standards will be deferred until March 31,
2012.
The 5010 versions of ...
CMS Starts Immediate Recoupment for Overpayments
5/6/2012
The Centers for Medicare & Medicaid Services (CMS) is implementing an immediate recoupment process for demanded overpayments. As it stands, Medicare contractors begin recoupment of an overpayment on day 41 from the date of the initial demand letter. Effective July 1, 2012, however, providers can...
CDC: One-in-two Americans will have mental health issue
5/6/2012
HEALTHDAY NEWS - 9/8/2011A report from the CDC says that about 25% of Americans experienced mental illness in the past year, and experts project that about half will suffer a form of mental illness in their lifetime. The cost of mental illness, including treatment and lost productivity, was roughly ...
Doc groups blast $320B Medicare, Medicaid cuts in 2013
5/6/2012
In response to yesterday's release of the White House budget proposal, provider groups are quickly blasting the President's proposed $320 billion cuts to Medicare and Medicaid, fearing repercussions for hospitals and their patients.
First announced in September, the federal plan targets $3.8 tri...