HEALTHCARE NEWS
Stay Informed: Latest Updates and Insights in Healthcare
Electronic Funds Transfer
6/27/2023
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...
Service-Specific Prepay Audit Being Conducted for Physical and Occupational Therapy Services Billed by Physicians
6/27/2023
INTERNET - 9/8/2011
National Government Services, Inc. is currently conducting a service-specific prepayment review for Physical Therapy and Occupational Therapy Services being performed by specialties other ...
Non-Specific Procedure Code Description Requirement for HIPAA Version 5010 Claims
6/27/2023
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 versi...
CMS proposes coverage for obesity counseling in seniors
6/27/2023
MEDPAGE TODAY - 9/8/2011
The CMS is proposing to offer coverage for behavior modification and weight-loss counseling among older, highly obese Medicare patients. The counseling will involve a weekly primary c...
Upcoming Medical Record Audits for 2012
6/27/2023
Adequate and proper medical documentation is essential for quality medical care. We conduct audits to review practitioner documentation and ensure compliance with Centers for Medicare and Medicaid Services (CMS) and New York State Department of Health (NYSDOH) regulatory requirements and to meet Nat...
27.4% cut has been postponed by Medicare for 10 months
6/27/2023
Congress passed a bill to delay a scheduled 27% cut in Medicare payments by 10 months, and the president released his 2013 proposed budget, which requests a slight increase for health programs.
Congress Passes SGR Deal
The House of Representatives voted 293-132 late Friday morning to pass a ...
Aetna buys popular mobile app iTriage maker for ACO
6/27/2023
Aetna
Aetna buys popular mobile app iTriage maker for ACO, which provides information about medical issues and finds nearby providers or health facilities.
"We're going to begin to change the healthcare industry by giving people tools they can put in the palm of their hand,&...
Deactivation of Clinical Education E-Mail Box and Telephone Line
6/27/2023
National Government Services12/28/11
National Government Services will deactivate the telephone line and e-mail box that are currently used for Clinical Education effective July 1, 2011. Providers who direct messages to this e-mail box or phone line on or after July 1 wil...
New out-of-state national account groups effective January 1, 2012
6/27/2023
Horizon Blue Cross Blue Shield.
Beginning January 1, 2012, physicians,other health care professionals and facilities that participate in the Horizon Managed Care Network may see patients, who are New Jersey residents, enrolled in several new out-of-state national account groups....
Kaiser pays cash when members lose weight
6/27/2023
Kaiser Permanente
Kaiser Permanente of Colorado hopes a new incentive--cold, hard cash--will motivate people to lose weight. Although other insurers have offered similar programs, Kaiser is one of the first to make a weight loss program available to all adult members, the Associated...
Harvard Pilgrim pays members to use cheaper treatments
6/27/2023
Massachusetts-based Harvard Pilgrim has started paying patients $10 to $75 each time they get medical tests at a lower cost provider.
Under Harvard Pilgrim's SaveOn program, when members get referrals from their doctors, they can call the insurer's "clinical concierge" line that directs ...
Provider Enrollment Revalidation Effort
6/27/2023
National Government Services 01/04/12
Are you looking for more information on the Provider Enrollment revalidation effort? The Centers for Medicare & Medicaid Services (CMS) has recently added to their list of Frequently Asked Questions (FAQs) specific to...
MIPS Reporting Countdown: Act Now to Avoid Penalties
2/14/2023
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 ...
New York State Workers’ Compensation Board: New Registration Requirement
2/7/2023
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 l...
Medicare Deductible, Coinsurance, Premium Rates and Therapy Cap Values for Calendar Year 2018
2/7/2023
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 dedu...