HEALTHCARE NEWS

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...

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...

 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 ...

MEDPAGE TODAY - 9/8/2011The 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 care office visit in the first month, one office visit every other week in the second to sixth...

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...

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    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,&...

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 will not receive a r...

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.
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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...

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 ...

 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...

Humana's $90 Million Settlement: Lessons for Healthcare Providers On August 16, 2024, Humana Inc., agreed to a $90 million settlement in response to a whistleblower lawsuit accusing the company of overcharging Medicare for prescription drugs. This case, brought forward by former Humana actuary ...

Digital Accessibility Matters The digital age has transformed the way we interact with healthcare. However, for millions of Americans with disabilities, accessing essential health information and services online remains a significant challenge. Recognizing this critical gap, the U.S. Department...

The American healthcare system, once a beacon of innovation, finds itself precariously perched on a financial precipice. Rising costs fueled by advancements in medical technology, an aging population with increasingly complex needs, and stagnant funding from public and private insurers create a suff...