Have You Updated Your Physician Profile? Click to Enlarge Have you been remiss about updating your Physician Profile in your Health Commerce System Account? Once you’ve created your Physician Profile, it needs to be updated every two years and must be completed within the six months prior to your
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NYRx Medicaid Pharmacy Prior Authorization Programs Update Click to Enlarge On October 25, 2024, the New York State Medicaid Drug Utilization Review Board (DURB) recommended changes to NYRx, the Medicaid pharmacy prior authorization (PA) program. The Commissioner of Health has reviewed the recommendations of the Board and has
NGS Addresses Claim Denials Related to HCPCS Code G2211 Click to Enlarge National Government Services (NGS) has reported an issue impacting Part B providers in Jurisdictions JK and J6 regarding claim denials for the HCPCS G2211 add-on code. The problem stems from a coding update on December 5,
CPT Codes for Prior Authorization: Reporting Prior Authorization–Related Activities Within E/M Services (99203, 99204, 99205, 99213, 99214, 99215, 99358, 99452, 99080) Click to Enlarge Prior authorization (PA) is an administrative process that requires physicians or other qualified health care professionals (QHPs) to obtain approval from
