Are You Getting Insurance Claims Denials for Care You Provided While on Call for a Local ER? Are you getting insurance claims denials for care you provided while on call for a local hospital ER because you don’t have a Medicaid number? MSSNY has heard from some physicians about this practice but we need additional
Digital RFAI Availity Training Now Available Anthem has partnered with Availity to offer self-paced training for administrators on updating Medical Attachment registration and enhancing claims processing speed through Digital RFAI. Care providers can now receive faster notifications for additional document requests via Availity Essentials. Administrators can access on-demand training, while associates have an enhanced session using the Attachments
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New Independent Dispute Resolution Resubmission Process The Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) are announcing a new process by which the Federal IDR portal will send disputing parties a unique web form to resubmit disputes that were originally improperly submitted instead of receiving a request from your certified
MSSNY in Action: Expanding Nebulizer Treatment Coverage for NYS Medicaid Patients MSSNY was recently made aware by Lisa Chinnici from Panoram Pediatric office that NYS Medicaid would only cover one in-office nebulizer treatment per month. If multiple CPT codes were billed within a month, the patient would be denied coverage, resulting in a loss of
New CMS 588 Electronic Funds Transfer (EFT) Authorization Agreement There is a new version of the CMS 588 Electronic Funds Transfer (EFT) Authorization Agreement (11/23). Effective 4/30/24, the Medicare Administrative Contractors (MAC) may only accept the CMS 588 EFT (11/23) version. If a provider submits the outdated form, it will be returned. Please note: If
COVID-19 Vaccines Billing Guide We are monitoring COVID-19 vaccine updates from state and federal governments. Effective September 11, 2023, for New York State Medicaid Fee-for-Service (FFS) and for Medicaid Managed Care (MMC) Plans, reimbursement is available to enrolled and qualified providers for COVID-19 vaccines and their administration as approved by the FDA or authorized for
Important Cybersecurity Update: Change Healthcare Incident Briefing Resources The following resources are from a recent HHS briefing on the Change Healthcare cyberattack, emphasizing the necessity for vigilant cybersecurity in healthcare. The comprehensive material, including UnitedHealth Group's slides and a webinar recording, is available on the HHS YouTube page. We urge you to review and share these insights with
Let’s Chat Open Forum: Change Healthcare/Optum Payment Disruption Accelerated/Advance Payment Program Part A and Part B Providers experiencing cash flow problems related to Change Healthcare/Optum Payment Disruption (CHOPD), which began on 2/21/2024, may be eligible for Accelerated/Advance Payments (AAP). Accelerated and Advance Payments are intended to provide necessary funds to Part A and B providers,
Register Today! The NY State Pain Society and the NY Workers Compensation Forum invite you to the Annual Meeting on Friday, April 6, 2024. You can earn up to 7 CME/ CEU in one day! 8:00 AM - 6:00 PM LIVE at the SUNY Global Center in NYC or Simulcast Online. Hurry - LIVE Seating
