2025 Medicare Physician Fee Schedule Proposed Rule Click to Enlarge The Centers for Medicare & Medicaid Services (CMS) has released the proposed rule for the Calendar Year 2025 Medicare Physician Fee Schedule. Key highlights include: Payment Adjustments: Proposed changes in payment rates for various medical services.
AMA Summary of 2025 Medicare Physician Payment Schedule Click to Enlarge The American Medical Association (AMA) released its summary of the 2025 Medicare Physician Payment Schedule proposed rule, along with the AMA’s analyses of CMS’ impact assumptions for proposed G-codes, the advanced primary care management services,
NYRx Information for Interns and Residents Click to Enlarge NYRx, the Medicaid Pharmacy Program and the NYRx Education and Outreach team has worked to compile information in the linked document, NYRx, the Medicaid Pharmacy Program Information for Medical Residents, to share with medical interns and residents to help
Extension for Open Negotiations Impacted by Change Healthcare Cybersecurity Incident The Departments of Health and Human Services, Labor, and the Treasury (collectively, the Departments) announced a 120-calendar-day exception period for disputing parties impacted by the recent Change Healthcare cybersecurity incident to initiate open negotiation for impacted items or services, beginning 6/14/2024 and ending 10/12/2024. Following
CMS Preparing to Close Program that Addressed Medicare Funding Issues Resulting from Change Healthcare Cyber-Attack The Centers for Medicare & Medicaid Services (CMS) announced that payments under the Accelerated and Advance Payment (AAP) Program for the Change Healthcare/Optum Payment Disruption (CHOPD) will conclude on July 12, 2024. Launched in early March, the CHOPD payments were
New Process for Batched IDR On May 1, 2024, a new process was released for resubmitting Independent Dispute Resolution (IDR) disputes that were originally improperly batched or bundled. This new resubmission process will streamline Federal IDR operations and enhance the user experience. Resubmission requests received on or before April 30, 2024 If a certified IDR entity
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
