Physician Payment And Practice

Extension for Open Negotiations Impacted by Change Healthcare Cybersecurity Incident

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

By admin|2024-06-20T21:39:10+00:00June 20th, 2024|Pulse|0 Comments

CMS Preparing to Close Program that Addressed Medicare Funding Issues Resulting from Change Healthcare Cyber-Attack

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

By admin|2024-06-20T21:33:30+00:00June 20th, 2024|Pulse|0 Comments

New Process for Batched IDR

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

By admin|2024-06-13T20:27:56+00:00June 13th, 2024|Pulse|0 Comments

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 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

By admin|2024-06-06T21:08:02+00:00June 6th, 2024|Pulse|0 Comments

Digital RFAI Availity Training Now Available

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

By admin|2024-05-31T18:09:38+00:00May 31st, 2024|Pulse|0 Comments

Anthem Provider News

Anthem Provider News Stay current on Anthem policies and processes, updates to clinical guidelines, and other issues affecting your practice and patients. Subscribe Now!

By admin|2024-05-09T21:32:28+00:00May 9th, 2024|Pulse|0 Comments

New Independent Dispute Resolution Resubmission Process

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

By admin|2024-04-18T19:46:46+00:00April 18th, 2024|Pulse|0 Comments

MSSNY in Action: Expanding Nebulizer Treatment Coverage for NYS Medicaid Patients

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

By admin|2024-04-04T20:28:18+00:00April 4th, 2024|Pulse|0 Comments

New CMS 588 Electronic Funds Transfer (EFT) Authorization Agreement

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

By admin|2024-03-28T17:08:42+00:00March 28th, 2024|Pulse|0 Comments

COVID-19 Vaccines Billing Guide

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

By admin|2024-03-28T17:02:15+00:00March 28th, 2024|Pulse|0 Comments

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