Billing & Coding Updates

MARCH 2020 UPDATE:

Revenue Cycle Housekeeping Checks for the Beginning of the Year:

  • Provider Directory information should be reviewed for each of your contracted payers.     Review locations, providers-including credentials, specialties, addresses, phone numbers, clinic hours, services, and status of accepting new patients.
  • Verify insurance coverage.  Plans often change at the first of the year.
  • Verify eligibility and benefit coverage  for patients.
  • Know which procedures will require prior authorization.   The mandated list seems to grow daily.
  • Ensure you have a strong policy to collect co-pays and deductibles prior to, or at the time of service.   Make sure you staff knows their role in this process.

 

DECEMBER 2019 UPDATE:

CMS UPDATE:   Reminder – New Medicare Card Transition ends effective 1/1/2020.    Read more

SEPTEMBER 2019 UPDATES:

CODING UPDATES:

PAYER UPDATES:  

Blue Cross Blue Shield:

  • BCBS has implemented a new appeals policy for no prior authorization effective June 3, 2019. See the policy at …

Cigna:

  • Cigna will no longer reimburse CPT consultation codes:  99241-99245 and 99251-99255.  This is effective for claims processed on or after October 19, 2019.
  • Cigna asks that providers review and update directory information.  This can be done online at …https://cignaforhcp.cigna.com/web/public/guest

HealthPartners:

  • HealthPartners now requires to be notified within 10 days after a practitioner leaves a practice.    Update directory information at:  http://healthpartners.com/provider/login.
  • Effective January 1, 2020 HealthPartners will add a new hearing aid benefit to Medicare Advantage and Cost plans.  The vendor for this benefit will  TruHearing.

Medica:

  • Medica is updating medical policies and guidelines effective November 18, 2019. These can be found at:   https://www.medica.com/
  • Medica ask that providers review and update directory information through their  secure provider demographic-update online tool (PDOT) found at http://www.medica.com

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