News & Information

Integrated healthcare is a part of Health Care Reform, it is a coordinated approach between Primary Care Providers and Behavioral health providers. This program is to detect, treat and ensure follow up for mental and physical conditions.

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We all know how time consuming and costly COB (Coordination of Benefits) can be to a practice.   February 2014, CAQH launched a new plan called COB Smart Registry. This will help expand the communication between health care plans and providers. Joining with some Major Health Plans CAQH has come up with a solution to Improve Healthcare Claims Processes.

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You need to have a prescription on file and note the correct modifiers on your claim form stating all conditions have been met (for Medicare). I have had better results attaching the prescription to the claim, however it is not required.

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Effective April 1, 2014, the SI for HCPCS code Q2052 (Services, supplies, and accessories used in the home under the Medicare intravenous immune globulin (IVIG) demonstration) will change:

1)  From SI=N (Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC payment.)

2) To SI=E (Not paid by Medicare when submitted on outpatient claims (any outpatient bill type)).

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Are you ready for testing?  CMS released  providers, suppliers, billing companies, and clearinghouses are welcome to submit acknowledgement test claims anytime up to the October 1, 2015, implementation date. In addition, CMS will be highlighting this testing y offering three separate weeks of ICD-10 acknowledgement testing. These special acknowledgement testing weeks give submitters access to real-time help desk support and allows CMS to analyze testing data. Registration is not required for these virtual events.

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