Month: December 2020
POET Holiday Hours
POET will be closed beginning December 23rd and re-open December 28th.
The Staff at POET wishes you all a very Merry Christmas and pray for good health to be with us all.
Stay safe.
Physician Directory Updated 12/17/2020
To View the Updated Directory
2021 E/M Coding, Billing, and Auditing Toolkit 12/9/20
Getting paid for some of the most routine outpatient office visits becomes a new challenge on January 1st, when guideline and code descriptor changes for E/M services — previously announced by
the American Medical Association (AMA) and the Centers for Medicare & Medicaid Services (CMS) – take effect.
Visit the Ink file called “The Business End” to access “MGMA’s 2021 E/M Coding, Billing and Auditing Toolkit”
- Outpatient Office Visit E-M Codes, Preparing for 2021 – On Demand Webinar
- 2021 Medical Decision Making for Outpatient E-M Codes
- Preparing Your Practice for 2021 E-M Changes
- Medical Decision Making for Outpatient E-M Codes
- 2021 Medicare Physician E-M Fee Schedule Analyzer Tool (Non-facility).
- MGMA-2021-Final-Rule-EM-Fee-Schedule-Analyzer-Tool
- 2021 Medicare Physician Fee Schedule (PFS) Tool (Non-Facility)
- MGMA-2021-Final-Fee-Schedule-NonFacility-V1
- 2021 Medicare Physician Fee Schedule (PFS) Tool (Facility)
- MGMA-2021-Final-Fee-Schedule-Facility-V1
- 2021 E-M Outpatient Office Visit Codes FAQ
- 2021 E-M Audit Worksheet
- 2021-EM-Audit-Worksheet
- 2021 E-M Coding Quick Reference
- 2021-EM-Quick-Reference
I Am Going to File A Complaint!!!!
Now you do! POET has scoured the Universe. We have compiled information on how to file a complaint, with just about anybody you might want to file a compliant with. The OIG, TDI, BBB, CMS, TRS, ERS, Texas School Board, State Employees, Federal Employees, CHIPS, Self Funded Employee Groups, TMHP, Tricare, the Attorney General… Check it out, downloaded it, get out your pen….
MGMA 2021 Medicare Outlook
MGMA hosted their “2021 Medicare Update” yesterday Dec. 10th. That presentation has been recorded and is available for MGMA members on their website.
For your convenience the slide deck has been place in POET InK’s files. To view follow this path.
Aetna OfficeLink Updates Published 12/1/2020
For new and updated information on:
- Changes to Aetna’s National Precertification List (NPL)
- Surgical procedures performed in the ER, modifier 54, rate change
- Beginning March 1, 2021 you may see new claim edits. These will be part of Aetna’s 3rd Party Claim and Code Review Program.
- Individual Service Codes are being assigned to Service Groups (a lot of changes are coming)
- Changes in Commercial and Medicare Drug list
- Changes in Prior Authorization Requirements
TMA’s Reimbursement Specialist Want You to Know
About These Items That Are Listed in the UnitedHealthCare December Bulletin:
- Starting January 1, UHC will follow the revised 2021 E&M coding and guideline changes for the AMA and CMS.
- January 1, for Medicare Advantage plans, UHC will expand prior authorization requirements and site-of-service medical necessity reviews.
- And, UHC has delayed implementation of its Laboratory Test Registry protocol
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