Month: July 2021
IF YOUR TREK TO COLLECT
is coming up with more dead-ends and reworks than you have ever had in your life!!!
There is a ray of hope!
Do you remember the old Texas Medical Association (TMA), Hassle Log?
It has a new name.
“Reimbursement Review and Resolution (RRR) services” (because hassle log was too hard, lol).
If you are a TMA member, this is a great resource.
Attached is the paperwork you will need to submit your issue. Just follow the links.
POET has recently reached out to TMA using this resource and so far it has been pretty simple.
Incident-To Billing Got You Confused?
Texas Medical Association (TMA) can help!
“Incident-to” billing – when services delivered by a nonphysician practitioner are billed under a supervising physician’s credentials – can be confusing, and Texas Medical Association staff are routinely fielding questions about those unique arrangements.
To help you avoid any billing blunders, TMA has released an education sheet on incident-to billing (login required), with a basic overview of guidelines and requirements.
The two-page guide addresses incident-to billing for Medicare, Medicaid, and commercial plans, along with helpful links to resources that can help answer your questions and resolve billing snags.
Download the incident-to education sheet – along with other resources on billing, collection, claims, and more – on TMA’s Educational Quick Tips page.
HealthSpring Insurance Card
You may have noticed the Cigna MA (HMO) insurance card no longer sports the “HealthSpring” name.
Here is a tip.
There are only three customer benefit plans (HMO) for our service area.
- 2021-TX-H4513-061-Preferred (HMO) – Medicare A, B, & D coverage
- 2021-TX-H4513-060-TotalCare (HMO DSNP) – Medicare/Medicaid A, B, & D coverage
- 2021-TX-H4513-009-Fundamental (HMO) – Medicare A & B coverage only (no part D); formerly known as the Advantage plan
Where you see “contract/PBP” with the orange circle around it, the card for our service area should have either H4513-061, H4513-060 or H4513-009. Any other number would suggest the patient is out of their service are.
Automate Your Revenue Cycle and Avoiding EFT Fees
ARE YOU PAYING TO GET PAID?
OR
Would you like to lodge a complaint against a health plan?
Frontline Resource for helping low-income, Uninsured Texas Women
From Women’s Health
Reference Sheet Outlines Public Coverage Options for Uninsured Women |
The Texas Collaborative for Healthy Mothers and Babies has developed a reference sheet for frontline health care workers to help low-income, uninsured women in Texas potentially find coverage through one of the state’s public health insurance programs. |
OSHA ETS
Original Message:
Sent: 06-14-2021 14:56
From: Drew Voytal
Subject: OSHA announces new COVID-19 temporary emergency standard for healthcare settings
Good afternoon MGMA members,
Last week, the Occupational Safety and Health Administration (OSHA) issued a COVID-19 emergency temporary standard (ETS) with implications for health care employers. The landing page for the ETS can be found here and the fact sheet can be found here. Once the rule is published in the Federal Register, the compliance deadline for most provisions is within 14 days and within 30 days for the rest.
Some of the requirements in the ETS include:
- developing a “COVID-19 plan” that includes a workplace-specific hazard assessment
- cleaning and disinfection guidelines
- health screening and medical management protocols, and
- physical distance and physical barrier guidelines.
For the full list of requirements under the ETS, see the rule. Certain requirements are waived if workers are vaccinated and are in well-defined areas where there is no reasonable expectation that a person with suspected or confirmed COVID-19 will be present. For more information, see the FAQ.
Thanks,
Emergency Temporary Standards
FINALLY! a flow chart that helps make since of some of this.
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