Month: April 2022
BCBS Drug Fee Schedule
HOW TO SEARCH THE CURRENT BCBS DRUG FEE SCHEDULE (UPDATED QUARTERLY)
Updated 5/2/2022. You can use CTRL F to bring up a search box. Then just enter the code you are looking for.
Paying to Get paid!
The Centers for Medicare & Medicaid Services (CMS) released new guidance that seeks to clarify requirements
for electronic funds transfers (EFT).
Although this guidance does not address all of MGMA’s questions and concerns (see MGMA’s letter to CMS), we are encouraged that CMS heeded our call to issue additional guidance and that CMS acknowledged in this guidance that a health plan may not adversely affect or attempt to adversely affect a provider, should a provider desire to receive EFT using a standard transaction
MGMA has voiced concerns to CMS that the business associates that health plans use to render payments to practices levy fees on the transaction. We are adamant that these ‘pay to get paid’ schemes are unacceptable and that CMS should prohibit these abuses. Although the guidance does not explicitly address these fees, it does clearly state that health plans cannot require providers to receive payment from its business associates. In essence, as we understand it, the fact that a plan cannot require a practice to agree to receive payment from its business associates should allow practices to forgo interacting with these vendors and thus avoid the fees.
MGMA is seeking further clarity on this guidance and stands firm on our belief that health plans and their business associates should be forbidden from levying these fees on medical groups.
HHS Drops Reporting Requirement for Certain Negative CoVID Tests.
Beginning Monday, April 4, facilities testing for COVID-19 will no longer have to report negative results for tests authorized for use under a Clinical Laboratory Improvement Amendments waiver.
A Better Communication Strategy Part 2
Small changes to practice workflows have been shown to affect overall organizational efficiency. The goal of a recent study was to support the Quadruple Aim of reducing costs while improving population health, patient satisfaction and the well-being of medical practice staff. By reducing administrative burdens, an intervention group could offer 48% more patient appointment slots than the control group.
Patient interactions must remain the focus of any practice contemplating workflow changes. At many practices, it’s already impossible to speak with a live person after negotiating a phone tree or sending an email through the patient portal. It’s imperative that any communications platform place patients front and center, with easy, secure and HIPAA-compliant interactions that don’t require the patient to download another mobile app.
Patient reminder calls waste staff time to make them and patient time to listen to them, return the call and/or ignore them. Instead, consider a personalized text message from the provider’s main phone line confirming the appointment. Studies show that 99% of text messages are opened — 97% within 15 minutes. The patient can quickly confirm the appointment or access the provider’s schedule to pick another time.
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