Month: May 2024
Avoid Medicaid Disenrollment
Physicians Must Validate Email to Avoid Medicaid Disenrollment, Payment Delays
By Emma Freer
Texas Physicians who care for Medicaid patients should confirm their email address is valid in the Texas Medicaid and Healthcare Partnership’s (TMHP’s) Provider Enrollment Management System (PEMS) to ensure effective communication and timely payments from the state Medicaid administrator.
Without a valid email address on file in PEMS, clinicians will not receive online correspondence from TMHP, including reminders regarding their upcoming revalidation due dates, or be able to start a revalidation request, among other consequences.
Clinicians who fail to complete their respective revalidations by their given due dates will be disenrolled from Medicaid.
For step-by-step instructions on how to add and verify your email address in PEMS, check out TMHP’s handout.
TMHP also encourages clinicians to add the “TMHP.com” domain to their safe senders list in their email system and to avoid unsubscribing from TMHP emails.
For more information, reach out to TMHP via email or by calling (800) 925-9126.
Physician Directory and Provider Roster Update
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Congratulations are in Order
POET and all it’s staff are very proud of our Credentialing Coordinator, Kelly Scroggins.
Kelly’s hard work, study, and perseverance has helped her achieve an outstanding goal in her skills and knowledge as a medical service professional. Kelly now holds certification from The National Association Medical Staff Services (NAMSS) as a Certified Provider Credentialing Specialist (CPCS).
There are only a little over 500 Certified Provider Credentialing Specialist in the state of Texas.
Virtual Vigilance
“The Change outage was disruptive to the business of my practice, but most importantly it was disruptive to my patients,” Dr. Bruggeman testified. “Every minute my staff spent trying to reconcile [electronic remittance advice] with received payments, assessing which patients received incorrect bills, [and] resubmitting prior authorizations is time taken away from patient care.”
Robust Cybersecurity Can Safeguard Practices
By Alisa Pierce Texas Medicine June 2024
Data held hostage
. . . cautions that ransomware attacks can be delivered via multiple platforms, such as in email attachments or links within an email. Malicious attachments can include documents, zip files, and executable applications, and suspicious email links can bring users directly to websites that are used to place malware on a system.
Similarly, “phishing” email scams can give hackers access to internal business systems that could reveal confidential information like credit card numbers, personal identity data, and passwords. Often these emails appear to come from real companies or trusted individuals.
From there, hackers steal electronic patient data, even encrypted information; block the practice from accessing it; and demand a ransom for its return, much like “a hostage situation,” according to Shannon Vogel, TMA’s associate vice president of health information technology.
If that data aren’t backed up, practices don’t have much leeway. At that point, they can either hope the data can be retrieved by law enforcement or move forward without patient records.
“It’s vital that practices talk to their [electronic health record] and other vendors about redundant systems so that all is not lost,” Ms. Vogel said. “Otherwise, it would be like starting from scratch.”
Cigna and Zelis
If you have accidently signed up to receive virtual credit card (VCC) payments, and would like to change back to Automated Clearinghouse (ACH), please call Zelis.
Zelis Customer Service:(877) 828-8770
If you have questions regarding claim payments, please contact Cigna Healthcare Provider Service Line (800) 882-4462.
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