Month: August 2024
Can Your Employee Handbook Get You In Trouble?
Many healthcare businesses have an employee handbook, but fail to update them on a regular basis.
There have been a large number of changes to employment law, over the past couple of years.
HHSC Extends Postpartum Coverage.
Effective March 12, 2024, women enrolled in Medicaid or CHIP who are pregnant or become pregnant will be automatically enrolled for 12 months of postpartum coverage (formerly only 2 months).
Medicaid or CHIP coverage will be automatically extended to women while pregnant and still within their 12-month postpartum period if they are still residents of Texas. Coverage will be reinstated for the remainder of the 12-month postpartum period.
New! Search Tool Helps Streamline Prior Auths
Prior authorizations are often cited as one of the top burdens for healthcare professionals. To help streamline your workflow and save time, Humana has launched a new prior authorization search tool.
Now you can search by CPT® code, procedure or drug name to determine if authorization is required. You also can find guidance on how to submit medical and pharmacy authorizations.
UHC Network News August Edition
To view these updates, click the blue button to the right.
Superior Records Retrieval Project
It is always good to know things before they occur. But often we are scrambling for information after the fact.
NOT THIS TIME
Superior gives us a Heads Up.
Superior is requesting your cooperation in providing access to specific member records to facilitate a Risk Adjustment chart review. Risk Adjustment is the payment methodology used by CMS and HHS for Wellcare By Allwell and STAR+PLUS Medicare-Medicaid Plan.
The purpose of these chart reviews is to verify that information reported to Superior, and ultimately to CMS and HHS via claims or encounter data, includes all pertinent diagnosis codes at accurate levels of specificity.
Please Note: Superior has executed a Business Associate Agreement with both Advantmed and Datavant (formerly CIOX Health).
Advantmed and Datavant have been engaged by Superior to retrieve medical records selected as part of this chart review. Any information shared during this review will be kept in the strictest of confidence, in accordance with all applicable state and federal laws regarding the confidentiality of patient records, including current HIPAA requirements. Superior appreciates your cooperation with this and will work with you to minimize disruptions in member care.
You will have the option to submit medical records in the following ways:
- Secure email
- Fax
- FedEx
- Remote Electronic Medical Record (EMR) download
AND
- Onsite scanning performed by an Advantmed medical record technician
Tell your staff to anticipate a call or fax from Advantmed or Datavant to schedule the medical record retrieval in the upcoming weeks.
For any questions, please email [email protected]
Have Questions About Capturing Telehealth Visits?
Teleheath appears to become increasingly complex on a daily basis.
The following is a list of guidelines provided by MGMA:
Click on the title to follow the link.
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