NOW YOU KNOW

Every business, especially a medical practice, needs to run like a well-oiled machine

Just as oil prevents an engine from drying out and freezing up, your medical practice must have a well-developed denial management program in place. This is the first proactive step.  

Security Training Tips for Frontline Employees

The shift towards digital solutions has had a profound impact and benefit. However, it has also introduced new challenges, particularly concerning security, which is why your frontline employees need to be properly trained to ensure your business and customers are protected.

As frontline sectors continue to embrace technology, the dependency on digital tools and platforms grows. Employees now rely on various devices and software to perform their duties, from processing transactions and managing customer interactions to accessing sensitive information. Point-of-sale systems, digital customer service platforms, electronic health records, and mobile apps are now standard tools in these environments. 

The Importance of Security Training for Frontline Workers

Frontline workers extend beyond emergency responders. It’s an encompassing term to describe individuals who are the first point-of-contact between a company and its customers. They can handle sensitive information, greet patrons as they enter facilities, or provide direct support when needed

Why is front line training so vital?

  1. Direct Customer Interaction
  2. Protecting Sensitive Information
  3. Identifying Threats
  4. Compliance with Regulations
  5. Building Customer Trust

For Additional Helps and Tips Visit:  Vector Security’s Security Blog.

Vector Security Blog

CMS Increased Payment for Influenza Vaccines

On August 1, the Centers of Medicare and Medicaid Services (CMS) increased payments to physicians for influenza vaccines and updated which codes physicians should use when billing for the service during the 2024-25 flu season.

Texas Medical Association billing and coding staff caution that to receive payment, physicians also will need to use a national drug code (NDC) associated with the current period.

Follow this link for proper CPT codes and more vaccine information.

Revisions to Medicare Part B Coverage of Pneumococcal Vaccinations Policy

Co-pays Resuming for Certain Services

Effective 10/1/24: Co-pays will Resume for CHIP CoVid19 Services.

During the COVID-19 public health emergency, the Texas Health and Human Services Commission (HHSC) waived co-pays for COVID-19 vaccines, testing, and treatment for Children’s Health Insurance Program (CHIP) members. This waiver will end on September 30, 2024

Providers may begin collecting co-pays for COVID-19 vaccines, testing, and treatment rendered to CHIP eligible members for dates of service on or after October 1, 2024.

Superior Co-pays

Providers may not charge co-pays for mental health and substance use disorder outpatient office visits

Co-pays have been permanently removed for mental health and substance use disorder outpatient office visits to comply with federal regulations.

Information for Medicaid Providers

Upcoming Changes to STAR+PLUS

Effective September 1, HHSC is transitioning contracts for the STAR+PLUS program. Below are a few resources that may help.

If you need help with….

Try…

Managed Organization Complaints. 

Knowing how this transition will impact my billing.

Please reach out to the MCO to understand their billing process. 

Helping your clients through the transition.

See the HHSC Star+Plus webpage for transition resources. 

For any STAR+PLUS transition related issues, please contact the STAR+PLUS Go Live Inbox.

And as always, contact POET if you have any concerns.

BCBSTX to Require E/M Codes for Consultation Services

Starting Nov. 18, Blue Cross and Blue Shield of Texas (BCBSTX) will no longer pay physicians for outpatient or inpatient consultations when they report those services with Current Procedural Terminology (CPT) codes 99242 – 99245 and 99252 – 99255. 

Instead, the payer says physicians will need to report consultation services with an appropriate office outpatient or inpatient evaluation and management (E/M) code representing where the visit occurred and its level of complexity.  

According to the health plan, consultation claims reported with CPT codes after Nov. 18 will be denied. 

Updated 12/10/2024, to add BCBS website information

Evaluation and Management Coding – Professional Provider Services

Policy Number: CPCP024

Version 1.0

Enterprise Clinical Payment and Coding Policy Committee Approval Date:

August 7, 2024

Plan Effective Date: November 18, 2024

(Blue Cross and Blue Shield of Texas Only

Consultation(s) CPT Codes 99242-99245 ,99252-99255 Effective 11/18/2024, the plan will no longer reimburse for office/outpatient consultation codes (CPT codes 99242–99245) and inpatient consultation codes (CPT codes 99252–99255). Consultation services should be reported with an appropriate office/outpatient or inpatient E/M code representing the location where the visit occurred and the level of complexity of the visit performed, such as code ranges 99221-99223, 99304-99306, and 99202-99215.