Category: Business
TMA “Ask the Expert” Virtual Series
Today’s “Ask the Expert” subject “How to Delegate to Non-physician Practioners” will be available On-Demand in a couple weeks. The link to access the recording will be www.texmed.org/asktheexpert.
UPCOMING TOPICS
VENDOR POLL
Please help POET, help your office.
Please take a moment to respond (comment) to the below questions.
- What vendor are you using for after hour calls?
- Does that vendor triage?
TX Prescription Monitoring Program
TX Prescription Monitoring Program, No Longer a Freebie!!
When Texas started requiring that physicians check the state’s prescription monitoring program (PMP), the state appropriated funds to cover the licensing fee for the first two years. Effective Sept. 1, however, that fee is no longer covered by the state, and Appriss, the state’s PMP vendor, has begun billing physicians for the annual PMP licensing fee.
TMA is exploring options with the governor’s office, Texas State Board of Pharmacy, and Appriss to tap into the opioid settlement funds to defray the cost of the PMP. However, it does not appear that funding will be available prior to Sept. 1, TMA officials say.
The association has reached out to Appriss to understand the pricing structure on the invoice that physicians are receiving. Appriss has indicated the following options for physicians:
- Cost for the basic service – integrated access to the PMP through the physician’s electronic health record– is $50 per prescriber per year. This is access to controlled substance prescription data only.
- Cost for the optional NarxCare graphic interface and Appriss analytics is an additional $250 per prescriber per year.
- Always available at no cost is manual web access to the PMP through the Texas Board of Pharmacy via PMP Aware.
Physician groups may check with Appriss to see if they are eligible for reduced pricing per prescriber.
At TMA’s urging, Appriss is working on additional communications to physicians that more clearly explain the options and associated fees.
If you choose not to renew with Appriss, access to the PMP will no longer be accessible through your EHR within your workflow. It will still be available for free when you log in to the state’s system, PMP Aware, to check a patient’s prescribing history as required by law before prescribing opioids, benzodiazepines, barbiturates, and carisoprodol.
Questions about prescribing and the PMP program may be directed to TMA’s Health Information Technology Department by calling (800) 880-5720 or by email. Also check out TMA’s PMP resource page.
Get the Latest Cigna Updates.
Nonphysician Practitioners and Scope of Practice
TMA Ask the Expert Virtual Event
August 17th at 1 PM
How to Delegate to Nonphysician Practitioners.
Nonphysician Practitioners and Scope of Practice, a TMA Ask the Expert virtual event, will teach participants how to comply with state laws and regulations on delegating and supervising prescriptive authority. Join Carra Benson, TMA manager of practice management and reimbursement services; Dan Finch, TMA vice president of advocacy; and Julian Rivera, health law partner at Husch Blackwell, on Aug. 17 at noon CT.
UHC Network Bulletin Overview 8/2021
Your NOTICE of protocol
and policy changes
from UnitedHealthcare
Medical policy updates: August 2021
This month, you’ll find updates for Medicaid, Medicare, Exchange and commercial plans.
Prior authorization and notification requirement updates
We’re making changes to certain advance notification and prior authorization requirements that are available for you in the 2021 Summary of Changes.
Reimbursement policy updates: August 2021
This month, you’ll find updates for Medicaid and commercial plans.
Specialty Medical Injectable Drug program updates: August 2021
See the latest updates to requirements for Specialty Medical Injectible Drugs for UnitedHealthcare members.
Prior authorization code updates for commercial plans
Effective Nov. 1, 2021, we are adding new codes to the prior authorization list for UnitedHealthcare commercial plans including All Savers, River Valley, Neighborhood Health Partnership, UnitedHealthcare West, MidAtlantic Health Plans
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.
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?
Recent Comments