Category: Medicare
Who ya’ gonna call?
HAVING ISSUES WITH MEDICARE CALLS?
Who do you call? A source from MGMA shared this information.
They suggest you file a complaint and email CMS leadership. Because complaints go to “low-level” administrative staff whose entire goal is to close them.
Create a complaint letter detailing your experience. Email it to CMS Administrator Chiquita Brooks-LaSure Administrator and CC to the relevant CMS leadership as follows:
CMS Administrator: Chiquita Brooks-LaSure [email protected]
Deputy Chief Operating Officer: Karen Jackson [email protected]
Director Office of Program Operations & Local Engagement: Nancy O’Connor [email protected]
Deputy Administrator and Director Center for Medicare: Meena Seshamani, M.D., PhD [email protected]
Deputy Administrator & Director Center for Medicare & Medicaid Innovation: Elizabeth Fowler [email protected]
Deputy Administrator and Director Center for Consumer Information & Insurance Oversight: Dr. Ellen Montz [email protected]
Deputy Director: Cheri Rice [email protected]
Seasonal Influenza Vaccines Pricing
The Medicare Part B payment allowance limits for seasonal influenza (flu) vaccines are 95% of the Average Wholesale Price (AWP), as reflected in the published compendia.
In hospital outpatient departments, payment is based on reasonable cost.
Annual Part B deductible and coinsurance amounts don’t apply for the influenza virus vaccinations. All physicians, non-physician practitioners, and suppliers who administer these vaccinations must take assignment on the claim for the vaccine.
Annual Influenza Vaccine season starts on August 1 and ends on July 31 of the following year.
Payment Allowances and Effective Dates by Flu Season
Humana Physician News
A Wealth of Information Just Waiting for You.
- Humana’s Neighborhood Centers offer patients one on one health education.
- Value-based care reduces acute care.
- Earn CME by attending the CMS Statin Webinar.
- Complete your annual 2022 Compliance Training.
- Many Resources and Support.
Cigna Network News 3rd Qtr 2022
Some Highlights:
- Covid Updates
- Virtual Care Services POS 02
- Policy Updates: Preventive Care, Precertification, Reimbursement and more
- Tips for online reconsiderations and appeals
- Advantage Plan Highlights
- And much more.
Heat Relief, Cooling Centers
Do you have Cigna MA Patients, that need relief from this Summer Heat?
Cigna MA is offering it’s customers transportation to “Cooling Centers” or other public locations that provide Air Conditioning (i.e. Library or Senior Center)
Just a Reminder-Cigna MA Plans
The below list is for Provider use only. Not to be distributed to Patients.
HMO Customer Benefit Plans for Our Service Area
PPO Customer Benefit Plans for Our Service Area
Cigna Preferred Medicare HMO, H4513-061
Cigna True Choice Medicare PPO, H7849-038
Cigna Preferred Savings Medicare HMO, H4513-066
Cigna True Choice Plus Medicare PPO, H7849-062
Cigna Fundamental Medicare HMO, H4513-009
Cigna TotalCare HMO D-SNP, H4513-060
Cigna Medicare HSConnect Portal
Cigna MA has reported two known issues with HSConnect.
- Referrals are pending unnecessarily.
- The procedure start and end date are defaulting to the same day.
An expected date for resolution has not been provided.
But there is good news (tongue in cheek) the PHE has been extended. Therefore, referrals are still waived. Those items requiring precertification will continue to need an authorization.
Sick of Chart Review Request?
If you are frequently being ask by Cigna MA for chart reviews, click the button below to find out how to reduce the number of requests you receive.
Close those Gaps
CLOSE THOSE GAPS
Please fax documentation for closing Cigna MA 360 gaps
Attention: Leslie (866) 214-5122
Or
Email to [email protected]
2% Medicare Sequester
Back to the ax!
July 1, 2022, CMS will begin sequestering the full 2% off your Medicare payment.
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