Aetna Update August 2022
Effective 11/1/2022
Computer-assisted surgical and musculoskeletal navigation coding update.
Aetna® will no longer consider the following codes for separate reimbursement:
• 20985 (Computer-assisted surgical navigational procedure for musculoskeletal procedures, image-less (List separately in addition to code for primary procedure))
• 0054T (Computer-assisted musculoskeletal surgical navigational orthopedic procedure, with image-guidance based on fluoroscopic images (List separately in addition to code for primary procedure)). The use of computer-assisted surgical navigation is considered
integral to the performance of the procedure.
POET ALERT
PLEASE PAY CLOSE ATTENTION
Another Lufkin Office has been Hit!
Scammers are using your office caller ID. Calling your patients asking for checking account numbers and other secure information.
Please take an active part and warn your patients.
Feds Clarify HIPAA Enforcement When PHE Ends
New federal guidance clarifies that relaxed HIPAA enforcement will end at the conclusion of the COVID-19 public health emergency (PHE), while offering instruction on how physicians and others covered by HIPAA can continue to use remote communication technologies to provide audio-only telehealth services.
Back at the start of the pandemic, the U.S. Department of Health and Human Services (HHS) Office for Civil Rights (OCR) said it would not “impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency.”
In the new guidance, OCR reiterated that this discretion remains in effect only until the HHS secretary determines the PHE no longer exists or when it expires, whichever occurs first. Congress previously granted a five-month extension for other COVID-related waivers following the conclusion of the PHE..
OCR issued the guidance in direct response to a December 2021 presidential executive order intended to help ensure patients can continue to benefit from audio-only telemedicine and telehealth services with protection of their personal health information.
The new guidance elaborates on types of technologies, business associate agreements with vendors, and ensuring HIPAA compliance when using audio-only technologies.
The Texas Medical Association has numerous resources designed to help physicians adopt and effectively use telemedicine. Visit TMA’s telemedicine page for more information.
Click on the blue highlighted text within the article for more information.
OR
Head to the Business End File and view articles on Telemedicine, and Telemedicine Policy, Procedure, and Form Templates
Angelina County New Card
We apologize these are not the best pictures, but we wanted to get this out to you, asap.
Some of you have already seen this new card from Angelina County. POET’s contract is with Angelina County not GPA or Imagine 360. POET has reached out to both Angelina County and Imagine 360. Imagine 360 told POET the benefits have not changed. We have asked if your representative will remain the same and are waiting for that response. As information comes in, we will keep you informed. Please let POET know if you are not paid according to contract
POET ALERT!
RED
ALERT
Callers Posing as Physician’s Office
Scammers can now use technology to make your office caller ID show when they make a phone call. This is called “Caller ID Spoofing”. They can also “clone” your phone number to steal your information.
One local physician’s office reports it is happening to their patients.
The caller is asking patients to verify their date of birth, Social Security and Medicare number along with other information.
Protect your patients! Let them know to be on alert.
Remember Social Security numbers are no longer part of claim information.
If you have this information in your patient’s file you should redact it for your protection.
Remind your patients that you would not call them for this information, and they should never give their social security information out over the phone.
Medicare nor the Social Security Department call for information.
Tell your patients to hang up as soon as possible, call you and report the call to the Federal Trade Commission.
Report telephone scams online to the Federal Trade Commission. You can also call 1-877-382-4357 (TTY: 1-866-653-4261). The FTC is the primary government agency that collects scam complaints. Report all robocalls and unwanted telemarketing calls to the Do Not Call Registry.
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)
What is the Value of Benefits for Staff
Do you know the actual value of benefits offered to your staff?
Maybe you should.
Maybe your staff should.
If you have been looking for a way to calculate the value of benefits offered for your staff, here is an option found on the MGMA Community.
Just click the download button to view the spreadsheet.
The “how to” instructions are below.
It’s basic, but the employees seem to really like it.
1. Use the + to add a tab for each employee.
2. Rename each tab to your employee’s names.
3. Copy and paste the content from the ‘Employee A’ tab to the rest of your employee tabs.
4. Update the DATA INPUT tab with the amount your clinic pays for each employee on a monthly bases (this info will pull into the employee’s individual tabs).
5. In each employee tab, input the amount you pay monthly for Life Insurance (if you provide that benefit) in column B.
6. In each employee tab, modify as needed, the number of days you give for PTO, Holiday & the Retirement % (you’ll need to update both the description and also the formulas in column C).
7. Add or remove benefits as it applies to your clinic and employee.
I hope you find this to be helpful!
Connie McVein, Chief Executive Officer
Oregon Neurology, Springfield OR
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
It Has to End Sometime. Doesn’t It?
What Will the End of the PHE Mean for Coverage?
The PHE has been extended 8 times since January 31st. We all have I fingers crossed that this is the last time. But there is a lot of uneasiness regarding the “WHAT IFs” of when it does.
To get some great insight check out this article from TMA.ED
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