BCBS Drug Fee Schedule
HOW TO SEARCH THE CURRENT BCBS DRUG FEE SCHEDULE (UPDATED QUARTERLY)
Updated 5/2/2022. You can use CTRL F to bring up a search box. Then just enter the code you are looking for.
Paying to Get paid!
The Centers for Medicare & Medicaid Services (CMS) released new guidance that seeks to clarify requirements
for electronic funds transfers (EFT).
Although this guidance does not address all of MGMA’s questions and concerns (see MGMA’s letter to CMS), we are encouraged that CMS heeded our call to issue additional guidance and that CMS acknowledged in this guidance that a health plan may not adversely affect or attempt to adversely affect a provider, should a provider desire to receive EFT using a standard transaction
MGMA has voiced concerns to CMS that the business associates that health plans use to render payments to practices levy fees on the transaction. We are adamant that these ‘pay to get paid’ schemes are unacceptable and that CMS should prohibit these abuses. Although the guidance does not explicitly address these fees, it does clearly state that health plans cannot require providers to receive payment from its business associates. In essence, as we understand it, the fact that a plan cannot require a practice to agree to receive payment from its business associates should allow practices to forgo interacting with these vendors and thus avoid the fees.
MGMA is seeking further clarity on this guidance and stands firm on our belief that health plans and their business associates should be forbidden from levying these fees on medical groups.
HHS Drops Reporting Requirement for Certain Negative CoVID Tests.
Beginning Monday, April 4, facilities testing for COVID-19 will no longer have to report negative results for tests authorized for use under a Clinical Laboratory Improvement Amendments waiver.
A Better Communication Strategy Part 2
Small changes to practice workflows have been shown to affect overall organizational efficiency. The goal of a recent study was to support the Quadruple Aim of reducing costs while improving population health, patient satisfaction and the well-being of medical practice staff. By reducing administrative burdens, an intervention group could offer 48% more patient appointment slots than the control group.
Patient interactions must remain the focus of any practice contemplating workflow changes. At many practices, it’s already impossible to speak with a live person after negotiating a phone tree or sending an email through the patient portal. It’s imperative that any communications platform place patients front and center, with easy, secure and HIPAA-compliant interactions that don’t require the patient to download another mobile app.
Patient reminder calls waste staff time to make them and patient time to listen to them, return the call and/or ignore them. Instead, consider a personalized text message from the provider’s main phone line confirming the appointment. Studies show that 99% of text messages are opened — 97% within 15 minutes. The patient can quickly confirm the appointment or access the provider’s schedule to pick another time.
TWO New Measures for Part C Stars
The Part C Stars Specification Overview has been updated for 2022 Dates of Service.
It includes two new measures –
- Follow-Up After Emergency Dept Visit for People with Multiple High-Risk Chronic Conditions (FMC)
- and Transition of Care (TRC).
A Better Communication Strategy Part 1
A Little Dramatic, huh?
But how would you like to increase your practice efficiency through a better communication strategy?
Tune in each Tuesday for another little blurp.
Part 1. Patient satisfaction, loyalty can affect profits
The importance of effective communications between patients and provider cannot be overstated, as 91% of patients who were unhappy with their care experience reported they wouldn’t return to the practice or recommend it to others. Retaining happy patients is more cost effective than recruiting and onboarding new patients.
In a recent survey of health executives, 83% said improving patient access using digital tools is a top strategic priority, and 43% rated improving patient satisfaction as a strategic aim.
Happy patients start with competent staff who have the right tools to communicate effectively. However, when physicians were asked to name their top challenges for 2022, they overwhelmingly chose “administrative burdens,” which include staffing issues, prior authorizations and ever-present issues with EHRs.
Healthcare routinely ranks among the top industries for job departures, according to the U.S. Bureau of Labor Statistics. In December 2021 alone, nearly 90,000 healthcare workers left their jobs.
The continuing effects of the COVID-19 pandemic impact medical practices in myriad ways. Practices are still playing catch-up with patients who avoided visits during the initial pandemic shutdowns and who remain leery of in-person appointments.
Updated Forms, Reflecting MRC Term
Please feel free to upload and print any or all of these charts.
MRC Contract Term 1/1/2022
Today March 28th, POET has received an official letter terminating the Methodist Retirement Community (MRC) direct contract. Termination was effective 1/1/2022.
MRC is now utilizing BCBS of Texas
Recent Comments