News from UHC
UnitedHealthcare remains committed to delivering timely news and updates to help you stay informed of fast-changing COVID-19 circumstances. Here’s a quick overview of the recent extension of the national public health emergency period, as well as billing updates and resources to help you answer patient questions about COVID-19 vaccines. For the complete article follow this link to the InK Files.
PHE Extended
HHS Secretary Xavier Becerra has renewed the public health emergency (PHE) for COVID-19 effective April 21, 2021. This extension will effectively continue all telehealth waivers and other flexibilities pursuant to this determination. As with previous determinations, the renewed PHE will terminate 90 days after its effective date on Tuesday, July 20, 2021, unless it is further extended. The Biden administration has previously indicated that it intends to continue extending the COVID-19 PHE at least for the remainder of 2021.
Prior Auth. Time Frames
Several commercial payers have resumed prior authorization time frames and requirements that had been suspended because of the COVID-19 emergency, while others will continue to approve prior auth requests or suspend them for at least part of the year.
Below is an overview of some payers’ COVID-19 prior authorization policies as of April 2021: Click on the Links for more detail.
Blue Cross and Blue Shield of Texas ended approvals on services with existing prior authorizations on Dec. 31, 2020.
Aetna is approving prior authorization requests for commercial and Medicare Advantage members until the end of the plan year. “Authorization may be extended beyond the plan year, for a period of six months, if continued eligibility can be confirmed.”
Cigna resumed standard prior authorization time frames and requirements beginning April 1, 2021.
Humana resumed standard prior authorization time frames and requirements beginning April 1, 2021
UnitedHealthcare will not require prior authorization for most services through the national public health emergency period, currently scheduled to end April 20, 2021. Exceptions include medical and behavioral health services, post-acute care admissions, site of service reviews, and transfers to new providers. Prior authorizations for medical and behavioral health were not subject to extension on or after April 10, 2020.
Article written by Ellen Terry : https://www.texmed.org/TexasMedicineDetail.aspx?id=53502&utm_source=Informz&utm_medium=Email&utm_campaign=TMT&_zs=cPrdA1&_zl=CvCF6
Check Those Checks!!!
- Don’t get caught in this dirty deal.
- Know what you are endorsing.
- If you receive payment with no patient information this should be a red flag.
- By endorsing you could be agreeing to accept whatever payment they wish to send.
- Your endorsement could also serve as an authorized signature for contract.
Claims Hold!
Temporary Claims Hold Pending Congressional Action to Extend 2% Sequester Reduction Suspension
In anticipation of possible Congressional action to extend the 2% sequester reduction suspension, we instructed the Medicare Administrative Contractors (MACs) to hold all claims with dates of service on or after April 1, 2021, for a short period without affecting providers’ cash flow. This will minimize the volume of claims the MACs must reprocess if Congress extends the suspension; the MACs will automatically reprocess any claims paid with the reduction applied if necessary.
Electrical Aggregation News
Many of your offices are part of the POET Electrical Aggregation.
If you will recall, this allows us to aggregate our electrical usage to put out for bid for best rates. If you are currently in the aggregation you have received an important email from POET on Thursday, April 1st.
Please respond to the email as quickly as possible. Any questions? Call POET! ~ Thank you~
Please Help POET Welcome:
POET email addresses: [email protected] and [email protected] have been disabled.
Information Blocking FAQs
THERE ARE NEW RULES
Regarding:
Information Blocking
Electronic Health Records
Patient Portals
Health Information Technology
To hear practical information from “Healthcare IT Today” on the coming “INFORMATION BLOCKING” regulation.
6 Keys to Addressing Denials
6 keys to addressing denials in your medical practice’s revenue cycle
MGMA STAT – MARCH 18, 2021
The Medical Group Management Association’s most recent MGMA Stat poll asked healthcare leaders, “Has your organization seen denials increase in 2021?”
- 69% said “yes.”
- 31% said “no.”
Common responses from respondents included payers not reimbursing for codes related to COVID-19 supplies, critical care claims and imaging CTs.
For those healthcare leaders who reported an increase in denials, the average increase in denials was 17%.
- Half responded that they increased by 1% to 10%.
- 34% said 11% to 20%.
- 12% who stated 21% to 30%.
The poll was conducted March 16, 2021, with 576 applicable responses.
For great tips and strategies to use, follow this link or visit “The Business End” folder located in the InK files.
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