Special Enrollments Periods

SEP for Individuals Affected by a Disaster or Emergency

Effective January 1, 2021, an SEP exists for individuals affected by a disaster or other emergency declared by a Federal, state or local government entity who were unable to, and did not make an election during another valid election period. This includes both enrollment and disenrollment elections.

THRIVE

THRIVE CareAllies’ Provider Newsletter May 2021

Education inside: Obtain Assistance with Coding Accuracy and Documentation, one-on-one education, coding reference tools. Get set up for remote access, email [email protected].

Resource Material inside: 

  • CoVid Vaccine Flyers
  • Call us first: Poster, Wallet Card, Wearable Button, etc. 
  • NO-SHOW: Poster and Wallet Card (customizable)

Email CareAllies at [email protected] with any topic suggestions for this (your) newsletter.

THRIVE

E&M Coding in 2021

Now is the time to take a few minutes to assess your coding.

 

  •  If you are coding close to your specialty’s bell curve and if your documentation supports your coding, take a deep breath. If you find you are an outlier, don’t panic. Time is on your side.

  • Under-coders of the world, look to increase your coding. Your documentation likely supports a higher code. Over-coders, make sure your documentation supports your higher coding.

  • You are at higher risk for an audit, and your best defense will be solid documentation

Are you curious to see how you are doing?  Follow this link to “Physicians Practice” article:

E&M Coding in 2021: Four Questions, Four Answers

 

Physicians Practice

New Resources Available on QPP Website

Over the past few weeks, CMS has added new resources to the Quality Payment Program (QPP) Resource Library. For performance year 2021, the new batch of resources includes:

  • MIPS User Guides, which provides details on a variety of topics to help participants understand the 2021 MIPS performance year requirements;
  • MIPS Measures and Activities Specialty Guides;
  • Medicare Promoting Interoperability Program vs. MIPS Promoting Interoperability Performance Category Infographic;
  • Facility-based Quick Start Guide;
  • Quality Benchmarks; and
  • MIPS Data Validation criteria.

Quality Payment Program

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. 

Bill Passes

Senate passes bill to extend Medicare sequester fix through 2021

Senate passes bill to extend Medicare sequester fix through 2021, 3/25/2021

[embeddoc url=”https://community.poetllc.org/wp-content/uploads/2021/04/Senate-passes-bill-to-extend-Medicare-sequester-fix-through-2021.pdf” download=”all” viewer=”google”]

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. 

Temporary Claim Hold

Regarding the Ever Changing Telemedicine Guidelines.

KZA Telehealth Solutions Center

An up-to-date, comprehensive resource regarding
the ever-changing telemedicine guidelines.

KarenZupko and Associates, Inc. has been around for a long time.  

They have shared a link to their website for updates to telehealth on the MGMA Community.

Please note, they update materials as changes are made by CMS.

So check back often!

There is a very nice chart on Payor Telehealth Policies and lots more.

Telehealth Solutions

Select CoVid-19 Temporary Cost Share Wavers are Extended. UHC Feb. 26, 2021

To continue to meet your needs through the evolving COVID-19 health emergency, UnitedHealthcare is extending select COVID-19 treatment cost share waivers, which are summarized below. We also continue to make ongoing updates to our COVID-19 billing and reimbursement guidance with the latest information, including giving providers a way to look up member Medicare ID numbers when submitting COVID-19 vaccine administration claims to the Centers for Medicare & Medicaid Services (CMS) Medicare Administrative Contractor (MAC).

To view the full article, follow this link.

Cost Share Wavers Extended