Tag: Coding
Aetna OfficeLink Updates Published 12/1/2020
For new and updated information on:
- Changes to Aetna’s National Precertification List (NPL)
- Surgical procedures performed in the ER, modifier 54, rate change
- Beginning March 1, 2021 you may see new claim edits. These will be part of Aetna’s 3rd Party Claim and Code Review Program.
- Individual Service Codes are being assigned to Service Groups (a lot of changes are coming)
- Changes in Commercial and Medicare Drug list
- Changes in Prior Authorization Requirements
TMA’s Reimbursement Specialist Want You to Know
About These Items That Are Listed in the UnitedHealthCare December Bulletin:
- Starting January 1, UHC will follow the revised 2021 E&M coding and guideline changes for the AMA and CMS.
- January 1, for Medicare Advantage plans, UHC will expand prior authorization requirements and site-of-service medical necessity reviews.
- And, UHC has delayed implementation of its Laboratory Test Registry protocol
Revised UnitedHealthcare E&M, Prior Auth Procedures to Take Effect Jan. 1. by Ellen Terry, Texmed.org
[embeddoc url=”https://community.poetllc.org/wp-content/uploads/2020/12/Revised-UnitedHealthcare-EM-Prior-Auth-Procedures-to-Take-Effect-Jan.-1-By-Ellen-Terry-12092020.pdf” download=”all” viewer=”google”]
Billing Locum Tenen When Physician is on LOA, MGMA 11/23/2020
[embeddoc url=”https://community.poetllc.org/wp-content/uploads/2020/12/Billing-for-Locum-Tenen-MGMA-11232020.pdf” download=”all” viewer=”google”]
New coding guidelines a recipe for improved revenue 11/20/2020
Bill Dacey, MHA, MBA, CPC-I is principal in The Dacey Group, Inc., a consulting firm dedicated to coding, documentation and compliance concerns for physicians.
New coding guidelines a recipe for improved revenue 11/20/20
[embeddoc url=”https://community.poetllc.org/wp-content/uploads/2020/11/New-coding-guidelines-a-recipe-for-improved-revenue-2020.1120-1.pdf” download=”all” viewer=”google”]
36 Guidelines to Evaluate a Practice Management
Need to know where to begin:
- Financial Management – Billing and Collections
- Financial Management – General
- Personnel Management
- Marketing and Practice Promotion
- Self Development
- Leadership Skills
Are You Confused About Out-of-Network Reimbursements?
Do you want to know more about 3rd-Party Agreements, What is an assigned benefit, What is a Limited Benefit Plan? Then this is the article for you.
Information from Collect Rx
Assisting the Elderly with Virtual Visit, How to Bill.
If your office assist a patient that does not have the technology to complete a virtual visit with another physician, while the patient is having an in patient visit at your office, can you bill?
Cigna’s response to COVID-19
Cigna Coronavirus (COVID-19) Interim Billing Guidance for Providers for Commercial Customers. Updated October 30, 2020 – Highlighted text indicates updates.
As the COVID-19 pandemic continues, we appreciate that providers across the country are on the front line to offer dedicated care to our customers and help protect local communities.
As federal guidelines continue to evolve in support of the COVID-19 pandemic, we have again extended our interim coverage accommodations for commercial Cigna medical services, as follows:
- The cost-share waiver for COVID-19 diagnostic testing and related office visits is extended until January 21, 2021.
- The cost-share waiver for COVID-19 related treatment is extended until December 31, 2020.
- Some other interim accommodations (e.g., for credentialing and authorizations) are extended through December 31, 2020, as outlined on this page.
- The interim COVID-19 virtual care guidelines as outlined on this page are in place until December 31, 2020. Beginning January 1, 2021, we will implement a new Virtual Care Reimbursement Policy. Please visit CignaforHCP.com/virtualcare for additional information about this new policy.
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