Tag: Staff Training
Humana
TIPS, TRICKS AND HELPS
PREAUTHORIZATON LISTS (PAL):
Lists of services and medications effective July 1, 2025, that may required preauthorization for members with Medicaid, Medicare Advantage, and dual Medicare-Medicaid coverage are now available.
Easily determine if a prior authorization is required with Humana’s search tool. Search by Current Procedural Terminology (CPT®) codes, procedures or generic drug name(s). Remember to verify benefit coverage in Availity Essentials
Availity Essentials Introduces Check Claim Status Feature:
Availity has enhanced its Eligibility and Benefits (E/B) page by adding a Check Claim Status feature.
What you can expect:
- Improved efficiency and accuracy: The check Claim Status tool pre-populates your patient’s information, ensuring accuracy.
- Time savings: You can access claim status with one click- saving time and effort
Superior: New Availity Claim Features and Webinars.
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Exclusion Review (HOW TO)
Part 3 of 3: System for Award Management Report (SAMS)
This one is a little bit tricky. If you need help, please give us a call.
Exclusion Review (HOW TO)
Part 2 of 3 Exclusion Review: Texas Office of the Inspector General
Exclusion Review Part 1 of 3
Texas Office of Inspector General (OIG) Exclusions
Don’t forget to retain searches for 10 years.
Exclusion Review
There are three (3) websites you are required to search before hire and monthly thereafter.
POET has tried to put together a step by step instruction to help you navigate each one. Today is:
PART 1 of 3: Office of the Inspector General (OIG)
Tips for Great Customer Service
- Make sure each of your employees can make a good 1st impression.
- Keep your promises.
- Show appreciation and gratitude to your patients.
- Provide solid training.
- Listen and act when your patients complain.
- Go above and beyond what patients expect.
- Make it easy on your patients.
- Be open with mistakes.
- Be a little obsessed with your patients.
- Treat your employees (and each other) like customers.
2025 Medicare Outlook
1st Come, 1st Served
POET will host MGMA’s 2025 Medicare Outlook Web Event
Date: December 10, 2024
Time: 12 o’clock, noon
Where: POET Office 111 Gaslight Blvd. Ste.B, Lufkin, TX 75949
Lunch will be provided
Limited Seating Available
Call or Email to reserve your place.
TMA Webinar Helps Equip Physicians for 2025
Medicare Fee Schedule
With the Centers for Medicare & Medicaid Services’ (CMS’) 2025 Medicare Physician Fee Schedule set to take effect Jan. 1, the Texas Medical Association is preparing physicians for changes in payment and coding, telemedicine, and quality and value-based care arrangements, among other areas.
LAST CHANCE
Compliance Training
There is still room at the table for POET’s last compliance webinar, November 5th, Noon.
Two topics will be represented: “OSHA for Medical Practices” and “Establishing and Maintaining a Healthcare Compliance Program”.
Come network with other Physician office managers and staff.
Get a bite to eat (you will need to submit your order for Chick-fil-a).
And concur some of that compliance training you have on your to-do list.
Call POET (936) 637-7638
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