News & Articles
Medicare Quality Programs: Transitioning from PQRS to MIPS Call — January 24
uesday, January 24 from 2 to 3:30 pm ET To register or for more information, visit MLN Connects® Event Registration. During this call, find out how to complete the final reporting period for the legacy Medicare quality reporting programs and transition to the...2015 Physician Quality Reporting System Feedback Reports and 2015 Annual Quality and Resource Use Reports Available Soon
The 2015 Physician Quality Reporting System (PQRS) feedback reports will be available in September 2016 for individual eligible professionals (EPs) and PQRS group practices. The PQRS feedback reports will provide the final determination on whether or not participants...2016 PQRS Reporting Measures Series, Session 3: MAV and How to Get Started
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the third session of a three-part Virtual Office Hours series regarding 2016 Physician Quality Reporting System (PQRS) quality measures. The series includes three separate sessions that cover topics related to PQRS measures, measure-specific definitions, measures-related resources, and next steps for participating in 2016 PQRS.
Provider Enrollment Revalidation – 2016 (Cylce 2)
The Centers for Medicare & Medicaid Services (CMS) has completed its initial round of revalidations and will be resuming regular revalidation cycles
CMS Announces the PQRS Web-Based Measure Search Tool
The Centers for Medicare & Medicaid Services (CMS) is pleased to announce the availability of the new Physician Quality Reporting System (PQRS) Web-Based Measure Search Tool located directly at https://pqrs.cms.gov/#/home and via the PQRS Measures Codes...Annual Meeting Feb 26th at 8:30
Medicare Secondary Payer (MSP) Basics Webinar
Register for the CGS J15 Part A webinar “Medicare Secondary Payer (MSP) Basics” scheduled January 14, 2016 from 10 – 11:30 am CST (9 – 10:30 am EST). This webinar is designed as a ‘BASICS’ session. New and experienced staffs may benefit from...Authorization required for WV Molina Providers
All Molina Medicaid patients, traditional and alternative plan must be per-authorized as of October 1st. The initial evaluation does not need to be pre-authorized. Forms can be found in the Members Section / DocumentsAnthem OrthoNet Authorzations Mandatory
Effective November 1, 2015, Anthem Blue Cross and Blue Shield (Anthem) will implement a physical therapy (PT) and occupational therapy (OT) benefit management program for outpatient and office services. In order to help us effectively administer this program, we have...SENATE TAKES HISTORIC VOTE ON THERAPY CAP REPEAL
April 14th, Senate voted to approve a permanent fix for the sustainable growth rate (SGR) by a vote of 92 to 8. The bill now heads to the President’s desk for signature.As part of consideration of the SGR bill, Senators Cardin (D-MD) and Vitter (R-LA) proposed...Looking for meeting topic(s) suggestions
We had a great Annual Meeting that reviewed Billing administration, claims workflow, PQRS and Risk Management. If you missed the event, look in the document section for 2015 Annual Meeting notes and handouts. We also announced that we are looking for topics that you,...Compliance Requirements for Health Care Providers
Humana has recently posted a notice that all providers must complete a Compliance Training, on one of their sites. Please click on: https://www.humana.com/provider/medical-providers/education/whats-new/compliance-requirements to learn where to complete this...Highmark Blue Cross Blue Shield West Virginia (Highmark West Virginia) / Update to liability rejections Effective 4/20/2015
Posted on 02-19-2015 IMPORTANT CHANGES EFFECTIVE APRIL 20, 2015: PROVIDER ASSIGNMENT OF LIABILITYPROVIDER RESPONSIBILITY IDENTIFIED On January 1, 2014 the Committee on Operating Rules for Information Exchange (CORE®) in conjunction with the Blue Cross Blue Shield...UHC is requiring all Providers elect their electronic payment method in 2015
UnitedHealthcare-contracted providers, who have not yet enrolled in EPS, must elect their preferred electronic claim
payment method in 2015. Failure to do so, your election will default to Virtual Card Payments – current credit card processing fees will incur!
CAQH has a new look on March 2, 2015
CAQH has incorporated feedback from both provider and health plan focus groups into the development of CAQH ProView. A range of new features will make it easier for healthcare providers to make updates, reducing the time and resources necessary to submit accurate, timely data to organizations that require that information. Providers will be able to easily submit information through a more intuitive, profile-based design