News & Articles

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.

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...

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 / Documents

Anthem 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...

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