News & Articles

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

Specific Modifiers for Distinct Procedural Services

CR8863discusses changes to HCPCS modifier -59, a modifier which is used to define a “Distinct Procedural Service.” Modifier -59 indicates that a code represents a service that is separate and distinct from another service with which it would usually be considered to...

Avoiding 2016 Negative Payments for CMS Medicare Quality Reporting

The next MLN Connects™ National Provider Call provides an overview of the 2016 negative payment adjustment for several Medicare Quality Reporting Programs. This presentation will cover guidance and instructions on how eligible professionals (EPs) and group practices...