like us on facebook connect with us on linkedin follow us on twitter July 20, 2022

 

Az 360
Az 360

To learn more about AstraZeneca Access 360, CLICK HERE.

Section Header Section Header

Save The Date - MSHO 13th Annual Payer Update!

Live Event November 9, 2022 - Schoolcraft College, Livonia

Details >
Section Header Section Header

WPS Oncology Related LCD Updates

July 2022

Updates that may be of interest to oncology including:
• Self-Administered Drug Exclusion List

Details >

WPS Recent Oncology Related News

Part A, Part B and Part A/B News

Includes articles that may be of interest to oncology released in the past 2 weeks
• Also, Medicare Hot Links to 2022 Final Rules and the WPS Fee Schedules

Details >

Join WPS for a Teleconference, Webinar or Seminar

• Medicare Secondary Payer (MSP) — Tips to Avoid Claim Issues; On Demand Training, How to Upload ADR Documentation to the Website Portal YouTube Training and SO much MORE!

Details >
Section Header

CMS-Medicare

Recent Oncology Related Articles

• Medicare Telehealth Services for 2023 – CMS Proposes Substantial Changes
• Now Available: 2022 APM Incentive Payment Details
• Claims Processing Instructions for the New Hepatitis B Vaccine Code 90759
• HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals
• Teaching Physicians, Interns, & Residents Guidelines — Revised
• Recent LearnResource & MedLearn Matters Articles

Details >

Michigan RAC Information

Region 1 - Performant Recovery, Inc.

RAC Audits Continue - However, No New Oncology Related Issues Posted Since May, 2021

Details >

Recent RAC Monitor Articles

This edition includes articles on:

• Understanding the Medicare Case-By-Case Exception
• Medicare Advantage Plans: More but Not Less
• RAC Audits Under Scrutiny

Details >
Section Header

BCBSM/BCN

Recent Oncology Related News

• We use clinical information to validate providers’ answers to some questionnaires in the e-referral system
• Reminder: Check for authorization requirements; not all Blue Cross patients require AIM authorization
• We’re designating preferred and nonpreferred IV iron therapy replacement drugs for Medicare Advantage members starting August 8
• Additional medical benefit drugs to have site-of-care requirements for BCN commercial members starting Sept. 1

Details >

BCBSM/BCN

Publications

• The Record
• BCN Provider News

Details >

Erroneous Reimbursement Denials “Exceeds Auth” When All Are Not Used

BCBSM System Still Not Fixed - Keep Sending Us Your Denials!

BCBSM is Manually Processing Denials QUICKLY.

Details >
Section Header

Payer Issue Tracking Page

Last Reviewed/Updated 7/20/22

Review the reported payer reimbursement issues including:
• BCBSM Phesgo Issue and Denials for Auth Exceeds Allowed still pending

Details >

Physicians Health Plan (PHP) Update

Zelis ePayments Postponed to July 26, 2022 and New Mailing Address Reminder

Details >

Medicaid

Recent Oncology Related News

Medicaid Updates Include:
• MSA Bulletin Updates
• Biller "B" Aware Notices

Details >

Newsletters of Interest

• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network News

Details >

Priority Health Update

• Legacy THC providers must wrap up claims, appeals by Dec. 31, 2022
• New clinical edits for facility claims going into effect on Sept. 15, 2022

Details >
Section Header Section Header Section Header

ASK MSHO

July 2022, Frequently Asked Questions

• New E/M Changes For Hospital Same as Office?
• Comparison of Oncology Models
• Appropriate Telehealth Location Codes

MSHO MEMBERS - You can access and search previous FAQs. Just use the search field on the bottom right corner of the MSHO website.

Details >