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Genentech Patient Support Services

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Have You Been Stumped on a Reimbursement Issue and Need Help?

Join an MSHO listserv and get advice from your peers.

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MSHO Featured Corporate Sponsor Assistance Programs

• Adaptive Assist 
• Deciphera Access Point 
• Ipsen Cares
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WPS Oncology Related LCD Updates

Stay current on new, retired, and revised policies/articles

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WPS Recent Oncology Related News

• System Maintenance
• Holiday Closure
• Fee Schedules
• Medicare Hot Links

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CMS-Medicare

Recent Oncology Related Articles

• No Surprise Act Resources
• Practitioner PTP Edits
• Medically Unlikely Edits

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Quality

• CMS Quality Program Updates
• MIPS EUC Exception
• MIPS Value Pathways

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Recent RAC Monitor Article

This edition includes articles on

• Speeding Up Cash Flow: Unveiling the Cost of Delayed Medical Billing
• Breaking Down the Basics of CAR-T Infusion Coding
• The Power and Value of Auditing for Revenue Loss Prevention

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BCBSM/BCN

Recent Oncology Related News

• Prior Authorization Changes Coming in June

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BCBSM/BCN

Publications

• The Record
• BCN Provider News

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Current Payer Issue Tracking Page

Last Reviewed/Updated 6/20/23

• BCBSM Withhold on Drugs Related to the PGIP Program
• Meridian Paying for Labs

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Resolved Payer Issues

Last Reviewed/Updated 6/20/23

• BCBSM AIM Auth Limit

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Aetna

• CCRP Update
• Changes to Commercial Drug Lists
• Important Pharmacy Updates
• How to Document Sepsis
• And more

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Cigna

• Virtual care Services require POS 02
• Planned Medical Policy Updates
• Educational Opportunities
• Specialty Medicine Injectables with Reimbursement Restrictions
• And more

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Health Alliance Plan

• Public Health Emergency Unwind

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Medicaid

Recent Oncology Related News

Medicaid Updates Include
• Income Guidelines for WIC Program Increased
• PHE Unwind Policy Crosswalk
• MSA Bulletin Updates
• Biller "B" Aware Notices

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Priority Health Update

• Out-of-Network Provider Surprise Billing Payment Disputes
• InterQual is Operational
• Medicaid Claims Rejection Issue Resolved
• Two New Chronic Pain CM Codes Now Covered
• And more

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United Healthcare

• Temporary Coverage for Drug Shortage
• Clinical Program Drug Step Therapy 
• 340B Medicare Advantage Drug Pricing Program
• Maximum Dosage and Frequency  
• And more

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Recent Oncology Related FDA Approvals and Expanded Indications

• Genmab & AbbVie Epkinly
• AstraZeneca Lynparza plus Abiraterone
• Genentech Columvi

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Drug Updates

• Coherus BioSciences' Single-Dose (6mg/0.6mL), Prefilled Autoinjector Presentation of UDENYCA® (pegfilgrastim-cbqv) is Now Available in US

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ASK MSHO

June 2023 Frequently Asked Questions

• JZ modifier

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