To learn more, click here.
NOW A VIRTUAL Event on November 10, 2021Sadly, due to payer restrictions on travel to any live event, we have to switch the format to a virtual event. We will still have a full day of speakers and updates from our Michigan payers! REGISTER TODAY! Details >
October 2021Updates that may be of interest to oncology including:
• Multiple Revised Policies Details >Part A, Part B and Part A/B NewsIncludes articles that may be of interest to oncology released in the past 2 weeks • Also, Medicare Hot Links to 2022 Proposed Rules, 2021 Final Rules and the WPS Fee Schedules Details >Check out these upcoming training events:• Learning Center: Content Library Enhancements • Exploring E/M Documentation for 2021 Office Services • Teleconference: Prevent Part B Rejections and Denials. • On Demand Training Including; Appeals - Understanding the Basics, E & M Services for 2021, 3 Day/1 Day Payment Window, and New YouTube Training on Transitional Care Management and more... Details >
Recent Oncology Related Articles• CMS Releases 2022 Medicare Advantage and Part D Star Ratings to Help Medicare Beneficiaries Compare Plans • Pneumococcal Conjugate Vaccine, 20 Valent • Non-Physician Outpatient Services Provided Before or During Inpatient Stays: Bill Correctly • January 2022 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files & Revisions to Prior Quarterly Pricing Files • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.Newest approved issues listed on RAC website: • Positron Emission Tomography for Initial Treatment Strategy in Oncologic Conditions • Next Generation Sequencing Medical Necessity and Documentation Requirements Details >This edition includes an article on:• Medicare Audits: Time is of the Essence Details >
Recent Oncology Related News• Important Reminder: BCBSM and BCN are transitioning to a new Pharmacy Benefit Manager • How to avoid claim rejections when Medicare is primary • October 29, 2021 ICT Webinar: You’ve submitted a few claims; now what? • Additional drugs require prior authorization for Blue Cross URMBT non-Medicare members, starting Nov. 1 • Asparlas to require prior authorization for Blue Cross URMBT non-Medicare members, starting Nov. 1 • Darzalex Faspro, Polivy and Trodelvy require prior authorization for URMBT members with Blue Cross non-Medicare plans, starting Dec. 3 • Prior authorization requirements expanding for Medicare Plus Blue, BCN commercial and BCN Advantage members on Jan. 1 • Additional drugs require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans, starting Jan. 3 Details >Publications• The Record • BCN Provider News • Blues Brief for Oncology Providers Details >Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find: • 835 Recoupment isn't reflected on voucher • 835 CARC 210 sanction amount is incorrect • The system is applying a denied authorization to a claim in error • Multiple RHC Issues Details >
Last Reviewed/Updated 10/19/21Review the reported payer reimbursement issues including: • Diagnosis loading for biosimilars to match brand drugs, denied claims being reprocessed Details >Recent Oncology Related NewsMedicaid Updates Include: • MSA Bulletin Updates • Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
• UHC Reimbursement Policy Update
Details >• Denials on the following lab panel codes 80053, 85025 & 84443 • You should no longer accept THC Medicaid member IDs, You can still serve THC members with commercial group and individual plans Details >Featuring this month: McLaren Health PlanTidbits regarding: • Physician Administered Drugs and NCD Reporting • Where to find the Site of Care Injectable/Infusible Required Drug list • Genetic Testing Pre-authorization Requirements can be found on their website Details >
October 2021, Frequently Asked Questions• Updated ABN Form Rules • Pass-through and Non Pass-through Drugs • Transitional Care Management • AMA CPT and Inpatient Hospital E & M Changes
MSHO MEMBERS - You can access and search previous FAQs! Scroll to the bottom of the Q & As to find out how!
Details >
|
|