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Co-pay Assistance Program for Some Generic Medications!Fresenius Kabi Introduces Copay Assistance for Cancer Treatments Using Generic Medicines Details >
Friday, April 29 at the Somerset Inn, TroyDetails >
April 2022Updates that may be of interest to oncology including:
• Multiple MolDx 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
• TPE Reviews on 96365 Reported by Facility MSHO Member!
• Also, Medicare Hot Links to 2022 Final Rules and the WPS Fee Schedules Details >• Evaluation and Management (E/M) Services Ask-the-Contractor Teleconference (ACT) Recording Available
• On Demand Training
• YouTube Training Opportunities! Details >
Recent Oncology Related Articles• Launch of the Cross-Cutting Initiatives
• What’s the Comprehensive Error Rate Testing Program?
• Claim Status Category and Claim Status Codes Update
• Advanced Practice Registered Nurses, Anesthesiologist Assistants, & Physician Assistants — Revised
• ICD-10 Diagnosis Codes: Comment by May 9
• Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.RAC AUDITS CONTINUE - All related to waste - not using the smallest vial available or not using the JW modifier!
Be Careful and Double Check To Be Sure You Are Doing It Correctly!
Also, Newest approved issues listed on RAC website Details >This edition includes articles on:• PHE Renewed for 90 Days - What does this mean to your clinic?
• Prepayment Review Appeals and their Ramifications Details >
Neulasta - J2506 - Be Careful Your NDC Units of Measure AND your HCPCS Units are Correct!This is a MUST READ alert for all MSHO members! Details >Recent Oncology Related News• AIM authorization IDs to include alpha characters starting in April
• Update: Claims for services delivered via telehealth with POS 10 that denied incorrectly
• Resubmit rejected claims to Medicare for patients with Medicare Supplemental coverage from group 71736, UAW Retirees of The Budd Company Health and Welfare Trust
• Update: Use HM, not BL, as Claim Filing Indicator Code for BCN commercial medical claims
• Virtual provider symposiums to focus on patient experience and HEDIS
• Nyvepria™ and Rybrevant™ to require prior authorization for UAW Retiree Medical Benefits Trust members with Blue Cross non-Medicare plans starting May 16
• Kimmtrak® and Tivdak® to require prior authorization for most members starting May 23
• Empaveli® and Actemra® to require prior authorization for Blue Cross URMBT non-Medicare members, starting June 1
• DanyelzaTM, Margenza® and SaphneloTM to require prior authorization for URMBT members with Blue Cross non Medicare plans starting June 30
• Inflectra® and Avsola® are the preferred infliximab products for pediatric commercial members starting July 1 Details >Publications• The Record
• BCN Provider News Details >BCBSM System Still Not Fixed - Keep Sending Us Your Denials!BCBSM is Manually Processing Denials QUICKLY! Details >
Last Reviewed/Updated 4/19/22Review the reported payer reimbursement issues including:
• BCBSM issues with Neulasta, Phesgo, and Denials for Auth Exceeds Allowed Details >Recent Oncology Related NewsMedicaid Updates Include:
• MSA Bulletin Updates - Reimbursement for Genetic Counselors!
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network News Details >• Change to referring/ordering/attending editing for Medicaid claims
• Appeal vs. claims inquiry: Steps for faster claims resolution
• Reminder: CMS' Two-Midnight Rule doesn't apply to Medicare Advantage members Details >
Kite's Yescarta® (axicabtagene ciloleucel) Novartis' Vijoice® (alpelisib) Details > 
April 2022, Frequently Asked Questions• Documenting time for telehealth visit
• PHE ends but can we still bill for telehealth visits
• 2023 split/shared visits based only on time, where can we address our complaints
• Sequestration and PAYGO cuts
MSHO MEMBERS - You can access and search previous FAQs! Just use the search field on the bottom right corner of the MSHO website! Details > |
