|
To learn more about Jazz Pharmaceutical's Patient Assistance Program, Jazz Cares, CLICK HERE.
Biotech initiative focused on bringing drug development and manufacturing back to U.S.Details >
Live Event November 9, 2022 - Schoolcraft College, LivoniaDetails >
Regeneron & Sanofi's LIBTAYO SurroundDetails >
September 2022Numerous retired and revised policies/articles Details >Part A, Part B and Part A/B News• Medicare Hot Links to 2022 Final Rules and the WPS Fee Schedules
• Chronic Care Management (CCM) Survey
• Upcoming System Maintenance Affecting Self-Service Tools
• Claim Timely Filing Exceptions - Issues Details >
Recent Oncology Related Articles• CMS 365-day lookback period
• Exceptions to Average Sales Price (ASP) Payment Methodology – Claims Processing Manual Changes
• National Stakeholder Call with the CMS Administrator on Inflation Reduction Act
• Medicare Telehealth Services for 2023 – CMS Proposes Substantial Changes
• 2022 APM Incentive Payment Details
• Seasonal Influenza Vaccines Pricing
• HCPCS Application Summaries & Coding Decisions: Drugs & Biologicals
• Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.Be sure to audit yourself before the RAC audits you! Details >This edition includes articles on• Auditors Accusted of Double-Dipping
• Splitting Hairs: “Incident to” or Shared Visit Details >
Recent Oncology Related News• Additional fee change schedules added
• Zynteglo® to require prior authorization for most commercial members starting Sept. 22
• Additional fee change schedules added to our provider portal
• Opdualag to require prior authorization for most members starting Dec. 1
• Next phase of Provider Secured Services and web-DENIS retirement is Sept. 15
• And many more Details >Publications• The Record
• BCN Provider News Details >Erroneous Reimbursement Denials “Exceeds Auth” When All Are Not UsedBCBSM is Manually Processing Denials. Details >
Last Reviewed/Updated 9/14/22Review the reported payer reimbursement issues
• 8/12 Resolution to BCBSM Phesgo Issue and Denials for Auth Exceeds Allowed Details >Recent Oncology Related NewsMedicaid Updates Include
• MSA Bulletin Updates
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network News Details >• Reminder: Save remittance advice files within 90 days
• New clinical edit: Principal or first-listed diagnosis codes
• 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 >
• Pharmacyclics IMBRUVICA (ibrutinib)
• Incyte Pemazyre® (pemigatinib)
• AstraZeneca Imfinzi (durvalumab) Details >
Frequently Asked Questions• Capturing Tumor Board discussions in an E/M outpatient visit Details > |
