BCBSVT Now Requiring Providers to Obtain EIN
Due to the federal “transparency in coverage” rule, BCBSVT is now requiring all providers to obtain and start utilizing an Employer Identification Number (EIN) for billing.
E/M Changes for BCBSMA 2020
E/M Changes for BCBSMA 2020 Blue Cross Blue Shield of Massachusetts has advised that, effective April 1, 2020, they will implement a reduced reimbursement policy when you bill an E/M service on the same day as a procedure. Starting on April 1, 2020, BCBS will begin to reimburse the lesser allowable service at 50% of […]
E/M Changes
Medicare has released the results of the CMS Final Rule 2019. They have announced that the changes to the E/M coding will be effective for Calendar Year 2021. Currently these codes will remain the same.
MassHealth Non-Billing Provider Regulation
All physicians who hold an active medical license in Massachusetts must enroll in Mass Health either as billing or non-billing providers – in order to maintain their licensure.
New Medicare cards coming in 2018
CMS will begin mailing new insurance cards in April 2018, replacing all Medicare cards by the April 2019 congressional deadline.
Congress Limits “Medigap” Insurance Policies for Medicare Deductibles
Medicare beneficiaries will often purchase “Medigap” insurance polies to cover their co-payment and deductible costs after Medicare. However, starting in 2020 Medigap plans will no longer…
New Version of CAQH in 2015
The new system is designed to offer features that will increase the ease of use and functionality for providers.
New Medicare 59 Modifiers
Effective January 1, 2015 – Medicare has 4 new HCPCS modifiers to define subsets of the modifier 59 “Distinct Procedural Service”. Learn More…
Routine Forgiveness of Co-Payments
Routine Forgiveness of Co-Payments – Published by the American Medical Billing Association Routine forgiveness or waiver of copayments may constitute fraud under state and federal law. Where the insurance contract requires a doctor to make reasonable attempts to collect the patient’s portion, an open question surrounds the definition of “reasonable attempts to collect the debt.” Historically, […]
2014 Rules for PQRS
2014 Rules for PQRS Original posting and content found here: http://www.mdinteractive.com/2014-PQRS CMS issued Final 2014 Physician Fee Schedule Rule on November 27, 2013. Summary of Changes: 2014 PQRS measures group reporting can only be done with a registry. It could be easier for a provider to report 2014 PQRS with a registry instead of using claims because a […]