To learn more about GSK Oncology, click here.
Now you can count CBCs as MDM Data even if you bill for them!Details >House Bill 4353 Supports Patient Access to Critical Treatments by Banning Discriminatory Copay Accumulator Adjustment ProgramsDetails >
Wednesday, April 21, 2021 - REGISTER TODAY!Details >Presented on February 16, 2021The handouts are available & a new recording will be available soon! Details >Presented on March 10, 2021Handouts and recording now available! Details >
TEVA CORE (Comprehensive Oncology Reimbursement Expertise)Details >
March 2021Updates that may be of interest to oncology including these updates/revisions:
• Tumor Markers • Complex Drug Administration Coding 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 2021 Final Rules and the WPS Fee Schedules Details >Check out these upcoming training events:• Teleconference - Basics of Medicare Documentation • On Demand Training -What's New for 2021 Session 2 • On Demand Training for E & M Services • YouTube Training Available Details >
Recent Oncology Related Articles• Biden-Harris Administration Increases Medicare Payment for Life-Saving COVID-19 Vaccine • Open Payments & You Call — March 25 • Average Sales Price Files: April 2021 • April 2021 HCPCS Code Update • Intravenous Immune Globulin Demonstration • Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.No New Oncology Related Issues Since March, 2020: • Latest under review at that time included: - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections Details >This edition includes articles on:• DOJ Announces 15-Year Term for Provider CEO Convicted of “Barbaric” Fraud Scheme • Kickbacks in the Medicare Advantage Program: $12.5 million Settlement in Whistleblower Case • No Surprise. It's the Law! Details >
Recent Oncology Related News• AIM Specialty Health® technical issues are resolved • Additional medications will require prior authorization for Medicare Advantage members, starting June 22 • Some Meijer Inc plans have wrong alpha prefix on web-DENIS ID card • Easier access to RC Claim Assist • Starting in June, we'll use clinical information to validate providers' answers to some questionnaires in the e-referral system • Medicare Advantage Claims Processed in Error • Deductible, out-of-pocket maximums for Medicare Plus Blue groups showing incorrectly in web-DENIS • HCPCS replacement codes established • Update to Medicare Plus BlueSM PPO Manual coming in April 2021 • Starting in May, additional medical benefit drugs will require prior authorization for some Blue Cross commercial members • Medical benefit specialty drug prior authorization list changing in April for most members • Some drugs not payable when administered by a health care professional to Blue Cross and BCN commercial members, starting April 1, 2021 • Changes coming to preferred products for drugs covered under the medical benefit for most members, starting April 1, 2021 Details >Publications• The Record • BCN Provider News 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 • Authorizations coming through are causing claim denials, multiple RHC Issues Details >
Last Reviewed/Updated 3/17/21Review the reported payer reimbursement issues including clarifications and issues with WPS Medicare, BCBSM, Medicare Plus Blue, BCN Advantage, and UHC Community Plan 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
Details >• Oncology supportive care medication sourcing requirement • Radiation therapy prior authorization update Details >• New Provider Portal Coming This Year • Changes to our preferred biosimilars for pegfilgrastim effective April 1 Details >Featuring this month: HumanaTidbits regarding: • Claim processing edit notifications • Claim payment inquiry resolution process guide • Telehealth FAQs Details >
March 2021, Frequently Asked QuestionsMultiple Questions Related to the New E & M Guidelines • Time or MDM • What are Social Determinants of Health • Ordering and Reviewing Tests • Can't Count a CBC You Bill For in MDM - UPDATED 3/17/21 • Reviewing Labs Ordered by Another Physician in the Group • Can I Count Time at Tumor Board • Pre-Charting Details >
|
|