Emblem Health: Echo Health Begins Claims Payment processing
ECHO Health began processing GHI payments since Aug. 18, while HIP started on Sept. 2. If you are currently enrolled…
Category: Policy Updates
Amerigroup of NJ News: Reminder: waived copays, deductibles, and coinsurance for CCM, complex CCM, and TCM
Effective from dates of service on and after September 1, 2019, cost-sharing requirements (copays, deductibles, and coinsurance) are no longer…
Horizon BCBS of NJ: Don’t delay! Register for EFT before November 3!
Starting from November 3, 2020, Horizon BCBSNJ will no longer make claim payments using print checks. If you are not…
Horizon BCBS of NJ: Alterations to claims for bundled procedures reported with 59 X{EPSU} modifiers
Now, see this: For services rendered on and after November 23, 2020, Horizon BCBS of NJ will not consider the…
Empire BCBS: Mental Health Services Limitations
Starting from December 1, 2020, Empire BlueCross BlueShield will apply a frequency limit to CPT codes 90791 (Psychiatric diagnostic evaluation)…
UHC: List of Covered CPT codes for PT and OT updated for UHC Community Plan
Do you know that effective October 1st, 2020, the most commonly used PT/OT CPT codes are no longer covered? You…
Aetna: Billing Modifiers 25, 59, and X series (NY and NJ)
New York: Starting from December 1, 2020, Aetna will apply new edits for billing modifiers 25, 59, and X series…
AETNA: Extended coverage of telemedicine services
The use of telemedicine is encouraged as a first line of defense to limit potential COVID-19 exposure in physician offices.…
NGS Medicare: Fee Schedule Adjustments Reminder for 99441-99443
Are you aware that when CMS announced that they were changing the fee schedule allowance for these procedures to mirror codes 99212-99214,…
NY Medicaid EHR Incentive Program Pre-validation Period: Sep 14 – Dec 14
Are you aware? EPs or a group of EPs that have already selected their reporting period and calculated their patient…