Anthem Blue Cross Modifiers Recently, Anthem Blue Cross released two articles relating to policy and contractual updates. Anthem has updated their modifier 25 policy and has released a fee schedule notification. May 1, 2019 General Anthem Blue Cross, E/M Services, Reimbursement Read More »
Expanded Emergency Health Services A new state law (AB 2576) will ensure that patients impacted by a disaster can continue to receive the care they need. October 10, 2018 General Reimbursement Read More »
Have you Received Your Supplemental Medi-Cal Payments? Physicians should have received their supplemental payments by August 31 in both fee-for-service and Medi-Cal managed care when providing Medi-Cal services under certain CPT codes. September 21, 2018 General Reimbursement Read More »
Livermore Measure U Threatens Access to Care Measure U seeks to limit the amount that a physician, hospital, clinic, or other health care providers can charge for patient care to 115% of the cost of treatment. September 12, 2018 General Reimbursement Read More »
CMS Proposes New 2019 Medicare Fees & QPP Rules On July 12, the Centers for Medicare & Medicaid Services (CMS) announced a plan to combine Medicare paperwork and levels of payment into one form and one flat rate for each office visit with a patient, with the option of filing for an �add-on� payment of $67 for more complex patients. August 6, 2018 General Reimbursement Read More »
What to Do If Your Medicare Patient Doesn't Have Their New Card The Centers for Medicare and Medicaid Services (CMS) has finished mailing new cards to Medicare patients in California. August 3, 2018 General Reimbursement Read More »
Check Your 2019 MIPS Payment Adjustment Calculation For providers who participated in the Merit-based Incentive Payment System (MIPS) in 2017, your MIPS final score and performance feedback is available for review on the Quality Payment Program (QPP)website (qpp.cms.gov). July 16, 2018 General Reimbursement Read More »
UHC Reimbursement for After-Hours and Weekend Care Effective August 18, 2018, UnitedHealthcare (UHC) will allow reimbursement for CPT code 99051 (services provided in the office during regularly scheduled evening, weekend, or holiday office hours, in addition to basic service) when billed with acute care services by a primary care physician (PCP). July 13, 2018 General Reimbursement Read More »
New State Budget Further Improves Medi-Cal Provider Reimbursement The California 2018�19 fiscal year budget includes $500 million in Prop 56 tobacco tax funds allocated for supplemental payments for Medi-Cal providers. July 6, 2018 General Reimbursement Read More »
Blue Shield Corrects System for AB 72 Claims Issues affecting the accurate payment of AB 72 claims through Blue Shield have been corrected through a system update implemented by the payor on June 28. July 6, 2018 General Reimbursement Read More »