Tagged with HIPAA
CMS has issued a reminder to Medicare providers regarding proper billing for certain beneficiaries enrolled in the Qualified Medicare Beneficiary (QMB) program and also announced the reinstatement of QMB information in provider Remittance Advices (RAs) and Medicare Summary Notices (MSNs).
Effective with dates of service of May 1, and beyond, Highmark PA will require prior authorization for three HCPCS Level II procedure codes before services can be provided.
New Jersey Medicaid has announced changes to the state’s NCPDP D.0/1.2 Payer Sheet, intended to enhance the State’s compliance with the National Council for Prescription Drug Program (NCPDP) D.0 standard.
CMS, on December 28th, issued a Survey and Certification Memorandum (S&C Memo) to state survey agencies to clarify and reinforce its position that it prohibits physicians and health care providers from texting orders.
Healthcare New England (HNE) has issued updated anesthesia guidelines surrounding the use CPT codes and claim submissions.
Effective December 8, Anthem EDI began implementation of a new edit related to independent laboratory claims which reduces the processing time and manual intervention for lab claims.
CMS’ newly released fact sheet explains how Administrative Simplification standards streamline day-to-day tasks such as billing, verifying patient eligibility, sending and receiving payment.
The Delaware Department of Insurance is investigating a security breach involving subcontractors of Highmark BlueCross BlueShield of Delaware: Summit Reinsurance Services Inc. and BCS Financial Corp.
Effective November 1, for participating providers and August 1, for non-participating providers, UnitedHealthcare will require CLIA Number on Laboratory Claims submitted on a CMS 1500 form or HIPAA 5010 837 P file.