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Author: Trawick Ellis

Medicaid enhanced “Bump” rates effective through September 30, 2016

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To qualify, Medicaid-enrolled primary care physicians must accurately self-attest by completing required paperwork as outlined below. Necessary steps for Provider eligibility to receive the Primary Care Enhanced Physician Rates: Visit medicaid.alabama.gov Select Provider Enrollment from the drop-down menu under “Providers” Complete a self-attestation form Attach proof of board certification, if applicable Mail original self-attestation form to the address specified For more information on which providers qualify for the “bump” rate please visit the Medicaid AL…
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PQRS – Informal Review Process for 2016 Negative Payment Adj

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ATTN PQRS REPORTERS: If you DID NOT satisfactorily report PQRS in 2014, then CMS will apply a NEGATIVE payment adjustment to qualifying providers & groups during the calendar year 2016. September 9, 2015 through December 16, 2015 – PQRS Informal Review Process  (NOTE: DEADLINE EXTENDED) Qualifying providers/groups that believe they were incorrectly assessed during the 2014 reporting period for the 2016 negative payment adjustment may submit an informal review now until 11:59 p.m. EST on Dec….
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Pass-Through Billing not Permitted for Labs Effective September 1, 2015 – BCBS AL

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Pass-Through Billing No Longer Permitted for Laboratory Tests Effective September 1, 2015, pass-through billing will no longer be permitted by Blue Cross and Blue Shield of Alabama. Pass-through billing occurs when an ordering provider (i.e., physician or laboratory) requests and bills for laboratory tests, but the tests are not actually performed by the ordering provider. The performing provider should bill for these services directly. This requirement is applicable to all in network providers. Pass-through billing…
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New MediSYS’ EHR Interfaces with St. Vincent’s and Brookwood Hospitals Streamline Lab/Radiology Results Delivery

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Montgomery, AL – MedConnect, Inc. continues to integrate its newest results interface with leading Alabama healthcare institutions. The interface into MediSYS’ EHR, MedConnect v2.3 has now been adopted by two hospital systems in Birmingham, Alabama: St. Vincent’s Hospital and Brookwood Hospital. Providing transmission of laboratory, radiology and other transcribed documents in real time, the interface to MediSYS’ electronic health record (EHR) product suite streamlines processes. Healthcare workers can now eliminate manual paperwork while achieving faster…
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Medicaid EFT & ERA Release Date Changes

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Important Changes coming to EFT and 835 electronic remittance advices (ERAs) Effective beginning July 24th, 2015, Medicaid will no longer offer immediate ERA 835 access. 835 ERAs will now be released within 3 business days of the release of the EFTs. Example from Medicaid BEGINNING ON JULY 24th, 2015: Check write is on Friday 7/24/15 EFTs released on Monday 8/3/15 835 ERAs available from Monday 8/3/15 – Thursday 8/6/15 For more information please view the…
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Reminder about Upcoming Industry Deadlines

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Meaningful Use Hardship Exemption – Deadline is July 1 Medicare eligible professionals who did not successfully meet Meaningful Use in 2014 have until July 1st, 2015 to file a 2016 hardship exemption to avoid the 2016 payment adjustment. The 2016 hardship exemption application and instructions can be found here: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/paymentadj_hardship.html In order to file a hardship exemption, eligible professionals must show proof of a circumstance beyond their control and clearly outline how those circumstances greatly impaired their ability to…
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Hardship Exemption Deadline – July 1st

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Meaningful Use Hardship Exemption – Deadline is July 1st Medicare eligible professionals who did not successfully meet Meaningful Use in 2014 have until July 1st, 2015 to file a 2016 hardship exemption to avoid the 2016 payment adjustment. The 2016 hardship exemption application and instructions can be found here: http://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/paymentadj_hardship.html 2016 Hardship Exemption Instructions: 2016 Eligible Professional (EP) Medicare EHR Incentive Program Hardship Exception – Instructions (Please Read). In order to file a hardship exemption,…
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United Healthcare Lock In Your Doc Program

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In 2015, UnitedHealthCare will launch Lock In Your Doc to encourage members to establish an ongoing relationship with their primary care physician (PCP). If you are a PCP, the program requires you to only provide services to members assigned to you or your medical group/tax ID number (TIN). Starting August 1, 2015, UnitedHealthCare Community Plan may not pay for services rendered by a care provider not assigned to that member. To help you prepare for…
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