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BCBS of AL – Inappropriate Billing Related to COVID-19

Visit AlabamaBlue.com/providers/coronavirus for the latest information: Through the use of advanced analytics and data mining, concerning trends have been identified over the past year related to testing and vaccinations for COVID-19 and telehealth visits. Additionally, Blue Cross continues to receive many complaints from members regarding inappropriate billing and unnecessary care.  Blue Cross will audit these trends and complaints to ensure appropriate application of our member’s benefits for medically necessary services. Patient interviews may be conducted as well to verify services rendered….
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CMS Automatic Extreme & Uncontrollable Circumstances Exception for 2020 MIPS

As an additional COVID-19 flexibility, CMS is applying the MIPS automatic extreme and uncontrollable circumstances (EUC) policy to all MIPS eligible clinicians for the 2020 performance period.  CMS has also reopened the application for the 2020 MIPS Extreme and Uncontrollable Circumstances Exception for COVID-19. The new deadline is March 31, 2021 8:00 PM ET. What does this mean if I have already submitted data? Note that applications received between now and March 31, 2021 won’t override previously…
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2021 MediSYS VIRTUAL User Conference

February 23rd, 24th & 25th Join us for our FIRST Virtual User Conference!  We will explore COVID challenges and solutions, billing and clinical optimization, plus MUCH MORE! BCBS of AL Primary Care & Specialist Updates Kim Huey – 2021 E/M Coding Getting Paid During a Pandemic SMART Documentation MIPS MediSYS M3: Minimal Change, Major Benefits ***The first 200 to register will receive a special goodie box – mailed to your home before the virtual conference!…
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2021 MIPS Performance Year Eligibility

You can now use the updated Quality Payment Program Participation Status Tool to check on your initial 2021 eligibility for the Merit-based Incentive Payment System (MIPS). Prepare now to earn a positive payment adjustment in 2023 based on your 2021 performance. Low-Volume Threshold Requirements To be eligible to participate in MIPS in 2021, you must: Bill more than $90,000 a year in allowed charges for covered professional services under the Medicare Physician Fee Schedule (PFS); AND Furnish covered professional services…
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2020 MIPS Performance Year Deadlines & More

Reminder: 2020 MIPS performance year data submission window closes March 31, 2021. For more information please visit the QPP website. Reminder: 2020 MIPS Extreme and Uncontrollable Circumstances Exception Application Deadline was extended to February 1, 2021. If you have any concerns about the effect of the COVID-19 pandemic on your performance data, including cost measures, for the 2020 performance period, submit an application now and be sure to cite COVID-19 as the reason for your application.  2020 MIPS…
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Last Week to Submit 2020 MIPS Exception for COVID-19 (Deadline is February 1, 2021)

Attention MIPS Eligible Providers: Reminder:2020 MIPS Extreme and Uncontrollable Circumstances Exception Application Deadline for COVID-19 has been Extended to February 1, 2021 For the 2020 performance year, CMS will be using the Extreme and Uncontrollable Circumstances policy to allow MIPS eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 public health emergency.  To provide additional support to clinicians…
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Alabama Mask Order Extended to March 5

Gov. Kay Ivey has extended the Alabama Safer At Home Order which requires masks to be worn when within 6 feet of someone else. Masks are also required in schools and colleges for employees and students in second grade and above. All other provisions of the health order remain the same. Visit: Alabama mask order extended to March 5 – al.com

Virtual Patient Check-In

Now Available – Enhanced Feature for PatienTXT! Utilize PatienTXT to offer contactless, virtual Patient Check-in to Patients! Send patient reminders via text Once patient confirms their appointment, confirm eligibility and update patient copay with our batch process Choose the day you would like to text the patient the check-in link and send automatically Patient will respond once they have arrived System automatically can ask for patient copay via text if you have MobilePay If patient pays,…
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2021 Physician Fee Schedule Update

On December 27, the Consolidated Appropriations Act, 2021 modified the Calendar Year (CY) 2021 Medicare Physician Fee Schedule (MPFS): Provided a 3.75% increase in MPFS payments for CY 2021 Suspended the 2% payment adjustment (sequestration) through March 31, 2021 Reinstated the 1.0 floor on the work Geographic Practice Cost Index through CY 2023 Delayed implementation of the inherent complexity add-on code for evaluation and management services (G2211) until CY 2024 CMS has recalculated the MPFS…
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CMS Adopts New eRX Standard for Part D

The Centers for Medicare & Medicaid Services (CMS) issued a final rule that requires Part D prescription drug plans support a new electronic prior authorization transaction standard for their Part D e-prescribing programs. This new electronic prior authorization standard will allow prescribers to see that a drug is subject to prior authorization, while they are prescribing it. This policy change helps ensure that there are secure electronic transactions between prescribers and Part D plan sponsors,…
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Reminder: 2020 MIPS Extreme and Uncontrollable Circumstances Exception Application Deadline for COVID-19 has been Extended to February 1, 2021

To provide additional support to clinicians during this time, CMS has extended the deadline to submit a COVID-19 related extreme and uncontrollable circumstances application for PY 2020 to Monday, February 1, 2021 at 8 p.m. ET. For the 2020 performance year, CMS will be using the Extreme and Uncontrollable Circumstances policy to allow MIPS eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0%…
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Upcoming 2020 MIPS Deadline – CMS Recommends to Submit an Exception

UPDATED: DEADLINE EXTENDED – 2020 MIPS Extreme and Uncontrollable Circumstances Exception Applications are Due February 1, 2021 For the 2020 performance year, CMS will be using the Extreme and Uncontrollable Circumstances policy to allow MIPS eligible clinicians, groups, and virtual groups to submit an application requesting reweighting of one or more MIPS performance categories to 0% due to the current COVID-19 public health emergency.  If you have any concerns about the effect of the COVID-19…
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