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New Remittance Advice Codes for PQRS Claims-Based Reporting

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Below is an email notification from CMS regarding the new claims-based PQRS remittance codes effective July 1, 2014: Are you a PQRS eligible professional participating in claims-based reporting this year? Effective July 1, 2014, look for the updated Remittance Advice Remark Codes (RARCs) for PQRS claims-based reporting that went into effect on April 1, 2014. CMS has released a new FAQ with information about the updated codes. What are the New Codes and What Do They…
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Blue Cross Value Based Program June 30 Deadline PM Software Diagnosis Code Exercise

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Blue Cross 2014 Primary Care Value Based Program **June 30 Deadline PM Software Diagnosis Code Exercise** Blue Cross of Alabama’s 2014 Primary Care Value-Based Payment Program is based on three performance categories: Efficiency of Care, Administrative and Effectiveness of Care.  One element of the Administrative category is performing a Practice Management (PM) Software Diagnosis Code Exercise by June 30, 2014 per Tax ID. This exercise involves: Setting up test patient account(s) in PM as defined…
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Medicaid – Patient 1st Changes June 1, 2014

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Below is a notice of changes made to Patient 1st program effective June 1st.  Providers treating or referring patients enrolled in Patient 1st must fax a Group/Clinic Patient 1st Update Form to Medicaid Provider Enrollment at 334-215-4298.  Claims will deny if providers are not enrolled.   Change to use of Group NPI and Non-enrolled Physicians in Patient 1st Program April 29, 2014 TO:     All Physicians and Enrolled Patient 1st Providers   The Alabama Medicaid Agency made…
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Medicaid Correction to CO for EOB Codes (3323, 3324)

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***IMPORTANT UPDATE for Medicaid EOB Codes (3323, 3324)*** From November 22, 2013 until May 20th, 2014 the new EOB codes 3323 & 3324 were being electronically submitted by Medicaid to providers in the electronic remittance file as the adjustment code: CO45 in error which automatically adjusted-off the rejected claim. On May 20th, for the June 6, 2014 check write, Medicaid corrected the issue and began sending CO4 (the procedure code is inconsistent with the modifier…
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Does your clinic file claims to Viva? If so, do you have more rejections for this carrier than others?

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Viva is one the of the top 5 commercial carriers that MediSYS clients file to through Emdeon. The payer claim rejection rate is higher on Viva than any of the others. WHY is this and how can you get a jump on correct filing with Viva? Often clients leave off the two digit suffix that is required on the policy number. Each patient that is covered under Viva has this suffix. For a family plan,…
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MediSYS ‘ICD-10 Validated’ by Blue Cross Blue Shield of Alabama

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MediSYS is ‘ICD-10 Readiness Validated’ by Blue Cross Blue Shield of Alabama as released in the recent update to their Vendor Functionality Matrix.  With the massive changes that will occur as a result of ICD10, regardless of the deadline delay, MediSYS will stay-the-course to be ready.  Currently, MediSYS is testing or has completed testing with all payers who are in the testing phase for ICD-10.  MediSYS successfully tested with Alabama Medicaid in 2013.  In addition,…
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Bill is passed that delays ICD10 implementation until 2015

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*Update* On April 1, 2014, the “Protecting Access to Medicare Act of 2014” bill was signed into law. This legislation delayed ICD-10 implementation which may not occur prior to October 1, 2015 as well as continuing the 0.5% update to Medicare physician payments through Dec. 31, 2014 and providing a 0% freeze to payments Jan. 1-March 31, 2015. ___________________________________________________________ On March 31, 2014, the US Senate passed a bill to delay the planned ICD-10 implementation…
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Aetna to eliminate paper checks

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Aetna to eliminate paper checks Aetna is moving to electronic funds transfer (EFT) payments and eliminating payments via paper checks. The insurance company recently announced it will require physicians to receive payments and explanation of benefits statements electronically beginning in a few months. Aetna’s plan to go paperless coincides with the federal requirement that health plans must offer EFT payments in a standardized format and utilize new “operating rules” for both EFT and electronic remittance…
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Final Day to attest is March 31st!

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Remember, the FINAL DAY to attest for the Medicare & Medicaid Meaningful Use Incentives for the year 2013 is Monday, March 31 at 11:00pm CST. CMS strongly encourages you to attest ASAP! REMINDER: Make sure and check that you received confirmation from CMS that your attestation is successfully COMPLETED before March 31st. If you did not receive confirmation and your attestation status is pending, waiting on information, or otherwise, please make any corrections/additions prior to…
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Attention MediSYS Clients: ICD10 Training Challenge

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Attention MediSYS Clients: MediSYS ICD-10 Training Challenge- Sign up today! We will be sending a weekly email beginning the week of March 3rd and going through July. See the rules below. Last day to register is Monday March 3rd. Note: If you already registered for the ICD-10 Challenge at one of the regional session, there is no need to register again. If you did not attend any of the regional sessions but would like to register…
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CMS eHealth Programs Interactive Timeline

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CMS has made available a helpful tool to display eHealth Programs dates and timelines.  This interactive tool can be filtered by program category, date, by physician, hospital or both.  The program category filters include EHR Reporting – Meaningful Use, Quality Measurement, Administrative Simplification and Patient Outcomes/Patient Reform. http://cms.gov/apps/interactive-timeline/ The legend below the graphical timeline by date, associates the milestone with resource links for attestation, specifications, etc. Note that the NEW Medicare deadline to attest to meaningful…
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CMS Delays Stage 3 Meaningful Use

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CMS has delayed Stage 3 Meaningful Use of Electronic Health Records until 2017.  Originally to begin in 2016, Stage 3 requirements are expected to be even tougher.  Stage 3 would begin in 2017 for providers who have satisfied Stage 2 for at least 2 years.  The delay would allow CMS to evaluate Stage 2 while finalizing Stage 3 requirements. Stage 1 Meaningful Use incentives for certified Electronic Health Records began in 2011 and many providers…
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