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Meeting Reformatted to Virtual EventDetails >
August 2020Including:
• Multiple MolDX Policy Changes, Addition of Reblozyl, Immune Globulins Updated Details >Part A, Part B and Part A/B NewsIncludes articles that may be of interest to oncology released in the past 2 weeks
• Also, Medicare Hot Links to Fee Schedules and 2020 Final CMS Rules Details >Check out these upcoming training events:• Medicare 3 Day/1 Day Payment Window
• Medicare Advantage - Understanding the Plan Types
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PLUS many additional on-demand educational opportunities including E & M training opportunities! Details >
Recent Oncology Related Articles• Electronic Prescribing of Controlled Substances in Medicare Part D: Request for Information
• MACs Resume Medical Review on a Post-Payment Basis
• Renewed ABN: Deadline Extended to January 1
• CMS and CDC Announce Provider Reimbursement Available for Counseling Patients to Self-Isolate at Time of COVID-19 Testing
• Quarterly Provider Compliance Newsletter, Volume 10, Issue 4
• Physician Compare Preview Period Open through August 20
• ICD-10-CM Diagnosis Codes: FY 2021
• Recent LearnResource & MedLearn Matters Articles Details >Region 1 - Performant Recovery, Inc.No New Oncology Related Issues Since March:
• Latest under review at that time included: - Bone Marrow Transplants, ESAs for Cancer Patients, and Therapeutic Injections Details >This edition includes an article on:• CMS Opens Door to G0463 Billing for Remote Physician Visits
• A View into Proposed Medicare PFS and Policy Changes for 2021 Details >
Recent Oncology Related News• IVIG dosing strategy is changing for the Medicare Part B medical specialty drug program, starting Dec. 7
• Some providers are being invited to participate in an online research community
• Commercial payer claims edit
• TecartusTM will require authorization for commercial members effective August and September 2020
• Blue Cross and BCN further extend authorization end dates on select medical and pharmacy benefit.
• During the COVID-19 emergency, we're extending global referrals through at least Dec. 31 for BCN HMOSM members
• Review August Edition of the BCBSM Record for the Second Quarter HCPCS Changes!
• Review August Edition of the BCBSM Record for MANY Oncology Specific Medical Benefit Policy Changes!
• Medicare Plus Blue expands prior authorization program to include genetic and molecular testing
• Medical specialty drug prior authorization lists are changing in September for BCN HMO, Medicare Plus Blue PPO and BCN Advantage members
• Effective Oct. 1, Nivestym® and Zarxio® are the preferred filgrastim products for all Blue Cross and BCN commercial and Medicare Advantage members
• Medicare Part B medical specialty drug prior authorization list is changing Aug. 21 and Sept. 28 Details >Publications• The Record
• BCN Provider News
• Newly Released Blues Brief! Details >Monthly Status ReportMany updates/corrections. Listed below is a sampling of what you will find:
• 835 Recoupment isn't reflected on voucher
• 835 CARC 210 sanction amount is incorrect
• System is applying denied authorization to claim in error
• RHC claim issues
• And more Details >
Last Reviewed/Updated 8/18/2020Review the reported payer reimbursement issues including BCBSM UMBRT denials and Mvasi additional coverage request approved. Details >Recent Oncology Related NewsMedicaid Updates Include:
• COA Files Comments on Medicaid Drug Rebate Rule
• MSA Bulletin Updates
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >• Non-Medicare outpatient services moving to 90-day window for retro authorizations
• Coming August 31: ePA for pharmacy
• Register today for our new authorization tool webinar training
• Billing reminders for providers treating Qualified Medicare Beneficiaries
• Medicaid Health plans transitioning to Preferred Drug List (PDL) Details >
August 2020, Frequently Asked Questions• PHE was extended, how long can we bill Medicare for telehealth for patients at home?
• Administration code hierarchy
• Aetna POS requirement for telehealth
• MUE Denials Details > |
