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AstraZeneca Prescription Savings ProgramDetails >
September 2020Including:
• Multiple MolDX Policy Changes, Bisphosphonate Drug Therapy Update 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• CMS Extends AUC Program Educational + Operational Testing Period to 2021
• COVID-19: Waive Cost-Sharing for These HCPCS Codes
• Physician Fee Schedule Listening Session: Audio Recording and Transcript
• Reduce Provider Burden: Electronic Medical Documentation Interoperability Pilot Program
• Medicare Secondary Payer (MSP) Provision
• Renewed ABN: Deadline Extended to January 1
• 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:• Medicare Audits Target COVID-19-Enhanced Reimbursement Rates and Remote Patient Monitoring
• Perils of Not Reading Payer Contracts Details >
Recent Oncology Related News• AllianceRx Walgreens Prime specialty pharmacy program starts Jan. 1 for certain Blue Cross PPO commercial members
• McLaren Erroneous Rejection
• IVIG dosing strategy is changing for the Medicare Part B medical specialty drug program, starting Dec. 7
• 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
• 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
• Blues Brief for Oncology Providers 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
• NEW - System is applying denied authorization to claim in error
• Authorizations coming through are causing claim denials
• RHC claim issues
• NEW - CMS procedure cods are denying incorrectly
• And more Details >
Last Reviewed/Updated 9/2/2020Review the reported payer reimbursement issues including an update on the BCBSM UMBRT denials. Details >Recent Oncology Related NewsMedicaid Updates Include:
• MSA Bulletin Updates
• Biller "B" Aware Notices Details >• Aetna OfficeLink Updates
• Cigna
• HAP
• Humana YourPractice
• UHC Network Bulletin
• UHC Medical Policy Update
Details >• We're reviewing the 2021 changes to E/M codes.
• Non-Medicare outpatient services moving to 90-day window for retro authorizations
• Register today for our new authorization tool webinar training
• Medicaid Health plans transitioning to Preferred Drug List (PDL) Details >Featuring this month: HAPTidbits regarding:
• Online Prior Auths
• Procedure Reference List
• Claims Access Online Details >
September 2020, Frequently Asked Questions• Billing for Coumadin Management
• 2021 Conversion Factor Decrease
• Proposed 2021 Drug Reimbursement Changes
• The Future of Reimbursement for Telehealth in the Home Setting Details > |
