|
 To learn more about Pfizer Oncology Together, please click here.
4 Weeks of Michigan Payer Updates which started October 21stBlue Cross, Michigan Medicaid, and WPS Medicare webinars have already taken place - If you missed them, you can download the handouts and listen to the recordings
• Registration is OPEN for the remaining program with Priority Health - Register TODAY! Details >
Genentech BioOncology Access SolutionsDetails >
November 2020Updates that may be of interest to oncology Including:
• Multiple MolDX Policy Changes along with updates on radoopharmaceuticals and Immune Globulins 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, 2021 Proposed Rules, and 2020 Final CMS Rules Details >Check out these upcoming training events:• Part B Rejections and Denials
• Part B Claim Review
• E/M Office and Outpatient Services for 2021 Q and A Teleconferences
•
PLUS new on-demand educational opportunity on the 3 Day/1Day Payment Window Part B Details >
Recent Oncology Related Articles• Trump Administration Announces Historically Low Premiums and New Insulin Benefit as Medicare Open Enrollment Begins
• Laboratories: Pay Your CLIA Certification Fees Online
• Laboratory Quick Start Guide for CLIA Certification
• Provider Compliance Tips — Revised
• 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 articles on:• Audit Hot Spots and the CARES Act
• Auditors Are Ramping Up Operations Details >
Recent Oncology Related News• Prior authorization requests for outpatient CAR-T therapy drugs for Medicare Advantage members.
• Injections minimum fee schedule for 11/1/20 added to web-DENIS
• UPDATE: Medicare Part A and B 277CA rejections – Action Required
• Coverage for autologous tandem transplant for Hodgkin lymphoma removed effective January 2021
• AllianceRx Walgreens Prime specialty pharmacy program starts Jan. 1 for certain Blue Cross PPO
• BCBSM/BCN: New Secure Provider Website in 2021
• Starting Dec. 1, some drugs covered under the medical benefit will require authorization for Blue Cross and Blue Shield Federal Employee
• IVIG dosing strategy is changing for the Medicare Part B medical specialty drug program, starting Dec. 7
• During the COVID-19 emergency, we're extending global referrals through at least Dec. 31 for BCN HMO members 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
• System is applying denied authorization to claim in error
• Authorizations coming through are causing claim denials, multiple RHC Issues Details >
Last Reviewed/Updated 11/4/2020Review the reported payer reimbursement issues including clarifications and issues with WPS Medicare, BCBSM, BCN, Medicare Plus Blue, and UHC. 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 >• 2021 commercial fee schedules now available
• Jan.1, 2021 Commercial and Medicare formulary changes
• Learn More - Attend the Priority Health Webinar on November 19th
• Non-Medicare outpatient services moving to 90-day window for retro authorizations Details >ATTENTION MSHO MEMBERS - IMPORTANT UPDATE• Copay Accumulator Program Begins January 1, 2021 Details >Featuring this month: UnitedHealthcareTidbits regarding:
• Network Bulletin PDF Format Retiring
• Prior Authorization and Notification Requirement Updates
• Leuprolide Acetate Requires Prior Authorization Details >
Violation of the False Claims Act by knowingly charging Medicare for services rendered by nurse practitioners wihtout meeting "Incident To" requrements. Details >
November 2020, Frequently Asked Questions• Medicare co-pay for Outpatient hospital services are capped at the inpatient deductible ($1,408 for 2020)
• How to bill telephone services
• Billing for non-face-to-face physician time for office visits in 2021 Details > |
|
