Reimbursement

One of the most frustrating issues facing members of the Society is overdue payments, especially rejections for approved drugs in approved tumor types by approved methods. These issues are being addressed head on through laision committees at the carrier level. This allows us to combine the efforts of our membership to pinpoint and prioritize issues to be addressed by insurance companies. Our main goal is to get insurance companies to correct system problems so future claims will be paid on first submission.

Please keep in mind that MSHO cannot directly submit status claims for our member offices. The liaison process is not to get a single claim paid, but to prevent system errors.

MSHO works directly with our member practices to provide a mechanism to educate and support our reimbursement personnel throughout the state. If your practice is a member of MSHO and you are involved in reimbursement, please be sure to check the MSHO event page to obtain information on the next MSHO Reimbursement Meeting.

MSHO Reimbursement meetings are held twice a year, as well as several webinars throughout the year.

AAPC

AAPC LogoAAPC is the world’s largest training and credentialing organization for the business of healthcare, with more than 175,000 members worldwide who work in medical coding, medical billing, clinical documentation improvement, medical auditing, healthcare compliance,revenue cycle management, and practice management.

Michigan Department of Health & Human Services

Michigan Department Of Health And Human Services LogoMedicaid Health Plan Pharmacy Benefit - This webpage is designed to provide easy access for members and providers looking for information on the drugs and supplies covered by Michigan Medicaid Health Plans.

Michigan Medical Billers Association

MMBA logo MMBA is a non-profit organization dedicated to the Education and Professional Advancement of Medical Billers. MMBA is best known for organizing educational seminars on medical billing and related topics to keep members abreast of industry hot topics and current issues. Speakers representing third party payers and experts from various health care fields are often asked to participate.

MSHO 2019 Physician Fee Schedule Analyzer Tool

MSHO LogoTo make analyzing the financial impact of the Medicare Physician Fee Schedule changes easier, we have created MICHIGAN specific tools. The tools incorporate the latest fee schedule released by WPS which includes the changes in the 2019 Physician Fee Schedule Final Rule.  This Excel spreadsheet will help analyze the impact of the Evaluation and Management codes as well as the Administration codes.  

Be sure to choose the correct spreadsheet for your locality (01 or 99). To determine the annual impact, you will need to input your approximate “units billed” during 2018 for each code in the yellow space provided. The tool will automatically give you the impact of the change for that specific code, as well as a grand total of all codes at the bottom of the spreadsheet based on your 2018 volume.

2019 Local 01 MSHO Physician Fee Schedule Analyzer Tool

2019 Local 99 MSHO Physician Fee Scheudle Analyzer Tool

MSHO 2019 Proposed E/M Fee Shedule Changes Analyzer Tool

MSHO LogoThis tool is intended for informational purposes only. Information provided could contain typographic errors. Tool is for reference only and is not intended to provide reimbursement or legal advice.

All Current Procedural Terminology (CPT) codes and descriptors are copyrighted by the American Medical Association. All Rights Reserved. No fee schedules, basic units, relative values, or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.

Final E/M 2019 Proposed Fee Schedule Analyzer

Practice Management Institute (PMI)

Pmi Logo Med ResPractice Management Institute® works with health care systems, hospitals, medical societies, provider organizations, and learning institutions nationwide to provide training for administrative staff working in outpatient facilities. Classes address the latest updates relevant to medical office coding, billing, operations and compliance. Since 1983, thousands of medical office professionals have attended PMI training; nearly 20,000 have earned one or more PMI certifications in their area(s) of expertise.