Anthem Blue Cross to move eligibility, benefits and claim status inquiry functions to Availity Web Portal in March Anthem Blue Cross has advised that effective March 14, 2014, patient eligibility, benefits and claim status inquiry functions will transition from its ProviderAccess portal to the Availity web portal. As of that date, practices will only be able to access this information via the Availity web portal. While BlueCard eligibility, benefits and claim status functions will also transition to Availity, the BlueCard Advisor function that allows practices to determine which Blues plan to send the claim to will continue to be available on the ProviderAccess portal. In order to access information ... February 5, 2014 General BlueCard, Managed Care, Anthem Blue Cross, Insurance/Reimbursement 0 0 Comment Read More »
Surviving the Second Month of Covered California As of January 15, Covered California reports that more than 625,000 individuals have enrolled in exchange plans. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff know what to expect. To help answer some of the more common questions, the California Medical Association (CMA) offers this second tip sheet to help physicians survive the second month of Covered California. Available to members only. February 4, 2014 General Health Insurance Exchange, Practice Resources, Covered California 0 0 Comment Read More »
Los Angeles Daily News publishes op-ed by CMA president The Los Angeles Daily News yesterday published an op-ed by Richard Thorp, M.D., president of the California Medical Association (CMA). In case you missed it, the piece, "Trial lawyer measure would undermine the promise of Covered California," can be read here. January 31, 2014 General MICRA 0 0 Comment Read More »
MICRA patient brochure now available in Spanish The California Medical Association (CMA)-led coalition working to protect California’s landmark Medical Injury Compensation Reform Act (MICRA) has published a patient education brochure to help inform California voters about the ballot initiative being pushed by trial attorneys. The ballot measure would impact access to care for patients, causing community health centers and physician offices across the state to close. The pamphlet, available in English and Spanish, can be distributed to patients during office visits and will be accompanied by talking points for physicians so you can have meaningful conversations with ... January 31, 2014 General MICRA, Patient Education, Professional Liability 0 0 Comment Read More »
CMS warns of fraudulent DME suppliers The Centers for Medicare and Medicaid Services (CMS) sent a letter this week to physicians asking them to pay attention to solicitations they receive from durable medical equipment (DME) suppliers and report any suspicious activity to the U.S. Department of Health and Human Services' Office of the Inspector General (OIG). According to CMS, most fraudulent solicitations are obvious in their wording or their attempts to get physicians to approve unnecessary medical equipment and supplies. These marketing schemes by DME suppliers can include: •Unsolicited orders for medical equipment or supplies, often with wording ... January 31, 2014 General Centers for Medicare and Medicaid Services, CMS, Fraud and Abuse, Quality of Care 0 0 Comment Read More »
Senate pro Tem considering MICRA legislation As both sides inch closer to a seemingly inevitable ballot war over California’s Medical Injury Compensation Reform Act (MICRA), a key figure in the legislature may be looking to step in before voters can weigh in on the issue. Earlier this month, Darrell Steinberg, president pro tem of the Senate, said that he was “thinking” about carrying a MICRA-related bill during the 2014 cycle. While Steinberg has previously stated that he wanted to see negotiations take place to avoid a costly ballot war between trial lawyers and physicians, the ... January 27, 2014 General Medical Liability, MICRA, Professional Liability 0 0 Comment Read More »
Professionalism courses for physicians and pharmacists coming in February The Institute for Medical Quality (IMQ) Professionalism Program for Physicians has been scheduled for February 22-23 at the DoubleTree Hotel LAX-El Segundo in Los Angeles. This program addresses both the legal and ethical dimensions of the practice of medicine in California, and introduces participants to a range of resources to address present or future problems. The course consists of a pre-course assessment, a two-day ethics course and a series of longitudinal assessments to track participants’ progress. To ensure interactive learning, each program is limited to 12 participants. IMQ is also offering ... January 27, 2014 General IMG, Institute for Medical Quality, Education and Events 0 0 Comment Read More »
CMA develops simple tool to identify physician participation status in exchange plans On January 1, 2014, Covered California began providing health coverage to more 500,000 patients statewide. With that figure expected to grow by the end of the 2014 open enrollment period, it is critical that physicians and their staff have a clear understanding of their exchange plan participation status so they can communicate this information to patients before scheduling. It’s equally as important that practices understand the reimbursement rates and other terms associated with the plans with which they are contracted. Even if you did not intentionally contract with any exchange ... January 27, 2014 General Covered California, Health Benefit Exchange, Insurance/Reimbursement, Health Care Reform 0 0 Comment Read More »
CMS to conduct ICD-10 testing in March On October 1, 2014, the ICD-9 code sets used to report medical diagnoses and inpatient procedures will be replaced by ICD-10 code sets. To help physicians prepare for this transition, the Centers for Medicare & Medicaid Services (CMS) has announced a limited national testing week for current direct submitters (providers and clearinghouses) from March 3 - 7, 2014. This testing week will give trading partners access to the Medicare Administrative Contractors (MACs) and Common Electronic Data Interchange (CEDI) for testing with real-time help desk support. While participants will not be able ... January 27, 2014 General CMS, ICD-10, Insurance/Reimbursement 0 0 Comment Read More »
Legislative Leadership Conference coming April 22 Mark your 2014 calendars now for the 40th annual California Medical Association (CMA) Legislative Leadership Conference. The conference will take place at the Sheraton Grand Hotel in Sacramento, just three blocks from the State Capitol and across the street from CMA headquarters. This is a unique event for California physicians and is free of charge to all CMA members. Plan to join more than 400 physicians, medical students and CMA Alliance members who will be coming to Sacramento to lobby their legislative leaders as champions for medicine and their patients. Prior ... January 27, 2014 General Legislative Leadership Day, State Legislation, Advocacy 0 0 Comment Read More »
