Medicare ICD-10 front-end testing week extended Due to the success of the first week of ICD-10 testing, Noridian has partnered with Centers for Medicare & Medicaid Services (CMS) to continue acceptance testing for EDI submitters and vendors for an indefinite period. The purpose of acceptance testing is to ensure that base system functionality and front end editing have been updated for ICD-10 and are functioning correctly. Acceptance testing will help ensure you are ready for the October 2014 implementation of ICD-10. The California Medical Association (CMA) encourages all direct EDI submitters and vendors to test with Noridian. ... March 19, 2014 Medicare ICD-10, Medicare, Insurance/Reimbursement, Noridian 0 0 Comment Read More »
House-passed SGR repeal with mandate penalty delay is DOA In a 238-181 vote, the U.S. House of Representatives today passed HR 4015, a bill to repeal the Medicare sustainable growth rate (SGR) and put in place a replacement payment system with an amendment offered by House Republican leaders that would pay for the repeal through a five-year delay of the Affordable Care act's individual mandate penalty. Though cheered by House Republicans, the legislation is viewed as "dead on arrival" by policy analysts and health care providers, as its defeat in the U.S. Senate is a near certainty. The move ... March 17, 2014 Medicare Insurance/Reimbursement, Advocacy, Medicare 0 0 Comment Read More »
Medi-Cal offers billing seminars April 22 and 23 in Anaheim Throughout the year, the Department of Health Care Services (DHCS) offers in person Medi-Cal training seminars, designed for providers and billing staff at all levels. The next two seminars are scheduled for April 22 and 23, 2014, at the Anaheim Convention Center. These seminars cover the following topics: Changes to Medi-Cal billing ICD-10 overview Basic and advanced billing issues Provider-specific billing questions Specialty programs such as California Children’s Services/Genetically Handicapped Persons Program For more information or ... March 12, 2014 Medi-Cal Billing/Coding, Medi-Cal, Practice Management, Insurance/Reimbursement 0 0 Comment Read More »
New Member Benefit: Members save 50% on DaisyBill RBRVS Calculator The California Medical Association (CMA) is pleased to announce a new valuable benefit for CMA members – 50 percent off DaisyBill’s workers' compensation RBRVS Calculator, plus a special introductory rate of 80 percent off through the end of June. That works out to $9.80 per user per month until June, then $24.50 per month thereafter. With DaisyBill’s calculator, you can quickly and easily determine the correct reimbursement amount for workers’ compensation medical services. This is time and money saving benefit will help physician practices make sense of California’s new ... March 12, 2014 General Member Benefits, Member Discounts, Workers Compensation, Insurance/Reimbursement 0 0 Comment Read More »
Practices required to use new CMS 1500 claim form beginning April 1 Earlier this year, the White House Office of Management and Budget (OMB) approved the revised Centers for Medicare & Medicaid Services (CMS) 1500 claim form (version 02/12 OMB control number 0938-1197). The CMS 1500 claim form is the required format for submitting paper claims to Medicare. As of April 1, 2014, CMS will no longer accept paper claims on the old form. Until then, CMS is accepting both the old and new forms. The revised form adds the following functionality: Indicators for differentiating between ICD-9 and ICD-10 ... March 12, 2014 Medicare Billing/Coding, Medicare, Practice Management, Insurance/Reimbursement 0 0 Comment Read More »
Deadlines loom for Medi-Cal EHR Incentive Program The deadline for providers to apply for Medi-Cal electronic health records (EHR) incentive payments the 2013 program year is March 31, 2014. After that date, the State Level Registry (SLR) will no longer accept 2013 applications. For the 2014 program year, providers who are attesting to adopting, implementing or upgrading certified EHRs can currently apply to the SLR for 2014 program year incentive payments. However, the SLR is currently unable to accept applications from providers attesting to meaningful use for 2014. The SLR will not begin accepting 2014 meaningful use ... March 7, 2014 Medi-Cal Electronic Health Record, Incentive Payments, Insurance/Reimbursement, Medi-Cal, EHR, Health Information Technology 0 0 Comment Read More »
Legislation introduced to restore Medi-Cal funding Today Assembly Budget Chair Nancy Skinner and Assembly Health Chair Richard Pan, M.D., introduced two bills, one that would restore the 10 percent Medi-Cal physician payment cut that went into effect this year and another that would extend the temporary Medi-Cal primary care rate increases called for under the Affordable Care Act (ACA). “I have sought to make the Medi-Cal program more cost-effective, transparent and accountable,” said Dr. Pan. “The legislation that we are introducing today continues this effort.” Medicaid rates in California are the lowest in the nation, while the ... February 20, 2014 Medi-Cal ACA, Insurance/Reimbursement, Medi-Cal, Medi-Cal Cuts, State Legislative Advocacy, Affordable Care Act, We Care for California 0 0 Comment Read More »
Blue Shield exchange/off-exchange plans leading to confusion among physicians The California Medical Association (CMA) has seen a large increase in calls from physicians confused about the plans/products offered by Blue Shield both on and off the exchange. As you may know, federal law requires that every plan offered in the exchange also be offered off the exchange, using the same network. This has resulted in a number of practices unknowingly seeing patients out-of-network for products that use the insurer's narrower exchange network. It has also created an additional level of confusion for physician practices when checking patients' coverage ... February 12, 2014 Managed Care Covered California, Health Benefit Exchange, Health Insurance Exchange, Insurance/Reimbursement, Managed Care, Blue Shield 0 0 Comment Read More »
Another delay for the Cal MediConnect project for dual eligibles The California Department of Health Care Services (DHCS) recently announced yet another delay for the Cal MediConnect project for dual eligibles. Implementation in Orange County has been delayed indefinitely, following a Centers for Medicare and Medicaid Services (CMS) audit of CalOptima—which is the county's only Medi-Cal managed care plan. The audit uncovered a number of serious issues that must be resolved before the duals transition can move forward in Orange County. Previously, Orange County was scheduled to begin passive enrollment on April 1, 2014. According to DHCS, implementation of Cal ... February 12, 2014 Medi-Cal, Medicare Medi-Cal, Medicare, Dual Eligible, Insurance/Reimbursement 0 0 Comment Read More »
DHCS pays over $100 million to primary care physicians in initial retroactive Medi-Cal rate increase payment The Department of Health Care Services (DHCS) has now made several retroactive interim payments to primary care physicians who have attested to their eligibility for the rate increases called for under the Affordable Care Act (ACA). These primary care payment increases have been put in place by the federal government in an effort to recruit more primary care physicians to treat low-income patients who will be newly eligible for health coverage in 2014. Although under the ACA the rate increases took effect on January 1, 2013, DHCS had been waiting ... February 7, 2014 Medi-Cal Affordable Care Act, Insurance/Reimbursement, Medi-Cal, ACA 0 0 Comment Read More »
