Medi-Cal to use ICD-10 crosswalk for claims payment The California Department of Health Care Services (DHCS) did not convert from ICD-9 to the ICD-10 coding system by the federally mandated October 1, 2015, conversion date. DHCS has received approval from the Centers for Medicare and Medicaid Services to take incoming claims coded with ICD-10 codes and convert them back to ICD-9 using a crosswalk in order to calculate payments. DHCS reports the crosswalk is a temporary workaround until the department is able to transition to a new claims processing system. The California Medical Association (CMA) has requested that DHCS ... October 14, 2015 Medi-Cal DHCS, ICD-10, Medi-Cal, Department of Health Care Services 0 0 Comment Read More »
Noridian Medicare announces web-based provider enrollment workshops Noridian, the Medicare Administrative Contractor for California, announced that it will offer web-based workshops focusing on provider enrollment. These webinars are intended for the Part B provider using the online Provider Enrollment, Chain and Ownership System (PECOS) to change enrollment information, track revalidation or set up a sole proprietorship. The Internet-based PECOS process can be used in lieu of the Medicare enrollment application (i.e., paper form CMS-855). The advantages of PECOS are: Faster than paper-based enrollment (45-day processing time in most cases, vs. 60 days for paper) ... October 14, 2015 Medicare Noridian, Medicare, PECOS, Provider Enrollment Chain and Ownership System 0 0 Comment Read More »
Like it or not, ICD-10 is here - what practices need to know After much debate and years of delay, the October 1, 2015, implementation date for ICD-10 has finally arrived. While concerns remain as to the preparedness of physician practices for this monumental transition, the full impact of the ICD-10 conversion will likely not be felt for several weeks or until the first payment remittances are received. CMA resources As the implementation unfolds, there likely will be unanticipated hurdles that need to be overcome. The California Medical Association (CMA) has a number of resources to help members prepare. CMA ICD-10 ... October 14, 2015 General, Managed Care ICD-10, Practice Resources 0 0 Comment Read More »
CONVERGANCE: Building the Healthcare Workforce in the Inland Empire Attendees and media turned out in force for the Inland Southern California Convergence Group’s press event and reception on September 23 at Inland Empire Health Plan (IEHP) in Rancho Cucamonga. Presenters announced developments with Convergence, a unique collaboration among health industry experts, corporate leaders, providers and higher education to overcome barriers and improve the much needed pipeline of health professionals for the Inland Empire. Convergence Chairpersons Devorah Lieberman, Ph.D., University of La Verne President, and Deborah Freund, Ph.D., immediate past president of Claremont Graduate University, were joined by IEHP CEO ... October 6, 2015 General Convergence, healthcare workforce, Inland Southern California Convergence 0 0 Comment Read More »
Space still available at IMQ medical staff conference There are still a few spots left to attend the California Medical Association's Institute for Medical Quality (IMQ) 2015 Medical Staff Conference on October 29 in Los Angeles. The one-day event will provide physicians with the information, solutions and best practices that they need to successfully lead their medical staffs. The conference will tackle some of the difficult decisions facing medical staffs, such as granting privileges for aging physicians and those reentering practice after an absence. Through examples and discussion, the faculty will demonstrate how, by maintaining a focus ... October 2, 2015 General Institute for Medical Quality, Medical Staff, Hospital Medical Staff, IMQ 0 0 Comment Read More »
CMA Capitol Insight: Sept. 28, 2015 CMA Capitol Insight is a biweekly column by veteran journalist Anthony York, reporting on the inner workings of the state Legislature. Shaping the ballot The legislature may be in recess, but the political fights in Sacramento continue. With lawmakers gone for the year, attention is turning to the ballot, where spillover from the legislative session, and some infighting among Democrats, are beginning to emerge. The big question will be what, if anything, to do about taxes. In the last couple of weeks, we have seen two different versions of proposals to extend ... October 2, 2015 General CMA Capitol Insight, Tax, Anthony York, Election 0 0 Comment Read More »
ICD-10 Has Arrived! The ICD-10 implementation date has finally arrived. While concerns remain as to the preparedness of physician practices, vendors and payors for this monumental transition, the full impact of the ICD-10 conversion will likely not be felt for several weeks or until the first payment remittances are received. In an effort to help practices navigate the transition, CMA has just published an FAQ titled, “Surviving ICD-10: An FAQ for physician practices." This resource is available free for CMA members (it is not accessible at all for non-members). We will be ... October 1, 2015 Managed Care, Medi-Cal, Medicare ICD-10 0 0 Comment Read More »
Audit says state lab oversight is duplicative, should be eliminated On September 10, the California Bureau of State Audits issued a report that said the California Department of Public Health's (CDPH) Laboratory Field Services should be eliminated because it duplicates a service provided by the Centers for Medicare and Medicaid Services (CMS). CMS regulates all human laboratory testing in the U.S. through the Clinical Laboratory Improvement Amendments system. In California, labs must also be licensed through the state's Laboratory Field Services. This dual regulatory system is a huge burden on physician-operated labs in our state, and the California Medical Association ... September 28, 2015 General Clinical Laboratories 0 0 Comment Read More »
AMA town hall to discuss meaningful use concerns On Tuesday, September 29, the American Medical Association (AMA) will hold a virtual town hall meeting to give physicians a chance to discuss concerns with poorly designed electronic health record (EHR) systems and the impact they have on patient care and government mandates. The U.S. government has spent some $25 billion on the program to promote a digital health infrastructure based on the power of EHRs to enhance patient care, improve productivity, and reduce costs. While 80 percent of physicians have adopted EHR technology, many physicians believe that the current ... September 28, 2015 General EHR, Electronic Health Record, Meaningful Use, American Medical Association 0 0 Comment Read More »
AMA offers resources to help physicians evaluate new payment model contracts The American Medical Association (AMA) has developed new resources that explain the key issues physicians should understand when evaluating payor contracts based on new payment models, such as pay-for-performance and bundled or episode-based payment. Each of these documents outlines important considerations, including a summary of the payment model; contractual issues, including model language; and guidelines for evaluating risk and success. To access the documents, click here. September 23, 2015 General Payor Contracting, Payor Contract Analysis 0 0 Comment Read More »
