Regular Medicare revalidations, which were mandated in the Affordable Care Act and commenced in March 2016 after the Centers for Medicare and Medicaid Services (CMS) completed their first widespread validation of all Medicare providers, are in full-swing. But the process is not without its challenges. Read more
While the debate over out-of-network balance billing rages on, one way to minimize the impact would be enter into or maintain contracts with payers. For those payers that you do decide to go or remain in-network with, here are a few tips for navigating payer contracts. Read more
Physicians practicing as hospitalists will soon be able to self-designate with Medicare using the new specialty code C6 when they enroll or update their enrollment. Read more
When the Centers for Medicare and Medicaid Services (CMS) recently released the final rule of the Medicare Physician Fee Schedule (MPFS), this was the first year in a while that industry insiders weren’t scouring for guidelines related to the Physician Quality Reporting System or the Value-Based Payment Modifier. With those programs being replaced through the MACRA Quality Payment Program, the MPFS dealt primarily with payment policies. Read more
Effective July 1, 2016, Anthem will start requiring credentialing for several additional practitioner and health delivery organization (HDO) provider types. Read more
New enrollment screening criteria under the Affordable Care Act requires regular revalidations for all providers enrolled in the Medicare program. The Centers for Medicare and Medicaid Services has begun notifying providers of round two revalidation deadlines. Read more
In late February, the Center for Medicare and Medicaid Services proposed several new regulations to further screen entities and individuals who pose a risk to the Medicare program. Read more
New enrollment screening criteria under the Affordable Care Act requires regular revalidations for all providers enrolled in the Medicare and Medicaid programs. Indiana providers face a March 26, 2016, deadline for the first round of revalidations with the Indiana Health Coverage Programs. Read more
Using several new strategies, including tools provided by the Affordable Care Act (ACA), the Centers for Medicare and Medicaid Services (CMS) is strengthening its screening process for providers and suppliers enrolling in the Medicare program. Read more
In December 2015, Medicare updated their PECOS Frequently Asked Questions Fact Sheet to help make the Medicare enrollment process more transparent for providers. Whether you already are a PECOS user or are wondering why you should be, here are a few other things to know about PECOS. Read more
