New Articles

  1. United Healthcare removes preauthorization requirements for many services

    Using a phased-in approach, United Healthcare has removed reauthorization requirements from many plans for many different services. Please see this listing from United Healthcare: https://www.uhcprovider.com/en/resource-library/news/2023/...
  2. New Place of Service (POS) code 27

    The Centers for Medicare and Medicaid Services (CMS) has created a new place of service code 27 to use when services are provided in a non-permanent location, effective October 1, 2023. If you provide services to patients where the locatio...
  3. Updated Advanced Beneficiary Notice (ABN) form

    Were you aware that the Centers for Medicare & Medicaid Services (CMS) updated the Advanced Beneficiary Notice (ABN) form? The new form CMS-R-131 is mandatory as of 6/30/2023. Any ABN signed after 6/30/2023 that is on the previous form will b...
  4. First annual report on the No Surprises Act

    Curious about how the first year of the No Surprises Act has gone and what impact it has had on the healthcare market? Check out this article from the American Hospital Association. https://www.aha.org/news/headline/2023-07-07-hhs-rel...
  5. Submitting DME claims that are subject to $35 out of pocket cap

    Beginning July 1, 2023, Medicare will begin limiting the patient's out-of-pocket cost to $35 for a month's supply of insulin used in an insulin pump. Medicare is advising to refrain from billing for supplies of insulin for July 2023 forw...
  6. Oxford Health Plan phases out paper checks

    According to United Healthcare (parent company of Oxford Health Plan), they will discontinue the issuance of paper checks for claims payment for "many... Oxford plans in Connecticut, New Jersey, and New York" sometime in late Q2 2023. Your c...
  7. UHC issues new ID cards April 2023

    According to United Healthcare (UHC), a new wave of members will be transitioned to their new commercial claims processing system. All transition members will receive a new ID card beginning April 1, 2023. The members will have a new group numb...
  8. End of Public Health Emergency (PHE) - What do I need to know?

    CMS (Centers for Medicare and Medicaid Services) has published an article and fact sheet explaining the impact on providers and patients if the PHE expires in May 2023 as scheduled. The fact sheet covers critical elements such as vaccine cov...
  9. NDC updates effective July 1, 2023

    Are you aware of the NDC changes coming from CMS effective July 1, 2023? Check out the article below for more details. The impacted codes include: NCD 20.4 - Implantable Cardiac Defibrillators (ICDs) NCD 20.7 - Percutaneous Translum...
  10. Medicare claim processing error - January 2023

    According to Palmetto GBA, (CMS- Centers for Medicare & Medicaid Services MAC Processor), claims with dates of service January 1, 2023, and forward billed with a combination of POS codes 19, 22, 23, or 62 with CPTs 99221, 99222, 99223, 99231, 99232...