Insurance News:

NYSCA News: Legislative Update - Budget Worker’s Compensation Reform

by NYSCA Legislative Committee | 4/17/2017 10:47:14 AM

The final NYS budget passed both houses late last Sunday night. Despite no significant workers’ compensation reforms being included in the original proposed budget bills, there were many last minute negotiations regarding worker’s compensation reform that we followed closely. 

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Insurance News:

2017 MAC Satisfaction Indicator (MSI) - JK Now Available!!

by CMS.gov | 4/17/2017 10:45:36 AM

CMS is once again conducting their annual survey of Medicare Administrative Contractors (MAC) performance and requesting feedback from the provider community we serve through the MAC Satisfaction Indicator (MSI).

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Insurance News:

FYI: When Will CMS Notify Clinicians about MIPS Eligibility

by CMS.gov | 3/31/2017 8:58:40 AM

The Centers for Medicare and Medicaid Services (CMS) has yet to release critical 2017 Merit-Based Incentive Payment System (MIPS) eligibility information to allow providers to determine if they fall under the low-volume threshold exemption.

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Insurance News:

Medicare: New ABN to be Used in 60 Days

by CMS.gov | 3/31/2017 8:51:43 AM

The Centers for Medicare and Medicaid Services (CMS) announced on March 28 that the Advance Beneficiary Notice of Noncoverage (ABN) Form and instructions were approved for renewal. The effective date for use of the updated ABN form is May 27.

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Insurance News:

CMS Extends Deadline for 2016 PQRS EHR Submission

by Centers for Medicare & Medicaid Services (CMS) | 2/6/2017 1:46:17 PM

CMS is extending the submission deadline until March 13, 2017 for 2016 Quality Reporting Document Architecture (QRDA) data submission for the EHR reporting mechanism.

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Insurance News:

Recoupment Audits

by Joseph Merckling, DC | 2/6/2017 9:51:08 AM

It has come to the attention of NYSCA that some members have received requests from insurance companies for over-payment recoupment audits involving claims that were processed several years ago.

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Insurance News:

Filing Paper Claims from NGS Medicare & CMS

by NYSCA Insurance Committee | 1/31/2017 12:01:50 PM

An update from the NYSCA Medicare Committee:  For those who are submitting  paper claims for treatment rendered to Medicare patients please read the following.

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Insurance News:

NY Workers' Compensation Update

by NYSCA Workers' Comp Committee | 1/23/2017 12:26:37 PM

As Governor Cuomo delivered his State of the State addresses, one of the issues again highlighted was workers compensation reform. As you know, this impacts your patients and your practice. The NYSCA, working with the NY Chiropractic Council, has recently met with the WCB to welcome its new Chair and discuss the issues facing the chiropractic patient. NYSCA's WC Committee will continue to address the issues we face.

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Insurance News:

Optum Health / UnitedHealthcare Update

by NYSCA Insurance Committee | 1/17/2017 9:59:30 AM

As some of you are aware, there are some changes coming to the Optum Health / UnitedHealthcare program which may impact your practice. The NYSCA Insurance Committee has responded to dozens of calls to assist our members in understanding these impending changes. 

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Insurance News:

Inappropriate Billing of Qualified Medicare Beneficiaries MLN Matters®

by Medicare Learning Network® Publications & Multimedia | 12/9/2016 1:18:13 PM

Federal law bars Medicare providers from charging individuals enrolled in the Qualified Medicare Beneficiary Program (QMB) for Medicare Part A and B deductibles, coinsurances, or copays.

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Insurance News:

Social Security Number Removal Initiative

by CMS.gov | 10/4/2016 8:41:28 AM

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number on new Medicare cards.

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Insurance News:

Social Security Number Removal Initiative

by CMS.gov | 10/4/2016 8:37:04 AM

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. A new randomly generated Medicare Beneficiary Identifier (MBI) will replace the SSN-based Health Insurance Claim Number on new Medicare cards.

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Insurance News:

ICD10 Coding Update

by Dr. Evan Gwilliam and Chiro-Code | 10/2/2016 10:46:42 PM

There are thousands of code changes going into effect on October 1.  Here is a list of the 70 or so that are most relevant to chiropractors.

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Insurance News:

ICD-10 Updates Coming Oct. 1

by American Chiropractic Association | 9/2/2016 7:57:14 AM

Doctors of chiropractic should be aware that there are some significant updates regarding ICD-10 that go into effect Oct. 1 due to the partial code freeze being lifted.

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Insurance News:

Medicare Update: Comprehensive Error Rate Testing Chiropractic Services

by | 9/2/2016 7:35:28 AM

The CERT program’s review of claims for chiropractic services has consistently yielded high improper payment rates. Please read the attached article on current Medicare documentation requirements

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Insurance News:

Educational Resources to Assist Chiropractors with Medicare Billing

by Center for Medicare and Medicaid Services | 6/22/2016 6:48:45 PM

This Special Edition (SE) MLN Matters® article is intended for Chiropractors submitting claims to Medicare Administrative Contractors (MACs) for chiropractic services provided to Medicare beneficiaries. CMS is providing this article in order to provide education for chiropractic billers on accessing the correct resources for proper billing. This article is intended to be a comprehensive resource for chiropractic documentation and billing.

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Insurance News:

NYS Workers Compensation BPR project and Medical Portal update

by NYSCA Workers' Compensation Committee | 6/7/2016 9:37:36 PM

The NYSCA WC Committee attended the first informational meeting of the second phase of the WC Business Process Re-engineering (BPR) project. In an effort to reach out to stakeholders, the WCB will be traveling with this presentation throughout the state. Interested parties are encouraged to attend and provide feedback.

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Insurance News:

UnitedHealth Group/Optum Health updates

by NYSCA Insurance Committee | 4/21/2016 12:32:48 PM

UnitedHealth Group / Optum has been implementing a 'per diem' capitated reimbursement methodology for many of it's health plans as it relates to chiropractic services in various states throughout the country.

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Insurance News:

Workers Comp Updates: Sedgwick and Broadspire erroneous denials

by NYSCA Workers' Compensation Committee | 4/18/2016 3:11:57 PM

The NYSCA Workers' Compensation Committee has been working with Broadspire and Sedgwick after issues were identified with inappropriate denials of Chiropractic Manipulative Therapy rendered within the recommendations of New York's Medical Treatment Guidelines.

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Insurance News:

Medicare Provision for Reimbursement of Chiropractic Manipulation Services

by CMS.gov | 4/6/2016 3:23:24 PM

NGS has reported that they have identified claims where a second manipulation service was billed and paid for a single beneficiary for the same date of services. It is important to note that chiropractic manipulation services are reimbursable only once per day.

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Insurance News:

NYS WCB Online Medical Portal Update

by NYSCA Workers' Compensation Committee | 3/28/2016 12:16:09 PM

On March 28, 2016 the NYS WCB hosted an informational webinar and feedback session regarding the web based Medical Portal they have been developing.  Continue reading for more information.

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Insurance News:

CMS Payment Adjustments & Hardship Information

by CMS.gov | 3/24/2016 1:12:28 PM

The Centers for Medicare and Medicaid Services (CMS) has extended the deadline for eligible professionals (EPs) to file hardship exemption applications for the EHR/Meaningful Use program. The new deadline is July 1, 2016. CMS also released new application forms to reduce the amount of information EPs must submit to apply for exemption. 

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Insurance News:

CMS Publishes New Series of Chiropractic Resources

by American Chiropractic Association | 3/24/2016 1:10:01 PM

The Centers for Medicare and Medicaid Services (CMS) recently published a series of three Special Edition educational articles for DCs submitting claims for services provided to Medicare beneficiaries. 

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Insurance News:

Important Information from the ACA Vice President regarding #MedicareEquality

by David Herd, DC, ACA Vice President | 2/23/2016 10:03:47 AM

The following is an important message from Dr. David Herd, ACA Vice President. Please feel free to share with colleagues, staff and patients. It is important everyone knows how hard we are collectively working for our patients and leveling the healthcare field for equal and quality access.

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Insurance News:

CMS issues Final 60-day Rule regarding return of overpayments made to providers and suppliers

by Karl Kranz DC JD, NYSCA Executive Director | 2/17/2016 12:04:41 PM

The Centers for Medicare and Medicaid Services released the Final Rule regarding the reporting and return requirements for "overpayments" received by providers under the Medicare Program.

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Insurance News:

NGS Medicare Fee Schedule Update

by Dr. Mariangela Penna, NY Medicare CAC Representative | 1/15/2016 11:13:16 AM

The Medicare 2016 Fee Schedule has been released.  Read more to learn how to access the Medicare Fee Schedule.

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Insurance News:

Informal Review Request Period for the 2016 Value Modifier Open Now Through December 16, 2015

by Centers for Medicare and Medicaid Services | 11/25/2015 2:26:32 PM

The period for requesting an informal review of the 2016 Value Modifier is open now and ends December 16, 2015.

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Insurance News:

2016 PQRS Negative Payment Adjustment and the Informal Review Process

by Centers for Medicare and Medicaid Services | 11/25/2015 2:25:43 PM

In 2016, CMS will apply a negative payment adjustment to individual EPs, CPC practice sites, and group practices participating in the PQRS GPRO (including ACOs) that did not satisfactorily report PQRS in 2014.

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Insurance News:

Contact List for Providers with Questions About Medicare and Medicaid

by Centers for Medicare and Medicaid Services | 10/14/2015 1:30:17 PM

On October 1 the United States health care community transitioned to ICD-10. Recognizing that providers may still need help with the transition, CMS has issued a new ICD-10 Resource Guide and Contact List to help them find answers to their questions.

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Insurance News:

Attention Paper Claim Submitters: Changes due to the implementation of ICD-10

by Centers for Medicare and Medicaid Services | 10/14/2015 1:27:24 PM

With the implementation of ICD 10 on October 1, 2015, it is important to use the appropriate ICD Indicators on claim submissions. The "ICD Indicator" identifies the ICD code set being reported. 

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Insurance News:

Use ICD-10 Now – Here’s How

by Centers for Medicare and Medicaid Services | 10/9/2015 3:55:28 PM

On October 1 the United States health care community transitioned to ICD-10. CMS wants providers to be successful in using ICD-10 and remains committed to working with industry on the transition.

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Insurance News:

2016 PQRS Negative Payment Adjustment and the Informal Review Process

by Centers for Medicare and Medicaid Services | 10/8/2015 9:22:46 AM

In 2016, CMS will apply a negative payment adjustment to individual eligible professionals (EPs), Comprehensive Primary Care (CPC) practice sites, and group practices participating in the Physician Quality Reporting System (PQRS) group practice reporting option (GPRO) (including Accountable Care Organizations [ACOs]) that did not satisfactorily report PQRS in 2014. 

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Insurance News:

Medicare ICD-10 Update and Information on EmblemHealth Medicare

by NY Medicare CAC Representative | 10/7/2015 10:58:10 AM

As of 10/1/2015 the following ICD-10 codes are required by Medicare as the primary diagnosis.

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Insurance News:

Workers Compensation Updates

by NYSCA Workers' Compensation Committee | 10/7/2015 10:20:48 AM

October 1st represents the transition date from ICD-9 to ICD-10 diagnosis codes.   The WCB Chair has published several announcements over the years expressing their intent to adopt the use of ICD-10 consistent with Medicare and Medicaid's timetable.  That time has finally arrived!

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Insurance News:

HHS issues rules to advance electronic health records with added simplicity and flexibility

by Susan McClelland, FICC | 10/7/2015 10:12:40 AM

CMS and ONC today released final rules that simplify requirements and add new flexibilities for providers to make electronic health information available when and where it matters most and for health care providers and consumers to be able to readily, safely, and securely exchange that information.

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Insurance News:

Federal Report Outlines Chiropractic Medicare Documentation Deficiencies

by American Chiropractic Association | 10/7/2015 9:58:22 AM

The U.S. Department of Health and Human Services (HHS) Office of the Inspector General (OIG) recently released a report on Medicare documentation by doctors of chiropractic (DCs) that put a spotlight on an all-too-familiar issue: that a fraction of DCs are responsible for the chronic error rates that plague the profession.

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Insurance News:

Coding Around the Compliance Date

by Centers for Medicare and Medicaid Services | 9/25/2015 4:20:21 PM

With the ICD-10 compliance date less than 10 days away, your practice may already be seeing patients whose claims will be submitted after the October 1 compliance date.  Remember that if the date of service was before October 1, 2015, you must submit the claim with the appropriate ICD-9 diagnosis code—even if you submit the claim on or after the ICD-10 compliance date.

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Insurance News:

Can Your Staff Code in ICD-10?

by Centers for Medicare and Medicaid Services | 9/19/2015 9:26:54 AM

ICD-10 is less than 15 days away. Can your staff code in ICD-10? The Centers for Medicare & Medicaid Services has released a new infographic to help you answer this question.

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Insurance News:

WCB Chair Announces Adoption of ICD-10 Starting on October 1, 2015

by New York State Workers' Compensation Board | 9/11/2015 2:27:30 PM

To promote consistency between medical systems and to avoid imposing significant costs to support multiple systems, the Board will require use of ICD-10 consistent with CMS for dates of service after 10/1/15. In the event that the CMS October 1, 2015 implementation date is postponed, the Board will adopt an implementation timeline that is consistent with the revised timeline announced by CMS.

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Insurance News:

Get Ready Now: Contact Your Software Vendors, Clearinghouses, and Billing Services

by Centers for Medicare and Medicaid Services | 9/2/2015 3:52:41 PM

With ICD-10 less than 30 days away, now is the time to get ready. You can make sure your practice is prepared by following the ABCs of ICD-10. Today, we’ll explore “C” – “Contact your vendors.”

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Insurance News:

Get Ready Now: Be Sure Your Systems Are Ready

by Centers for Medicare and Medicaid Services | 9/2/2015 3:51:03 PM

With ICD-10 less than 30 days away, now is the time to get ready. You can make sure your practice is prepared by following the ABCs of ICD-10. Today, we’ll explore “B” – “Be sure your systems are ready.”

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Insurance News:

Get Ready Now: Assess How ICD-10 Will Affect Your Practice

by Centers for Medicare and Medicaid Services | 9/2/2015 3:46:25 PM

With ICD-10 just 30 days away, now is the time to get ready. You can make sure your practice is prepared by following the ABCs of ICD-10. Today, we’ll explore “A” – “Assess how ICD-10 will affect your practice.”

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Insurance News:

JLTF Pleased to Report Positive Response from WCB on Proposed New Medical Fee Schedule

by Joint Legislative Task Force | 7/15/2015 9:49:13 PM

The New York State Chiropractic Association (NYSCA) and the New York Chiropractic Council (the Council) are pleased to report further progress has been made to secure a fair and reasonable chiropractic fee schedule.

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Insurance News:

NYSIF Announces Launch of Online Medical Provider Portal

by NYSCA Workers' Compensation Committee | 7/15/2015 3:21:17 PM

Starting on September 1, 2015, the NYSIF will be using the Medical Provider Portal in place of the call center. This portal will update providers on the status of claims, reimbursements, explanation of benefits, payment breakdown, etc.

 

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Insurance News:

CMS and AMA Announce Efforts to Help Providers Get Ready for ICD-10

by NGS Medicare | 7/6/2015 12:15:49 PM

With less than three months remaining until the nation switches from ICD-9 to ICD-10 coding for medical diagnoses and inpatient hospital procedures, the Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are announcing efforts to continue to help physicians get ready ahead of the October 1 deadline.

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Insurance News:

Get Ready for ICD-10 with the CMS ICD-10 Infographic

by NGS Medicare | 7/1/2015 3:16:49 PM

Last week CMS daily Email Updates featured 5 steps for getting ready now. This week, we’re featuring an infographic that offers a visual overview of the 5 steps with links to more details.

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Insurance News:

ICD-10 Compliance Deadline 10/01/2015

by NYSCA Staff Writer | 6/26/2015 1:21:32 PM

While ICD-10 is almost here, you still have time to get ready. But you must get ready now.

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Insurance News:

ICD-10 Compliance Step 5

by Centers for Medicare & Medicaid Services (CMS) | 6/26/2015 1:05:35 PM

This week CMS is highlighting the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. The focus of this article is: Step: 5 Test Your Systems and Processes

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Insurance News:

ICD-10 Compliance Step 4

by Centers for Medicare & Medicaid Services (CMS) | 6/26/2015 12:01:06 PM

This week CMS is highlighting the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. The focus of this article is: Step: 4 Talk to Your Vendors and Health Plans

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Insurance News:

ICD-10 Compliance Step 3

by Centers for Medicare & Medicaid Services (CMS) | 6/26/2015 11:56:26 AM

This week CMS is highlighting the 5 steps from the new Quick Start Guide: 1) Make a Plan, 2) Train Your Staff, 3) Update Your Processes, 4) Talk with Your Vendors and Health Plans, and 5) Test Your Systems and Processes. The focus of this article is: Step: 3 Update Your Processes

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