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Attention: Network providers for American Specialty Health (ASH)

Your office may have received a notice from American Specialty Health (ASH) titled REMOVAL FROM PARTICIPATION FOR SPECIFIC CLIENT SOURCES. The letter indicates that your office has been terminated from participation in Medicare specific Client Summaries as allowed in your ASH Practitioner Services Agreement.

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Now Is The Time! Free Webinar: Workers’ Compensation and Auto/No-Fault Made Easy How to get paid faster!

As many of you are aware, we will be required to submit our workers' compensation claims and clinical documentation in an electronic format.  Most (if not all) clearinghouses who work with commercial carriers and Medicare do not accept No Fault and Workers' Compensation Claims. 

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UnitedHealthcare COVID-19 Update

UnitedHealthcare recently published an update relative to COVID-19.  Noted in the introductory paragraph of this notice:

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Registration is open for the NGS May 2020 Virtual Conference

The NYSCA is pleased to share with you the following educational opportunity from National Government Services.  This platform will allow you to hear about the latest Medicare education from the NGS Provider Outreach and Education team and ask your questions immediately following.

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Important Changes to Workers' Compensation Telemedicine

Please note the following updates to the telemedicine protocols implemented by the NYS Workers' Compensation Board. This emergency adoption supersedes the previous WCB telemedicine amendment, and is effective immediately.

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UHC Updates Telemedicine Policy to Include Chiropractic

The NYSCA Officers thank the insurance committee for their work in continuing this conversation and assisting in bringing more options to New York's chiropractors and chiropractic patients.  Updates to the United HealthCare policies allowing chiropractors to utilize telemedicine services to care for their patients is below.

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Telemedicine Coding and Coverage

During the COVID-19 crisis, telemedicine and telehealth services will allow you to continue to care for your patients from a distance.  The NYSCA Insurance Committee continues to interact with various NYS offices, commercial carriers and TPAs to discuss and seek their guidelines relative to the application and coverage of telemedicine services for doctors of chiropractic.

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Telemedicine is an option for New York Chiropractors, your patients, and your practice

As we in New York begin to experience the exponential surge of COVID-19, members are questioning how they can care for their patients. Some offices remain open as part of essential services, while others have decided to close because of the risk factors. Geography and patient population seem to be the biggest determinants in this professional choice.

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No Fault covers Telemedicine Services per WC Amendment

NYSCA members have been asking, "Does the WC amendment allowing temporary performance of telemedicine services during Covid-19 extend to No Fault?"  

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Telemedicine Services and Workers’ Compensation in New York

Telemedicine and telehealth services are currently being reviewed and discussed by the state board for chiropractic.  However, you may currently perform telemedicine for injured workers in need of timely help.

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Some WC Carriers have yet to update their reimbursement fee schedules

NYSCA Members have reported that a few workers compensation carriers have failed to properly update their fee schedules based on the January 1, 2020 update.  As you know, these changes for parity were needed and overdue.  The Workers Compensation Committee continues to act on your behalf to make necessary changes. 

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UnitedHealthcare requires 'GP' Always Therapy Modifier effective April 1, 2020

UnitedHealthcare will require the use of a 'GP' modifier for all billed physical medicine services effective 04/01/2020. 

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NYS WCB CMS-1500 Q&A Webinars

In order to increase health care provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) is supporting electronic submission of CMS-1500 forms, along with a medical narrative. The CMS-1500 streamlines medical billing and may reduce the paperwork requirements currently in the workers' compensation system.

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NYS WCB Announces Medical Narrative Report Template for Form CMS-1500 Submissions

To further assist medical providers in the implementation of the CMS-1500 for workers’ compensation patients, the Board has created a medical narrative report template that can be used to create the medical narrative that must accompany all CMS-1500 submissions.

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CMS Feedback on Scope of Practice - NYSCA Response

In response to the CMS call for Feedback on Scope of Practice, the NYSCA has submitted the following:  

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Setting the record straight: The new 1/1/2020 NYS Workers' Compensation Fee Schedule

The NYSCA Workers' Compensation Committee has received numerous calls from our members regarding the revised 1/1/2020 Workers' Compensation Chiropractic Fee Schedule.  A fair amount of misinformation is being communicated, particularly in the downstate region, resulting in confusion in the application of the 1/1/2020 Schedule.

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CMS Calls for Feedback on Scope of Practice - due by 01/17/2020

The NYSCA has been in contact with the American Chiropractic Association (ACA) regarding possible changes to Medicare as outlined in the following letter from National Government Services.

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Medicare Documentation Job Aid for Doctors of Chiropractic

Have you received a request for documentation from a Medicare contractor but not sure if your records comply? We understand the challenges Doctors of Chiropractic face when determining what to include in responding to a request for medical records. The A/B Medicare Administrative Contractors (MACs) partnered together to create this job aid to help you properly respond to these requests.

Download the Job Aid from CMS.gov

New NYS Workers' Comp Fee Schedule Effective January 1, 2020

The New York State Chiropractic Association (NYSCA) and New York Chiropractic Council have been actively working with the New York State Workers' Compensation Board (WCB) to achieve parity in the system for services provided by Doctors of Chiropractic in New York State.

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Workers' Compensation Update

Please be advised that the proposed increase to the chiropractic conversion factor will be going into effect on January 1, 2020 as anticipated. This change recognizes the need for parity in the Workers Compensation system and represents a positive step forward in the recognition of the value of chiropractic care. We appreciate the willingness of the WCB to address this issue.

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