Filtered by category: Insurance News Clear Filter

New TPAs for Workers' Compensation, Volunteer Firefighter, and Volunteer Ambulance Claims

 

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WC Update: Special Funds Closes Down

As of 09/07/2018 Special Funds Conservation Committee has officially closed down operation. Each patient that was assigned to Special Funds will revert back to the original carrier they had prior to special funds or NCA (Neuman claims administrator).  Many patients were notified of this by their designated carrier.

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Changes to Aetna Program Effective 09/01/18

 

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The NYSCA and Council Submit Comments on the Proposed NYS Workers' Comp Fee Schedule

 

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The NYSCA Co-Signs ACA Response to UHC Headache Policy

 

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The NYS WCB Announces Public Comment Period for Proposed Medical Fee Schedule

 

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Proposals to Improve Medical Care for Injured Workers

To increase provider participation in the workers' compensation system and improve injured workers' access to timely, quality medical care, the Workers' Compensation Board (Board) is proposing an increase to provider fees and adoption of the universal CMS-1500 form to reduce administrative burden, among other measures.

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Revised WC Medical Authorization Request Forms

Please note that the WCB has updated a few common forms including the MG-2 and MG-2.1. They have been revised to include a place for providers to include their National Provider Information (NPI) number.

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Urgent: New CMS Billing Rules Effective 01/01/2018

Please note that CMS implemented a new rule to requires doctors of chiropractic to add a 2nd modifier when billing Medicare for non-covered physical medicine services.

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MIPS - To Participate or Not Participate: That is the Question

Medicare’s Merit-based Incentive Payment System (MIPS) Final Rule increased the threshold for participation. With this increase, a significant number of providers fall into the exempt category and they are now breathing a sigh of relief. However, there’s one hidden tidbit which you may have missed - the potential damage to your reputation and practice if you DO NOT participate. As incredulous as this may sound, it’s a possibility to consider as your scores will be published on the Physician Compare website for all the world to see. Those scores may also be used for other third-party physician rating websites. One study found that 65% of people are aware of these rating sites and many use them regularly. Providers with high scores have an advantage over their competitors. Damage to online reputations could take years to undo.

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2018 Permanent Impairment Guidelines for Schedule Loss of Use Evaluations

The Workers’ Compensation Board has finalized the new Schedule Loss of Use Impairment Guidelines after consideration of much input from a variety of stake holders, including health care professionals.

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Chiropractic Treatment Visit Note Standards

As we at ChiroCode worked to find an example of the perfect daily treatment visit note, we came across many authoritative sources. For your convenience, we have included them here. The four sources here include Medicare, a chiropractic network, one state board's rules, and one insurance company's requirements. At first glance they may appear to be very different, but, there are many similarities. For the 2018 ChiroCode DeskBook, we considered all these sources and created a SOAP note format that we believe captures all of these requirements so that you can use the same layout for all payers and circumstances. You can read about it in Chapter 4.3 in the 2018 ChiroCode DeskBook.

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NYS WCB Chair Proposes Revised Impairment Guidelines

 

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Deadline Approaching for Required Registration with WCB

By now most, if not all, healthcare providers will have received notice from the New York State Workers' Compensation Board advising providers of their responsibility to register with the WCB and update their office address and contact information. Authorized providers are asked to register with the Board and update their office address(es) and contact information by December 29, 2017. This registration process will be an ongoing initiative every two to three years.

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Quality Payment Program Year 2

CMS has issued the final rule and comment period for the 2018 (year 2) Quality Payment Program.

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New Health Care Provider Registration Coming Soon

The Workers’ Compensation Board (Board) has initiated a registration process to update and maintain a current list of medical providers who are authorized to treat injured workers. The goal of this process is to enable an injured worker to easily and accurately identify Board-authorized medical providers.

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CMS Reveals New Medicare Card Design

Removing Social Security numbers strengthens fraud protections for about 58 million Americans

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Chair Proposes New Permanent Impairment Guidelines

In April 2017, Governor Andrew M. Cuomo signed into law the 2017-2018 Executive Budget, which contained several significant pieces of workers’ compensation reform designed to protect workers while also achieving savings for businesses. Included in the reforms was Workers’ Compensation Law (WCL) § 15(3)(x), which requires new Permanency Impairment Guidelines (“Guidelines”) to be adopted by January 1, 2018. The new Guidelines cover determinations of permanency under WCL § 15(3)(a) through (v), which are also known as scheduled loss of use.

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New Medicare Cards with New Numbers: 3 Changes You May Need to Make

The Medicare Access and CHIP Reauthorization Act of 2015 requires CMS to remove Social Security Numbers (SSNs) from all Medicare cards by April 2019. CMS will begin mailing new Medicare cards with a new Medicare number (currently called the Medicare Claim Number on cards) to your patients in April 2018. You may need to change your systems to:

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Compliance with Medicare Documentation Continues-CMS

Provider Compliance

Chiropractic Services:
High Improper Payment Rate within Medicare FFS Part B

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