As noted in our previous communication, Highmark BCBS of Western NY and Northeastern NY is implementing a prior authorization program for certain services rendered by DCs, PTs, OTs and home care providers.
In mid-Summer 2021, the NYSCA issued a memorandum in response to a question about whether chiropractors as merchants could levy a surcharge on a patient who used her credit card to pay for her deductible, copayment or visit charge in order to offset the credit card companies processing fees often referred to as “swipe fees.”
On Wednesday, November 29, 2023 NGS Medicare released a statement that the calendar year (CY) 2024 Medicare Physician Fee Schedule (MPFS) is now available. You can view the new fees using the Fee Schedule Lookup tool located on NGSMedicare.com.
The NYSCA Insurance Committee (The NIC) is requesting your assistance as we compile recent blinded examples of claims which have not been acknowledged or processed and in a timely manner by Cigna. These are claims which do not involve American Specialty Health (ASH), but are solely the responsibility of Cigna. Remember: Health Plans subject to the laws of New York are required to acknowledge or process clean claims within 30 or 45 days of receipt. Failure to do so can result in interest and penalties.
2023 brings forth continued positive changes for doctors of chiropractic practicing in New York. Across the state certain health plans have increased fee schedules and enhanced coverage. In addition, a few third-party administrators have been eliminated, and unreasonable utilization review has been discontinued. Reasonable reimbursement and the elimination of administrative burdens affords us more time to assist our patients in achieving their goals. With significant involvement from our members, the NYSCA continues our drive to parity and fairness in reimbursement and administrative practices.
A member relates then asks:
The NYSCA Insurance Committee (The NIC) continues to receive numerous calls and emails from our members seeking assistance implementing the new workers' compensation requirements. Our webinars and Lunch and Learn presentations have been well attended. This article will be limited to workers' compensation cases, and offers some pearls which you may find beneficial. The new MVP program (effective 1/1/23) has been addressed in a separate article.
Warm Greetings from the NYSCA Insurance Committee! This summer has brought forth several important changes and deadlines which have impacted how you interface with payers. The NYSCA Insurance Committee (The NIC) has been inundated with calls, especially with the new Workers' Compensation requirements and the new MVP program effective 1/1/23. This article will address questions related to the New MVP program. Workers’ Compensation will be addressed in a separate piece.
As you may be aware, the No Surprises Act was passed at the end of 2020 as a part of the Consolidated Appropriations Act of 2021. Initially most experts believed this act applied only to facility-based providers. However, the recent finalization of Part II of the rules has a specific portion that applies to all health care providers.
For many years, the NYSCA in conjunction with our lobbyist have been working tirelessly to gain Chiropractic parity in reimbursement with other health care providers.
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.
