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No show appointment

Reduce No Show Rates with Proven Dynamic Scheduling Tactics

Your no-show appointment rate will never be zero but keeping it low is essential to keeping your provider’s schedule full and protecting your practice’s revenue flow. Dynamic scheduling could be your knight in shining armor. When patients don’t show up, you’ve lost an opportunity to get paid, your providers are wasting their time, and you’re […]
Pharmaceutical rep

Ward Off Kickback Penalties from Common Drug Rep Gifts

Don’t forget that pharmaceutical reps have an agenda. When they bring lunch for your entire office or offer your doctor tickets to a sold-out event, it may seem like they are just being nice, but they are trying to influence prescribing habits. The consequences of accepting freebies from drug reps can be significant if you […]

New Tests With CLIA-Covered Code Files And QW Modifier

Summary: The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) utilize new tests enumerated by CMS with CLIA-covered code files and a QW modifier and evaluate claims according to CMS protocols. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3812CP.pdf Subject: New Waived Tests Number: 3812 Title: 10198 Release Date: July 27, 2017 Effective Date: October […]

Updates From FISS

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) observe and work with updates from FISS, a Medicare Part A claims processing system. Contractors shall participate in five 1-hour meetings to discuss testing. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1874OTN.pdf Subject: Implementation CR: Integrating NLR into the HQR system Number: 1874 Title: 10134 Release […]

Tasks For FISS Analysis

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) perform various tasks for FISS analysis. Contractors shall participate in eight weekly 1-hour calls, take meeting minutes and post them in ECHIMP during a given timeline of two days, provide final analysis papers, and otherwise conduct research and comply with CMS […]

Changes To FISS System Regarding Taxonomy Codes

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) utilize and apply changes to the FISS system regarding taxonomy codes. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1876OTN.pdf Subject: Modifications to the National Coordination of Benefits Agreement (COBA) Crossover Process Number: 1876 Title: 10155 Release Date: July 27, 2017 Effective Date: January 1, 2018 Implementation […]

MACs to Evaluate CMN and DIF

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) evaluate CMN and DIF depending upon medical record content and the existence of any errors or omissions, for the purposes of deciding whether denials are appropriate. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R733PI.pdf Subject: Clarification of Certificate of Medical Necessity (CMN) and Durable Medical Equipment […]

New Requirements In Medicare Contractor Beneficiary and Provider Communications Manual

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) comply with new requirements for Pub. 100-09, Chapter 6 Medicare Contractor Beneficiary and Provider Communications Manual. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R36COM.pdf Subject: Updates to Pub. 100-09, Chapter 6 Beneficiary and Provider Communications Manual, Chapter 6, Provider Customer Service Program Number: 36 Title: 10168 […]

Changes To Medicare Provider Reimbursement Manual

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) review changes to the Medicare Provider Reimbursement Manual, Part 2, Provider Cost Reporting Forms and Instructions, Chapter 23, Form CMS-276-16. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R1P223.pdf Subject: NA Number: 1 Title: NA Release Date: July 21, 2017 Effective Date: NA Implementation Date: NA Special […]

CMS Coverage Of Hepatitis B Screening

The Centers for Medicare & Medicaid Services (CMS) requests that Medicare Administrative Contractors (MACs) work to accommodate CMS coverage of Hepatitis B screening for non-pregnant, high risk individuals with the appropriate U.S. Food and Drug Administration (FDA) approved/​cleared laboratory tests. The coverage is compliant with Clinical Laboratory Improvement Act (CLIA) regulations. Full Transmittal: https:/​/​www.cms.gov/​Regulations-and-Guidance/​Guidance/​Transmittals/​2017Downloads/​R3831CP.pdf Subject: […]
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