Tuesday, January 17, 2012
To date we have converted 76% of our payor and trading partner connections to 5010. These represent over 90% of the claims volume; those who have yet to be converted are some Medicaids and other smaller payors who have opted to extend their 5010 transition, due in part to the CMS extension. To ensure that your claims are processing, XIFIN continues to work diligently with these payors to complete testing and convert over to 5010 as soon as they are ready. To see a current status and to access a payor-by-payor list, please visit the 5010 page on the customer portal.
Wednesday, October 27, 2010
The Medicare contractors shall implement an interest rate of 10.75% effective October 22, 2010 for Medicare overpayments and underpayments.
Tuesday, October 26, 2010
The final 2010-11 State Budget (Chapter 313 of the Laws of 2010) requires across the board reductions to most undisbursed general fund and state special revenue aid to localities appropriations (including Medicaid, school aid, social services, etc.,) effective September 16, 2010. Based on this recently enacted statute, the State is implementing a 1.1% across the board reduction to all Medicaid payments that
are processed on or after September 16, 2010. The reduction will remain in effect through March 31, 2011.
Services exempt from the reduction include:
Wednesday, March 31, 2010
Medicaid is dedicated to protecting your personal information against fraud and scams. You can help protect your license and personal bank accounts by being cautious in giving out your own personal information such as first name, last name, business name, email address, userid/password, financial information (credit card, bank account number, PIN), social security number, and driver's license number. We will never request personal credit card or bank account information over the telephone.
Thursday, February 04, 2010
All chemistries ordered for ESRD patients must be billed individually with the following modifiers:
- CD - AMCC test that has been ordered by an ESRD facility that is part of the composite rate
- CE - AMCC test that has been ordered by an ESRD facility that is a composite rate test, but is beyond the normal frequency covered under the rate and is separately reimbursable based on medical necessity
- CF - AMCC test that is not part of the composite rate and is a separately billable test that has been ordered by an ESRD facility
Thursday, February 04, 2010
The Clinical Laboratory Improvement Amendments of 1988 (CLIA) regulations require a facility to be appropriately certified for each test performed.
Thursday, February 04, 2010
Florida Medicaid has published notice that effective for dates of service beginning on April 01, 2005, Medicaid is implementing a 10% reduction for all Medicaid independent laboratory fees. The reduction was mandated by the Florida Legislature because no contract will be in place by April 01, 2005.
Wednesday, January 27, 2010
The Medicare, Medicaid, and SCHIP Extension Act of 2007 made several changes affecting payments to physicians. One such change provides for a 0.5 percent increase to the physician fee schedule conversion factor for January 1 through June 30, 2008, instead of the -10.1 percent that was scheduled to take place. As of July 1, 2008, the -10.1 percent update to the physician fee schedule will go into effect.
Wednesday, January 27, 2010
If the State of California does not enact the Fiscal Year 2008-2009 budget by June 30, 2008, the Department of Health Care Services (DHCS) will direct the fiscal intermediary (EDS) to continue to pay Medi-Cal practitioners and institutional providers through the MPIP fund until the loan is exhausted, which is anticipated to be by July 17, 2008.
Tuesday, January 26, 2010
Viral tropism tests are reimbursable through Medicaid fee-for-service using procedure code 87999 for Medicaid managed care enrollees. For Family Health Plus enrollees, these tests must be billed to the enrollee's health plan. Viral tropism testing identifies patients who are likely to respond to the new HIV entry inhibitor drug, Selzentry. Currently, one testing method (Trofile assay) is eligible for coverage.
Tuesday, January 26, 2010
While scheduled for March 1, 2009, implementation of APGs in Diagnostic and Treatment Centers (D&TCs) including free-standing ambulatory surgery centers cannot begin until federal approval is received. The Department has responded to CMS' request for additional information on the State Plan Amendment authorizing federal financial participation for APG payments. Discussions with CMS are ongoing and approval is anticipated soon.
DT&C providers should continue to submit claims for outpatient services to eMedNY using existing rate codes (not APG rate codes) until further notice.
Tuesday, January 26, 2010
The General Assembly recently approved a "50-percent budget" for the twelve-month period beginning July 1, 2009. That fiscal year 2010 budget underfunds a long list of vital services and programs, including the medical assistance programs administered by the Department.
Tuesday, January 26, 2010
CPT code 88299 - Unlisted Cytogenetic Study is currently reimbursable at a maximum rate of $10. Effective for dates of service on or after July 1, 2009, this procedure code will be subject to manual pricing and will require documentation for reimbursement.
Thursday, January 07, 2010
The Medicaid Integrity Group (MIG) of CMS is required to review Medicaid provider actions, audit claims, and identify over payments. CMS has contracted with Health Integrity, LLC, to conduct audits of providers enrolled with the Nebraska Medical Assistance Program. Beginning in January of 2010, Health Integrity, LLC, will begin auditing providers. The review will include record requests, entrance and exit conferences, and will be an onsite field audit, a desk audit, a comprehensive audit, or a cost report audit.
Wednesday, December 02, 2009
New York State Medicaid
Effective December 1, 2009, all orders for laboratory or radiology procedures must indicate the diagnosis by use of the appropriate ICD-9-CM code. Use of general ICD-9-CM codes such as those listed below or other non-specific codes does not satisfy this requirement.
Wednesday, December 02, 2009
Florida Medicaid
The Florida Agency for Health Care Administration (Agency) announced today that Florida is the first state to launch a Medicaid claims-based electronic health record portal for providers. The Florida Medicaid Health Information Network powered by Availity is available through a common portal where similar records from other payers may also be accessed. This will allow health care providers treating Medicaid recipients to access up to 18 months of Medicaid claims history, helping them make better-informed decisions about their patients.