New Waived Tests - (CR) Number: 11354 Latest Tests Approved by the FDA as Waived Tests Under CLIA

  • Sep 9, 2019

CR 11354 presents the latest tests approved by the FDA as waived tests under CLIA. The Current Procedural Terminology (CPT) codes for these new tests must have the modifier “QW” to be recognized as a waived test. Note: The tests mentioned on the first page of the list attached to CR 11354 (CPT codes 81002, 81025, 82270, 82272, 82962, 83026, 84830, 85013, and 85651), do not require a “QW”...

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Humana Secures Louisiana Medicaid Contract

  • Sep 9, 2019

The Louisiana Department of Health has selected Humana as one of four Medicaid managed care organizations that it will contract with for Medicaid benefits and services. The other three organizations are AmeriHealth Caritas Louisiana, Community Care Health Plan of Louisiana (Healthy Blue) and United Healthcare Community Plan, all of which previously had Medicaid contracts with the state...

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Humana CEO Broussard Urges Congress to Roll Back ACA's Maligned Health Insurance Tax

  • Sep 9, 2019

Bruce Broussard, Humana CEO, urged Congress to repeal HIF, which is maligned by the insurance industry, on the company's second-quarter earnings call. Eliminating the unpopular tax enjoys bipartisan support, Broussard said. Additionally, Humana is projecting that an additional 480,000 to 500,000 people will enroll in its Medicare Advantage plans this year.

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Interpace Diagnostics Announces Contract with Blue Cross Blue Shield of Michigan

  • Sep 9, 2019

Interpace Diagnostics Group, Inc. (NASDAQ: IDXG) announced today that it has contracted with Blue Cross Blue Shield (BCBS) of Michigan.  The contract makes the ThyGeNEXT® and ThyraMIR® tests both covered services as well as in-network services for their total of 6 million members.

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How Manual Administrative Tasks Between Providers and Payers Slow Healthcare Down

  • Sep 9, 2019

By 2020, healthcare spending by the United States is projected to reach almost 20% of GDP, making the U.S. the largest healthcare spender of any nation in the world. While curbing healthcare spending is a herculean task, the 2017 CAQH Index estimated that shifting from manual to electronic transactions between healthcare providers and healthcare payers could save the industry $9.4 billion...

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PFS: Proposed Policy, Payment, and Quality Provisions Changes for CY 2020

  • Sep 9, 2019

The Centers for Medicare & Medicaid Services (CMS) (@CMSGov) is proposing major policy changes to ensure clinicians spend more time providing high-value care for patients instead of filing cumbersome paperwork.

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BCBS-Anthem: Reimbursement Policy Update: Frequency Editing-Professional

  • Sep 9, 2019

Frequency Editing policy applies frequency maximums per day and/or per date span within the same grouping which may be based on the CMS’s MUEs, industry standards, and/or code description.  Beginning with dates of service November 1, 2019, maximum units per day may be based on claims data analysis.

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How to Communicate Clearly with Patients About Healthcare Costs

  • Sep 9, 2019

Forty-one percent of patients responding to surveys said the health care industry's performance is subpar when it comes to billing, and 61% of health care providers surveyed said confusing bills reduce health care efficiency. Health care providers can use patient-engagement technology to communicate with patients about costs, bills and financial obligations, as well as payment options, writes...

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