Is your office getting calls from various Medicare entities regarding medical records, documentation, and other information? Are you wondering, “What’s going on?” You should; and you’re not alone.
After fielding calls from providers who were confused about the responsibilities of several entities and what they can and should not share, the Centers for Medicare & Medicaid Services (CMS) set out to define the differences. A special article and table can help you and your colleagues understand the roles and boundaries of the following Medicare entities:
- Claims processing contractors
- Program integrity contractors
- Special medical review contractors
- Appeals contractors and entities
- Quality improvement contractors
September 16th, 2011
Since announcing that CPT® consultation codes (ranges 99241-99245 and 99251-99255) would no longer be recognized for Medicare Part B payment effective Jan. 1, the Centers for Medicare & Medicaid Services (CMS) has been bombarded with questions.
In response, the agency has issued MLN Matters Special Edition article SE1010, entitled “Questions and Answers on Reporting Physician Consultation Services.” MLN Matters article MM6740 was also revised Feb. 24 to clarify some language and add reference to SE1010. (more…)
March 12th, 2010
Section 111 of the Medicare, Medicaid, and SCHIP Extension Act of 2007 (MMSEA) added new mandatory reporting requirements for group health plans (GHP) and non-group health plans (NGHP), such as liability insurance (including self-insurance), no-fault insurance, and workers’ compensation.
The implementation dates for most casualty insurers have come and gone, but there’s still time for compliance.
November 2nd, 2009