Medicare Re-assignment When Crossing State Lines
CMS announced guidance on inter-jurisdictional reassignments affecting providers in one MAC jurisdiction that re-assigns benefits to an organization located in another MAC jurisdiction. The full program guidelines can be found here. Here is the text of the article:...
The Provider Enrollment Process
Provider Enrollment (or Payor Enrollment) refers to the process of applying to health insurance networks for inclusion in their provider panels. For Commercial Insurance networks, this process involves 1) Credentialing and 2) Contracting. During the first step, the...
Payor Enrollment for Nurse Practitioner’s
Health plan credentialing (Enrollment) for Nurse Practitioners can bring about some unique challenges. Providers who are operating an outpatient clinic as a primary care provider will need to be directly credentialed and contracted with health plans. Know the...
Medicare enrollment now required for Part D prescribing
Medicare Provider Enrollment Changes Last last week, the Centers for Medicare & Medicaid Services (CMS) issued a final rule for Medicare Advantage and Medicare Part D that includes provisions directly affecting physicians. Beginning June 1, 2015, in order to...
New Physician Credentialing – Timing is Everything
It is always a good sign when your practice recruits a new physician fresh from medical school. It brings attention to your practice, and can help you build a reputation of being a forward-thinking practice that offers the newest and best patient care practices. ...PECOS Changes Improve Staff Access
CMS rolls out surrogate user program The Centers for Medicare & Medicaid Services (CMS) recently released information about its surrogate user program, which is now available for use. The program authorizes individuals or organizations to work on behalf of...Setup EFT For All Payers
Electronic Funds Transfer (EFT or Direct Deposit) is a quick and simple method of receiving reimbursement from payers directly into your bank account as opposed to receiving a paper check. EFT helps to reduce administrative burden of processing paper checks by...Medicare Provider Enrollment Options Including Opt-Out
Medicare enrolling/enrolled providers have two contractual options with Medicare. 1) Providers may submit an enrollment application and sign a participating (PAR) agreement and accept Medicare’s allowed charge as payment in full for all Medicare patients. 2)...Chiropractic Clinic conversion to Integrated Health Group
We receive many inquiries from Chiropractic practices that are partnering with physicians and mid-level providers to convert their chiropractic practice to a multi-specialty medical clinic providing primary care services, walk-in medical care, chiropractic care, and...
