Medicare DMEPOS Competitive Bidding Program – Round 2
Round 2 of the competitive Rebid is scheduled to go into effect in 91 Metropolitan Statistical Areas (MSAs) on July 1, 2013. At the same time, CMS is implementing a national mail-order program for diabetic testing supplies. When a Round of the program becomes...
CMS releases 2013 Physician Fee Schedule
The 2013 Medicare fee schedule shows some dramatic changes affecting several medical specialties. Find more information about the fee schedule here including downloading the full schedule. In addition to fee schedule changes there are expanded privileges for...
Medicare Alert regarding address information on file
The Medicare Learning Network has issued an alert to remind all providers that practice address on file must be physical locations and not a PO Box or Lockbox address. Claims submitted with a PO Box as the provider address won't be crossed over and your EOMB will...
BCBS DME Changes
All BlueCross Blue Shield plans are making a significant change to how they process claims for DME, independent clinical laboratories, and for specialty pharmacy. Beginning October 14, 2012 each of these supplier types must have a contract with the BCBS plan where...
CMS Application Fees
Federal regulation requires CMS intermediaries to impose an application fee on each institutional provider of services or supplies. The fee is used to cover cost of Medicare compliance efforts including initial screening of applicants. The application fee for...
Focused Practice designation by ABMS
Some of the American Boards of Medical Specialties are implementing programs to recognize areas of expertise for focused practice in a specific clinic area. On board certification documents, a notation of a Focused Practice will designate the specialized are of...
Medicare Revalidation
All Providers are subject to Medicare Revalidation of provider enrollment records The Affordable Care Act (ACA) established requirements for all providers enrolled in the Medicare program to revalidate their enrollment records under the new, more stringent, enrollment...
Aetna to purchase Coventry Healthcare
Aetna announced a potential purcahse of Coventry Healthcare today for a reported $5.6 billion. Read more here. National Credentialing Solutions "nCred" offers provider enrollment services and primary source verification for practitioners in the healthcare industry....
Fingerprint-Based Background Checks for Medicare Provider Enrollment
An integral part of the Medicare provider/supplier enrollment process includes background checks of providers and suppliers applying for enrollment in the program. The background checks for high risk providers/suppliers includes fingerprint based background...
