Insurance news
ICD-10 Reporting
Written by Editor   
Friday, July 10, 2015 09:00 PM

Have You Made Your List of Diagnosis Codes?

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ACA Debunks ICD-10 Myths
Friday, July 10, 2015 08:59 PM

ACA has received numerous inquiries about ICD-10 implementation from doctors of chiropractic and their staff across the country. It is apparent there is a significant amount of misinformation being disseminated, causing increased confusion and frustration. This has stymied the timely transition to ICD-10.

ACA is committed to providing clear and accurate information about ICD-10. To that end, we have developed an infographic that addresses five prevalent myths in the profession.

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CMS Unveils Steps to Ease ICD-10 Transition
Written by Editor   
Friday, July 10, 2015 08:53 PM

The CMS "is releasing additional guidance that will allow for flexibility in the claims auditing and quality reporting process as the medical community gains experience using the new ICD-10 code set." In addition, the agency will appoint an ICD-10 ombudsman "to triage and answer questions about the submission of claims."

The ombudsman will be located in a new ICD-10 communications and coordination center that CMS is setting up. The center will be "learning from best practices of other large technology implementations that will be in place to identify and resolve issues arising from the ICD-10 transition," the announcement said.

The guidance document noted that "for 12 months after ICD-10 implementation, Medicare review contractors will not deny physician or other practitioner claims billed under the Part B physician fee schedule ... based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the right family." This 1-year grace period also will apply to codes submitted in connection with the Meaningful Use program as well as quality reporting programs like the Physician Quality Reporting System.

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UnitedHealth Drops Membership in Insurance Trade Group
Written by Editor   
Thursday, June 25, 2015 11:15 AM
Quick Brief:  UnitedHealth Group, the largest health insurer in the nation, is withdrawing from the health insurance industry's biggest trade group.

 

UnitedHealth Group Inc. is planning to leave the health insurer industry's biggest trade group, America's Health Insurance Plans (AHIP), saying it no longer represents the best interests of the company or its customers.

UnitedHealth is the nation's largest health insurer, providing health coverage to about 45 million Americans. AHIP represents insurers and had a key role in negotiations and the rollout of President Barack Obama's national healthcare reform law.

"UnitedHealth Group believes the interest of our company and the customers we serve are no longer best represented by AHIP and accordingly are ending our membership effective June 30," Matt Stearns, UHG spokesman said in a statement.

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New Medicare Legislation Vital to Chiropractic: FAQs
Thursday, June 25, 2015 09:22 AM

Quick Brief:  IMPORTANT:  Repealing the SGR system, in place for nearly 20 years, means that chiropractic physicians will no longer fear double digit cuts in reimbursement every year. However, there were other provisions in the bill that will also affect doctors of chiropractic.  This FAQ from the ACA explains more about this new law.

 

In midApril, the Congress passed, and the president signed, sweeping legislation designed to repeal the flawed Sustainable Growth Rate (SGR) formula used to determine provider reimbursement levels under the federal Medicare program. The plan would give physicians treating Medicare patients, including doctors of chiropractic (DCs), an annual payment increase of 0.5 percent for the next five years, with valuebased payments starting after that time.  For years, the imposition of the SGR payment formula threatened to produce unsustainable reductions in Medicare payment levels for all Medicare providers. Congress was repeatedly forced to enact a series of temporary postponements to avoid the full brunt of the payment reductions from taking place.

Repealing the SGR system, in place for nearly 20 years, means that chiropractic physicians will no longer fear double digit cuts in reimbursement every year. However, there were other provisions in the bill that will also affect doctors of chiropractic.

Q: I’m hearing a lot about the term “PIMA.” What is that?

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