Medicare Claim Hold The Centers for Medicare & Medicaid Services (CMS) has identified technical issues with certain parts of the April 2013 quarterly systems release. The problem impacts claims received by the Medicare contractors (Palmetto GBA for California) on or after April 1, 2013. April 1, 2013 Medicare, Payment Medicare, Medicare claim hold 0 0 Comment Read More »
CMS Approves Medicare/Medi-Cal Duals Project The Department of Health Care Services (DHCS) announced that CMS has given approval to the project to require Medicare/Medi-Cal dual eligibles to enroll in a managed care plan. The project, which was previously known as the “Coordinated Care Initiative,” will now be called CalMediConnect. March 28, 2013 Advocacy, CMA, Medi Cal, Medicare dual eligibles, Medicare/Medi-Cal dual eligibles, CalMediConnect 0 0 Comment Read More »
One Physician’s Story on Medical Volunteerism SFMS member Howard Kleckner, MD discusses medical volunteerism after retirement. March 28, 2013 Local Events, SFMS Member physician volunteer, medical volunteerism , thesecondopinion 0 0 Comment Read More »
Medicare Ordering/Referring Claims Denials to Take Effect May 1 Medicare will begin denying claims on May 1, 2013, if the ordering/referring provider listed on the claim is not in the Provider Enrollment, Chain and Ownership System (PECOS), the database Medicare uses to track physicians and other providers. March 27, 2013 Medicare, Payment, Physician Resource Medicare, Medicare ordering/referring, CMS-855o, PECOS 0 0 Comment Read More »
Blue Shield Requires Physicians to Notify Patients Before Referring Out-of-Network On March 15, Blue Shield announced that it would soon begin requiring contracted physicians to notify patients in writing before making out-of-network referrals. Effective May 15, physicians will be required to notify patients in writing using a form provided by the payor when referring a patient to an out-of-network provider. March 27, 2013 Payment Blue Shield, managed care 0 0 Comment Read More »
