If you happen to see or talk with the lovely Mrs. Sarah Joy Becker, please be sure to wish her a happy 30th birthday.
Someone around here is getting old — and i think it might be me!
Posted in MPMS NEWS.
By MPMS
– February 1, 2012
This time of year you may receive a number of denied claims as insurance companies research if the patient is covered by another insurance contract. This coordination of benefits process is an unfortunate part of our insurance system. It can be easily resolved by having your patient contact the insurance carrier in question and answer a few brief questions. The patient is also likely to be sent a questionnaire which can be easily completed and returned. Until this process is complete, claims are not going to be processed.
Keep in mind that the individual contracts between insurance companies and the patients is what determines which insurance coverage will be primary if more than one policy is in place. This is not let to the discretion of the patient.
We suggest that you remind patients to quickly address any correspondence they receive from their insurance company.
If you have any questions, please feel free to contact your MPMS representative.
Posted in PRACTICE MANAGEMENT.
By MPMS
– January 25, 2012
The 2012 deductible for Medicare Part B will be $140.00. This is actually a reduction from the 2011 deductible of $162.00.
While most Medicare patients have a supplement plan, very few of those plans cover the deductible. Keep in mind that was with all plans, the deductible must be met before you will receive payments from Medicare. Also the services that will counted under the deductible are determined by Medicare based upon the order in which the claims are submitted. If a patient is being treated by other doctors, we recommend that you do not collect any deductible until the EOB’s are received and the exact deductible applied to your services is determined.
If you have any questions, please feel free to contact any member of the MPMS staff.
Posted in MEDICARE.
By MPMS
– January 25, 2012
MPMS is pleased to welcome a new intern to our team — Rachael will be working with us and training on different aspects of billing and coding over the next three months. Rachael is from Career Traning Academy and has done extensive classroom work in medical billing. She will be working with all of us to help serve you and to learn more about the industry. She can be contacted at intern@mpms.info.
If you have any questions, please feel free to contact any member of the MPMS staff.
Posted in MPMS NEWS.
By MPMS
– January 22, 2012
One struggle in managing a practice is proper management of patient accounts. MPMS is happy to send out patient statements to your clients at no charge. We do recommend that you include some other steps into your process.
First, after the third patient statement, a collection letter should be sent from MPMS. In this letter we gently remind the client that they have an outstanding balance and request that arrangements be made to address this balance.
If there is no response from this letter, we suggest that you utilize a collection agency to address these accounts. We have can recommend a collection agency Summit Business Consultants, they have worked with other clients and have a professional approach to getting you paid. We have no business connection with Summit and are not compensated in any way for your accounts being sent to their agency. Any fees and services should be arranged directly with Summit and we can provide contact information.
It is always difficult to manage past due balances on current patients. The best solution is to try to collect at time of service. We also strongly recommend that you accept debit and credit cards for payment. It is also possible to provide a portal for your patients to pay their bill through the MPMS website. There is a slight charge for this service from the web development company, and again MPMS does not receive any financial compensation for this service, but it is a convenience for your customers.
For more information on any of the issues discussed in this blog, please contact any member of the MPMS staff or post a response to this article.
Posted in PRACTICE MANAGEMENT.
By MPMS
– January 21, 2012
Just as a point of information, Independence Blue Cross is not prepared to accept claims in the 5010 format. This affects claims submitted to Personal Choice, Keystone East and Magellan.
MPMS is prepared to submit all claims in 5010 format, and have completed testing with all insurance carriers who are equally prepared to accept the 5010 format. We are also capable of submitting claims to these carriers in the old format, and we have taken the necessary actions to submit claims in the acceptable format.
IBC has until the end of the 1st quarter of 2012 to be prepared to accept 2012 claims under the current CMS mandate. We will convert those claims when they are prepared.
If you have any questions, please contact any member of the MPMS staff.
Posted in INSURANCE INDUSTRY NEWS.
By MPMS
– January 13, 2012
There has been a slight change made to Highmark’s policy regarding the payment of adjunctive physical therapy services. In order to be paid for these services, the provider must have a valid adjunctive procedures license, which should be on file with Highmark’s Provider Data Services. This document must be on file for services after February 3, 2012 to be paid.
Please note that this document is routinely included in the credentialing documents that we have on file, and i do not foresee any issues with current MPMS clients. If we should identify an issue, we will take action to get the necessary documents in place to avoid an interruption in your cash flow.
Additionally, there was a recent post on Navinet indicating that an authorization would be required for these services. At this time there is no change to the authorization requirements for any chiropractic services. We will notify you of any changes that should happen in the future.
Lastly, please keep in mind that this change does not affect the coverage of adjunctive physical therapies for Freedom Blue or Security Blue patients. These plans follow Medicare guidelines, and do not provide for these services by a chiropractor.
If you have any questions, please contact any member of the MPMS staff.
Posted in BLUES, INSURANCE INDUSTRY NEWS.
By MPMS
– January 8, 2012
You may be seeing insurance cards for United Community Health Plan. This is a medicaid product of United Health Care. In order to accept this plan, you must be enrolled in that particular medicaid managed care network. This product is a replacement for the Unison Health Plan. Participation in the United Health Care network for commercial products does not automatically enroll a provider in the new Community product. We strongly recommend that you carefully read the patients card before accepting their insurance and verify your participation and eligibility for payment.
Additionally, if you are a behavioral health provider, you must participate in the MCO for the patient’s county before you can accept this insurance for payment. This would include Value Behavioral Health or Community Care Behavioral Health, depending upon the patient’s county of residence.
If you have any questions, please contact any member of the MPMS staff.
Posted in INSURANCE INDUSTRY NEWS, MEDICAID.
By MPMS
– January 3, 2012
Help your colleagues start the new year off right For every client referral we receive in the month of January, you will receive a set of tickets to an upcoming Penguins game. For those of you in the eastern part of the state, we will have Flyers tickets for your enjoyment.
Your referral must actually submit billing in the month of January inorder to qualify.
If you have any questions, please feel free to contact any member of the MPMS staff.
Posted in MPMS NEWS.
By MPMS
– January 3, 2012
It is very important to keep the information on your NPI registry updated. If you have a change of name, address, or tax identification number then the information must be updated on the NPI registry. Failure to maintain this information can cause issues with your credentialing status with major insurance carriers, including medicare.
If we obtained your original NPI Number or if we are supplied with this information we are happy to make these updates for you. Otherwise you are responsible for this maintenance item. Please be sure that you keep a copy of your log in and password so that you can make any necessary changes.
If you have any questions, please feel free to contact any member of the MPMS staff.
Posted in INSURANCE INDUSTRY NEWS.
By MPMS
– December 28, 2011