For each client, we maintain a Credentialing File. This file contains all the information we use to establish a provider’s database, along with the documents that may be necessary to complete any insurance credentialing. Some of the documents in this file include:
- Your current professional license;
- Your current malpractice declarations sheet;
- Curriculum Vitae (CV);
- IRS form CP575 which was used to issue your Tax ID number;
- Your basic demographic info such as year you graduated from school, city you were born etc.
We use these documents to complete any requests for information from an insurance company as well as any requests from you to enroll you with new insurance carriers. It is essential that this information be kept current.
As you receive updated documents, particularly your license and malpractice documents, please be sure you send a copy to the office so that we may keep your credentialing file current.
Also, please keep in mind that we will gladly complete any credentialing applications for you free of charge. However, if additional information requested by the insurance carrier is not provided in a timely fashion and we have to start the process over, we will charge a nominal fee.
Should you have any questions, please feel free to contact any member of the MPMS team.
Posted in MPMS NEWS, PRACTICE MANAGEMENT.
By admin
– August 26, 2010
Very often, patients will have a question that needs our attention. And we are most happy to talk with your patients regarding their benefits, insurance claims, outstanding bills, or whatever matter necessary.
If a patient needs a return phone call, we need specific permission from them to be able to leave a voice mail message. This is necessary to ensure their privacy. We will not leave a message unless a patient or their guardian specifically give us permission to do so.
Should you have any questions, please address them directly to Melissa.
Posted in MPMS NEWS, PRACTICE MANAGEMENT.
By admin
– August 23, 2010
Patients are often confused by the difference between having unlimited benefits and the insurance company’s definition of what is “medically necessary”.
For the most part, insurance companies define a service or supply as “medically necessary” if the patient’s condition is acute, the patient is experiencing functional imparment and if there is a likelihood that the patient will see improvement from the services or supplies being provide. This standard is applied in chiropractic care, physical therpay, counseling services, as well as medical services. If the patient’s condition does not meet these three criteria, then the services may be denied when the claim is submitted, or may be disallowed during a post payment review.
We strongly encourage that you do not bill insurance carriers for services that to not meet this definition of “medical necessity”. At the start of patient care, we suggest you provide a letter explaining what can and cannot be billed to insurance, and explain that the patient will be responsible for non-medically necessary services and supplies. If a patient calls indiciates that they are going to call their insurance company for clarification, be sure to advise them to ask their carrier if they will cover maintenance care, and for a definition of what is considered maintenance care.
Should you or your patients have any questions, please feel free to contact any member of the MPMS team.
Posted in PRACTICE MANAGEMENT.
By admin
– August 16, 2010
As you have noticed, we have started to get the electronic EOB’s from Aenta. As we receive these, we are forwarding them to you as appropriate. We suggest the following process for managing your EOBs and checks:
1. When you receive a check, deposit the check and hold the EOB in a separate file.
2. We will send you the EOB by fax or in your purple folder.
3. Match the check and the EOB together.
4. Permanently file EOB and the check stub.
Remember that if we manage your EOB file for you, you will not need to follow this process, we will do it for you. And you no longer need to give us the Aetna EOBs for posting to patient accounts, that will already be done electronically.
If you have any questions, please do not hesitate to contact any member of the MPMS team.
Posted in INSURANCE INDUSTRY NEWS, PRACTICE MANAGEMENT.
By admin
– August 11, 2010
Congradulations to MPMS client Dr. Pavel Somov on the publishing of his third book “Lotus Effect: Shedding Suffering and Rediscovering Your Essential Self” due to be released on October of 2010.
Dr. Somov has published two other books: “Eating the Moment” and “Present Perfect”. I have read both of his prior books and found them to be thought proking and holistically spiritual. I am very excited to be able to read the new book this fall. And i suggest both reads ffor anyone who has in interest in self-growth, self-discovery, and finding new ways to revel in the beauty of life. I thank Dr. Somov for sharing his mindful insights with me, and suggest everyone who shares a constant journey of self discovery and growth should take time to read these books.
If you have exciting things happening in your practice, we would love to share them with our other readers.
Posted in Uncategorized.
By admin
– August 7, 2010
A few folks have asked to see a picture of sarah and her dress from the wedding. You can go to this website and see for yourself. The password to the sight is thompson.
http://www.redlotusphotography.biz/beckerbooth/e33d6689f
Thanks to the great folks at Red Lotus Photography for capturing this special day for Sarah and Bill, and for allowing us to share it with you.
As most of you know, Sarah is the lead for all of our chiropratic and physical therapy clients, she has been with us since 2002; and she is my neice.
Posted in MPMS NEWS.
By MelissaRomanelli
– August 5, 2010
Melissa will be out of the office Monday – Weds of next week, August 9-11. I will be checking email and voice mail. If there is something urgent, please direct your issues to Richelle or Sarah.
Thanks
Posted in MPMS NEWS.
By admin
– August 5, 2010
In order to be compliant with the Federal HITECH standards, MPMS will begin sending all service invoices to clients electronically beginning November 1, 2010.
In order to prepare for this, you will be receiving an electronic invoice and a hard paper invoice. If you wish to discontinue the paper invoice, please email us at customerservice@mpms.info.
Also, in compliance with HITECH we will soon be rolling out a link on the MPMS website to allow you to pay your bill online. This service will not affect those already enrolled in our automatic payment process. You will be able to pay your bill via credit card or as a draft to your checking account. You may set up your account to process your payment automatically each month or to make just one payment.
If you have any questions, please feel free to contact Melissa directly.
Posted in MPMS NEWS.
By admin
– August 2, 2010
UPMC has begun sending forms wth EOBs for enrollment in their EFT program. If you are interested in participating, we will be happy to complete the forms for you and manage the enrollment process.
Again, EFT will become mandatory over the next year and a half.
If you would like to participate, please contact any member of the MPMS staff to begin the process.
Posted in PRACTICE MANAGEMENT.
By admin
– July 24, 2010
It is absolutely and unconditionally forbidden for any Medicaid participating provider to charge any Medicaid recipient for any out of pocket expenses. There are no exceptions.
What does this mean:
- You may not charge patients for uncovered services;
- You may not put patients on any type of family or payment plan;
- You may not charge patients for missed appointments;
- You may notcharge patients for copayments from a primary, non-Medicaid insurance.
This standard applies whether you participate in the patient’s Medicaid HMO or not. For example, if the patient is enrolled in the Gateway Medicaid HMO, but you do not participate in that HMO, you are still forbidden to bill the patient.
The only exception to this stardard applies to a few Medicaid Advantage Plans for dual enrolled patients, and any fee that can be charged to the patient in that case will be identified on the EOB.
Remember that patients are enrolled in the Medicaid program because they have demonstrated a financial need for aid.
For more information on Medicaid and the Medicaid HMO’s, please review our earlier post explaining Medicaid policies. If you have any questions, please direct them to Melissa or any member of the MPMS team.
Posted in MEDICAID, PRACTICE MANAGEMENT.
By admin
– July 20, 2010