Effective 2/1/2020, BlueCard patients will need to have biometrics reported for Wellness visits. This has been a requirement for AHS plan mem-bers. Effective 4/1/2020, BCBS will be applying Maximum Allowable Cost (MAC) pricing to applicable generic drugs, including the office... Read More

Just a reminder that Medicare deductibles also come into play at the beginning of the year. The deductible amount for 2020 is $198. Be sure to collect the deductible, if applicable, at the time of service to prevent delays in collections. Read More

During 2019 CMS began implementing new Patient Id numbers that did not contain the patient’s Social Security Number. Providers were given a grace period to implement the new Id’s. Through 12/31/2019 Medicare will allow use of either the old or the new Id. However, beginning in... Read More

Although penalties for violating some of the HIPAA regulations have been reduced, it has come to our attention that HIPAA audits will significantly increase this year. A primary focus of the audit will be the security assessment associated with computer security and security of... Read More

Centene, which is Ambetter and Magnolia’s parent company, has had a policy in place for it’s Medicaid Advantage products concerning the reimbursement of in-office lab charges since 2017. Beginning 5/1/2019 the same reimbursement policy has been implemented for it’s marketplace... Read More

The evolution of how providers will be paid continues its metamorphosis in 2014 and is gaining traction.  While having to deal with the recurring issue of SGR payment reductions, practices must also contend with the quality payment aspects that portend to be part of future... Read More

  Physician Quality Reporting System PQRS 2013  Harold Ingram   CMS (The Centers for Medicare and Medicaid Services) created several quality initiatives intended to provide quality of care information for a variety of providers, in a number of different settings.  The... Read More

 THE INSURANCE EXCHANGE August 15, 2013 Harold Ingram   Enrollment will begin October 1, 2013, in the federally administered Insurance Exchange for Mississippi.  Currently there are still a lot of questions to be answered.  How much will insurance cost through the Exchange? ... Read More

As part of the Affordable Care Act (ACA), manufacturers of devices, biologicals, medical supplies, and drugs that are covered by Medicare, Medicaid, and/or CHIPS are required to report to CMS payments or transfers of value for items, such as lunches, travel, gifts, etc. given to... Read More