Priority Health Medicare physician reimbursement
As we told you in the June/July newsletter, the Complexity of Care (COC) Incentive program continues in 2010. You have until December 31, 2010, to complete the COC form and return it to Priority Health to receive the $25 payment. Changes to the COC program for 2010 are listed below:
- Medical records need to be from a comprehensive visit. Medical records from visits that are less than comprehensive (focusing on a cold, flu, earache, etc.) won’t be accepted.
- Any condition marked as “Active” on the COC form must be documented outside of the history section in the medical records submitted by the provider. Conditions listed only in the history section of the notes are not acceptable for data validation for CMS.
- COC payments to the providers will be made at two different times for services this year. Payments will be made in third quarter 2010 for COC information received at Priority Health by July 31, 2010. Payments will be made in the first quarter of 2011 for COC information received between August and December 31, 2010.
NOTE: All forms must be received or postmarked on or before December 31, 2010, to qualify for the COC payout. Qualifying visits should be scheduled accordingly.
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