Billing & payment news for providers
- 04/15/2024: Resubmitting incorrectly denied COVID vaccine claims
- 04/12/2024: Appeals on incorrectly coded claims will be denied
- 04/10/2024: Newborn claims processed separately from the mother
- 04/03/2024: Provider based billing policy goes into effect June 1
- 03/29/2024: We're reprocessing certain ABA service claims submitted from Jan. 1 to March 1, 2024
- 03/29/2024: Hearing aid invoices no longer needed for Medicaid
- 03/08/2024: POS 02 virtual care reimbursement update for professional providers
- 02/06/2024: Correcting claims rejected for member ID match error
- 01/24/2024: Virtual care services covered at some urgent care centers
- 01/18/2024: Resolving COVID vaccine claim denials for facilities
- 01/16/2024: Submitting claims for Priority Health members outside of Michigan
- 01/11/2024: Aligning assistant surgeon reimbursement rates with industry standard
- 01/02/2024: Medicaid claims rejection issue resolved
- 12/27/2023: Medicare therapy cap changes effective Jan 1 2024
- 12/20/2023: Medicaid edit 5171 rejecting some claims incorrectly
- 12/20/2023: Virtual care billing update for professional providers
- 11/02/2023: HCC coding shifting to the V28 model starting Jan. 1, 2024
- 11/02/2023: 2024 commercial fee schedules are now available
- 10/05/2023: New clinical edit going into effect on December 5
- 09/26/2023: Claims temporarily denying in error after CMS update
- 09/26/2023: New clinical edits going into effect on November 26
- 09/18/2023: Update to electronic service receipts today
- 09 08 2023 provider news August 2023 clinical edits
- 08/31/2023: Edits Checker and Clinical Edits tools are back online in prism
- 08/14/2023: RAs in Filemart for 365 days
- 07/31/2023: New clinical edits went into effect in July
- 07/27/2023: Disease burden capture webinar now on demand
- 06/28/2023: We're working to fix incorrectly denied claims for Cigna members
- 06/12/2023: Claim form 1500 street address reminder
- 06/09/2023: Submitting surprise billing appeals as an out-of-network provider
- 06/02/2023: Medicaid claims rejection issue resolved
- 05/25/2023: Medicaid claims being incorrectly rejected
- 05/23/2023: New clinical edit starts July 23
- 05/16/2023: Include disputed codes with your claim appeals
- 04/24/2023: New clinical edit for allergy testing goes into effect June 24
- 03/30/2023: New date formatting for payment reference IDs
- 03/29/2023: Check out the updated Reviews & Appeals section
- 03/29/2023: New clinical edits going into effect on May 28, 2023
- 03/23/2023: Required modifiers for Medicare therapy services
- 03/10/2023: Clinical edit error fixed
- 03/08/2023: Pre-claim appeal deadline now 60 days
- 02/24/2023: New policy for Medicare LVAs
- 02/22/2023: New professional claim edits will go into effect on April 23
- 02/16/2022: Appeal tips for non-contracted Medicare providers
- 01/27/2023: Related readmissions policy updates coming April 27
- 1/26/2023: Reprocessing Medicare inpatient claims
- 1/19/2023: Retiring level II audit appeals on Mar. 19, 2023
- 1/18/2023 New provider types accepted for hospice and home health claims
- 12/23/2022: Edits Checker tool gets an upgrade
- 12/23/2022: How we're addressing the 340B-Acquired Drugs ruling
- 12/23/2022: Update to secondary claim process
- 11/14/2022: 2023 commercial fee schedules are available
- 10/24/2022: Turning off four clinical edits
- 10/19/2022: Fixing a chemotherapy clinical edit error
- 09/15/2022: Visit our updated Medicaid Billing webpage
- 09/15/2022: Unspecified Codes clinical edit coming October 11
- 08/29/2022: Save remittance advice files within 90 days
- 08/16/2022: New clinical edit goes into effect Oct. 15, 2022
- 08/10/2022: New clinical edit coming Oct. 1, 2022
- 07/15/2022: Duplicate RAs in Filemart, slight paper check delays this week
- 07/13/2022: Legacy THC providers must wrap up claims, appeals by Dec. 31, 2022
- 07/12/2022: New clinical edits coming Sept. 15, 2022
- 07/12/2022: Medicaid claims rejection issue resolved
- 06/30/2022: New clinical edits announced in June 2022
- 6/03/2022: New clinical edits going into effect
- 06/03/2022: Medicaid claims rejection issue resolved
- 05/20/2022: New clinical edit and medical policy for pain management
- 05/19/22: New clinical edits for professional and facility claims
- 05/13/2022: We're working to resolve Medicaid claims being rejected incorrectly
- 05/09/2022: New billing guidance for follow-up colon cancer screenings
- 04/14/2022: New virtual care billing requirement or FQHCs and RHCs
- 04/13/2022: Reporting other insurance on Medicaid claims for vision, NEMT and MIHP providers
- 04/06/2022: Appeal vs claim inquiry: Steps for faster claim resolution
- 04/06/2022: Change to referring/ordering/attending editing for Medicaid claims
- 04/05/2022: Paper claim payments delayed
- 03/16/2022: Bill bilateral procedures separately starting Jun. 1, 2022
- 02/28/2022: Incorrectly denied DME claims will reprocess automatically
- 02/28/2022: Resubmit claims for Medicaid members with other insurance
- 01/31/2022: Anatomic modifiers required starting Apr. 1, 2022
- 01/19/2022: New COVID-19 vaccine CPT code for 5-11-year-olds
- 01/19/2022: Submitting claims for Medicaid members with other insurance
- 01/12/2022: Use POS 10 for virtual visits in the patient's home
- 12/15/2021: What makes a good appeal? Tips from our Reimbursement team
- 12/15/2021: Medicare therapy threshold changes effective Jan. 1, 2022
- 12/10/2021: HealthbyChoice payments coming in January
- 12/02/2021: CMS is resuming standard sequestration
- 11/23/2021: Multi-panel lab tests for viral infections aren't covered
- 11/08/2021: Medicaid edit 21007 is a front-end rejection
- 11/05/2021: Chiropractors updated CMS LCD now in effect
- 11/02/2021: New payment policy for unbundled services going into effect Jan. 1, 2022
- 10/28/2021: Changes to COVID-19 vaccine and lab testing billing coming Jan. 1, 2022
- 09/01/2021: Changes to appeals process coming Nov. 1
- 08/18/2021: COVID19 treatment $0 cost share will end on Sept. 30, 2021
- 07/16/2021: MDHHS has updated the billing requirements for G2025
- 06/23/2021: Hand surgery rates
- 05/05/2021: New Medicaid edits
- 02/19/2021: March 1 newborns on mother's remit
- 01/05/2021: Appeals tips for Medicare non-contracted providers