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Managed Care/Payer Issues
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What You Need to Know about Medical Audits
The Physicians Advocacy Institute (PAI), in collaboration with NCMS and other state medical associations, has developed a new resource to help physicians avoid and respond to audits and financial reviews conducted by Medicare, Medicaid and private payers.
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NCMS Member Resource Center FAQ of the Week: 5010
Due to a high volume of questions coming in through the Member Resource Center, the NCMS will provide a Frequently-Asked-Question (FAQ) for its members each week to make them more […]
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Payor News
NC Medicaid Offers Guidance on Grace Period for 5010 Implementation The North Carolina Division of Medical Assistance (DMA) has issued a response to the recent announcement from the federal Office of E-Health […]
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Electronic Funds Transfer Requirement in Effect
Physicians and other Medicare providers are reminded that all Medicare provider and supplier payments must be made by Electronic Fund Transfer (EFT).
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New HHS Rule Aims to Cut Paperwork, Saving Physicians Time and Money
A new regulation announced Thursday by the US Department of Health and Human Services establishes Electronic Funds Transfers (EFT) standards that, when implemented by health plans, will save physician practices and hospitals between $3 billion to $4.5 billion over the next ten years.
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Special Report: Managed Care in 2011
This special edition of the Bulletin focuses on the accomplishments achieved on your behalf in the managed care arena by the NCMS and the Physicians Advocacy Institute, a national organization in which the NCMS is actively involved. Throughout 2011 the NCMS remained actively engaged with the health plans. We successfully addressed and resolved a variety of managed care issues; read on for an overview of what we accomplished this year…
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DOI Sides with Medicine, Blocks Controversial BCBSNC Radiology Policy
This week the North Carolina Department of Insurance (DOI) informed Blue Cross and Blue Shield of North Carolina (BCBSNC) that the company could not implement a policy that would unilaterally reduce reimbursement rates to providers of certain hi-tech imaging procedures.
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UHC Deploying a Revised Treatment Cost Estimator for Members in 2012
Starting January 1, 2012, UnitedHealthcare (UHC) will begin deploying a Revised Treatment Cost Estimator for commercial members in selected markets, with a new Health Care Cost Estimator to be introduced […]
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IPG Inks Agreement with BCBSNC to Provide Implantable Device Management
Atlanta-based Implantable Provider Group (IPG) has announced an agreement to provide implantable device management for Blue Cross Blue Shield of North Carolina’s (BCBSNC) provider network. Under the agreement, IPG will […]
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“Heal the Claims Process” and PractEssentials: Resources to Help Cut Practice Costs
If you are a physician seeking to cut costs and speed payments to your practice, the NCMS suggests that you check out the tools available through the AMA’s “Heal the […]
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