Revised the list of allowable provider types, replacing “Primary care physicians and Midlevel primary care providers” with “Primary care physicians and Advanced Practitioner primary care providers”. Replaced statement regarding reimbursement of Midlevel Practitioners services with a statement regarding Advanced Practitioners. Revised behavioral health policy statement to specify that services are not applicable to behavioral health inpatient and residential treatment services. Temporary Telemedicine/Telehealth and Telephone Only Services - Payment Policy (Medicare, Commercial): BCBS Rhode Island reviewed its Temporary Telemedicine/Telehealth and Telephone Only Services Policy with the following changes to criteria, coding, and supporting information: News Updates: BCBS Minnesota published provider bulletin announcing that any providers submitting appeal for the denial of services related to COVID-19 should clearly document that the appeal is related to either COVID-19 or coronavirus. 97755 - Assistive technology assessment.97112 - Therapeutic procedure, 1 or more areas.G0337- Hospice evaluation and counseling services, pre-electionĪdded temporary coding section for Medicare only, including but not limited to the following codes:.99315-99316 - Nursing facility discharge day management.90962 - End-stage renal disease (ESRD) related services monthly.88329 - Pathology consultation during surgery.80502 - Clinical pathology consultation comprehensive.77427- Radiation treatment management, 5 treatments.Added billing requirements for Medicare professional claims for non-traditional telehealth services for the duration of the Public Health Emergency (PHE), including the use of modifier 95.Īdded temporary codes including, but not limited to, the following:.Telehealth may be provided over a non-HIPAA compliant audio-visual application, such as Skype or FaceTime.Telehealth may be provided over the phone, without the requirement of the visual component.Telehealth may be provided to both new and established patients.Updated statement regarding temporary changes related to COVID-19, adding that BCBS Minnesota is waiving certain requirements to allow the following: Televideo Consultations/Telehealth Services - Payment Policy: BCBS Minnesota reviewed its Televideo Consultations/Telehealth Services Policy with the following changes to criteria, reimbursement, and coding: Please see below for further information about each update. Anthem revised its Robotic Assisted Surgery, and Taxotere, Docefrez Policies.Īdditionally, BCBS Alabama archived its Gene Expression Profiling and Protein Biomarkers for Prostate Cancer Management and Genetic Biomarkers for the Diagnosis and Risk Assessment of Prostate Cancer Policies, and updated its Urinary Biomarkers for Cancer Screening, Diagnosis, and Surveillance and Whole Exome and Whole Genome Sequencing for Diagnosis of Genetic Disorders policies. Aetna updated its Benign Prostatic Hyperplasia, Biofeedback, and Electrical Stimulation for Pain, Erectile Dysfunction, Near-Infrared Vascular Imagining and Near-Infrared Fluorescence Imaging, and Urinary Incontinence Policies. This week’s update includes the release of COVID-19 and Telehealth/Telemedicine newsletters and policy updates. Due to the volume of insurance policy updates, we are focusing our updates on the Medicare Administrative Contractors (MACs) and the major commercial insurance companies. In case, you’re looking for some additional information, feel free to contact us or comment below.Each week, the AUA publishes weekly updates on the latest insurance issues pertaining to urology. In this article, I have mentioned everything you need to know about timely filing limit along with the timely filing limit of all major insurances in United States. Also ask your accounts receivable team to follow up on claims within 15 days of claim submission. If insurance company allows electronic submission then submit claims electronically and keep an eye on rejections. To avoid timely filing limit denial, submit claims within the timely filing limit of insurance company. How to avoid from claim timely filing limit exhausted? What if claim isn’t sent within the timely filing limit?įailing to submit a claim within the timely filing limit may result in the claim being denied with a denial code CO 29, so it is important to be aware of the deadline and submit the claim promptly. Unitedhealthcare Non Participating Providers Keystone First Resubmissions & Corrected Claimsġ80 Calender days from Primary EOB processing dateġ2 months from original claim determination Amerigroup for Non Participating Providers
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