Tag: #Consulting

Posted in In The Know Series, Insurance, MU Stage 2 and 3, My services, NY Medicaid EHR incentive program, Practice Fusion EMR, Training

Attesting to MU in New York State? Registered on NY DOH MURPH?….Well you also need to register with NYSIIS too!

Posted on by KR2Medical Billing

Background: (year 2016)

I started the attestation process for a SOLO SPECIALIST practice back in 2017. Program is NY Medicaid EHR incentive program, now CMS Promoting Interoperability Program, for the payment year 2016. (Attestation is the year after the payment year) Anyway, during the initial attestation process, in order to meet the MU, they ask you to register with the State or City , if you are located in the NYC, reporting registries; and transmit the information electronically utilizing the EHR you have at the practice.

OK, sounds simple enough. I went into the EHR (Practice Fusion) and followed their steps on how to get connected to ONLY NYSIIS, since the attestation is done for the specialist. Contacted the NYSIIS and after conducting a test connection with the Practice Fusion, the specialist was connected to TRANSMIT to NYSIIS immunizations given to the patients.

P.S. The specialist only transmits flu shots that are administered by the provider during each flu season.

Late 2017:

In October/November of 2017 the specialist received an email that ALL providers attesting to the NY Medicaid EHR Incentive Program have to register with MURPH. MURPH is Meaningful use Registration for Public Health. In that system the provider registers the INTENT to attest to MU and REPORT to the specialized registries.

Ok, done that!

Now let’s remember that the provider has been transmitting to NYSIIS through Practice Fusion ALL THIS TIME.

Fast forward to June 2018:

After registering now with Healthylink NY, which is another system, the provider now received an email from DOH stating that the specialist is not in the NYSIIS system and therefore needs to register in order to meet MU. WHAT?! This took me aback. I thought that maybe I have done something wrong. NOPE! I quickly went back to Practice Fusion and clicked to Settings, making sure that the provider IS connected to NYSIIS to transmit the Immunizations. Aha! The information is there in black and white! I take a screen shot of the information and send it to DOH. Thinking that the provider was all set.

To my surprise, the next day the provider receives another email regarding this matter informing her that she also needs to register DIRECTLY with NYSIIS in order to do the attestation for NY Medicaid EHR Incentive Program/ CMS Promoting Interoperability.

Lesson learned!

PCP’s should have access to NYSIIS, to report or look up vaccinations for the patients. However, for specialists that was optional, but signing up to transmit ( ex. flu vaccines) through your EHR was required.

Starting last year Providers (Specialists) need to register first on MURPH system AND starting in 2018 they need to register and obtain the NYSIIS registration number too!

Now don’t fret the registration is fairly easy and takes about 1 week.

After all said and done make sure to answer the email from DOH and give them that NYSIIS registration number, even if you already submitted your ATTESTATION on MIEPASS portal

Posted in In The Know Series, Insurance, Training

MVP Health Care and Urgent Care Payment Policy

Posted on by KR2Medical Billing

 

With the number of Urgent Care Centers on the rise since 2015, there were new codes added just to represent where the patient went. However, not all payers had a clear payment policy for those codes. When I used to work for the Urgent Care back in 2015-2016, this was a major billing issue I had to personally deal with.

Here is the most updated Payment policy for Urgent Care codes: S9088 and S9083:

Definition: S9088- the services provided in an urgent carte center

Definition: S9083- global fee urgent care centers

*CMS considers both of these codes as informational codes so there is no reimbursement for them.

According to MVP Health Care effective 12/01/2018 they will adopt reimbursement payment policy “based on the E/M code billed for the services”.

***Providers should bill an appropriate E/M code with a Place of service 20 (URGENT CARE)*** Unless the Urgent care is part of a hospital where the POS (place of service can be 22, outpatient hospital). Article 28 is not recognized by some payers, therefore to avoid unnecessary denials the providers should still bill POS 20.***

 

 

Posted in In The Know Series, Insurance, My services

UHC buys POMCO insurance. UMR is the third-party administrative payer

Posted on by KR2Medical Billing

In March of 2017 there were talks of UHC (UnitedHealthCare) buying POMCO, a third party insurance administrator, located in Syracuse NY.

POMCO is the largest benefit administrator for self-funded and risk management plans in the nation. They offer dental, vision and medical benefits to different types of employees in NY, both state and Westchester County employees.

POMCO had suffered a previously a loss of letting go more than 100 employees after Health Republic of NY, was forced to close by the state and federal regulators.

But lets get back to UHC buying out POMCO – UHC hopes to expand into the Central and Upstate New York areas; offering medical coverage to patients to its multi level of professionals.

UPDATE: 

IN APRIL 2017, the purchase of POMCO by the UHC was finalized! The purchase price was not disclosed.