Training – KR2 Medical Billing

EmblemHealth Plans that DO NOT require a REFERRAL-2019

Posted on June 28, 2019December 13, 2019 by KR2Medical Billing

The following is the list of all the EmblemHealh Plans for 2019 that do not require a referral from their primary to see a specialist.

Commercial Plans:

Access I/II, EmblemHealth Platinum Choice, EmblemHealth Gold Choice, EmblemHealth Silver Choice, EmblemHelath Gold Premier 1, EmblemHealth Silver Plus1, EmblemHealth Silver Premier, EmblemHealth Platinum Premier, EmblemHealth Gold Premier, EmblemHealth EPO Value, EmblemHealth EPO Value HDHP

Medicare Advantage Plans:

EmblemHealth VIP Go (HMO-POS) plans, EmblemHealth Affinity Medicare Passport Essentials (HMO), EmblemHealth Affinitiy Medicare Passport Essentials NYC (HMO), EmblemHealth Affinity Medicare Utimate (HMO SNP), and EmblemHealth Affinity Medicare Solutions (HMO SNP)

Remember if the EmblemHealth HIP plan has a Montefiore Logo and you are going to the provider associated with Montefiore you still also DO NOT Require a referral to see that specialist.

In The Know Series, Practice Fusion EMR, Training

Practice Fusion introduces paid package for their EMR 2017/2018

Posted on March 5, 2018December 13, 2019 by KR2Medical Billing

At the beginning of this year, Allscipts bought Practice Fusion EMR.

It’s been a long road but in the last 3 years, Practice Fusion has become the most customer friendly EMR on the market- with over 75% of customer satisfaction. In the last year it has become certified EMR that could be used for PCMH Certification, MIPS (Medicare QCDR registry), and Meaningful Use.

Of course the BEST thing that made Practice Fusion so attractive as an EMR, is that it was for FREE and therefore very affordable for the solo and small practices.

However, starting in May 2017, Practice Fusion will cost you $99 per provider, per license. Yes, that is the new price!

Now you can still access the PF FREE version, but with LIMITED options.

Now its your turn: if your office is using Practice Fusion EMR , are you planning on switching to another or are you keeping it?

In The Know Series, Insurance, Training

EmblemHealth HIP Access I plan-information

Posted on January 10, 2018December 13, 2019 by KR2Medical Billing

Traditionally, any provider that has dealt with EMBLEM HIP in the past knows that the plan requires a Referral for a visit with the Specialist. (Exception- if the Specialist provider belongs to the same IPA; ex. Montefiore IPA)

However, as of 01/01/2018 Emblem has released a new HIP plan: HIP Access I. This plan DOES NOT REQ a referral and has a $25 co-pay for the office visit.

Now it is your turn: have your office encountered any new plans from EMBLEM so far? Please share your experiences.

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