• Payer

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      Medicaid Fee Hike Requires Eligibility Confirmation

      Primary care physicians who treat Medicaid patients will receive fee increases for 2013 and 2014 under the Patient Protection and Affordable Care Act, but only if they sign an attestation form confirming they're eligible for the raise, state officials say.

       

  • Are you taking advantage of these resources?

    • Deadlines for Doctors

      Find out about upcoming state and federal compliance timelines and key health policy issues that impact Texas physicians.
       

    • TMA’s Hassle Factor Log (HFL)

      Has a payer upheld a claim denial, even after an appeal? The TMA HFL program is here to help. 

    • TMA Mini-Consultation Program

      TMA staff experts provide free half-hour consultations to member physicians and their employees at the county society headquarters. Contact your CMS to see when mini-consults will be in your area.

    • Attend a TMA seminar/webinar

      TMA offers CME accredited seminars and webinars to educate you and your staff. 

  • What are the Payers up to?

    • Medicaid Fee Hike Requires Eligibility Confirmation
      Primary care physicians who treat Medicaid patients will receive fee increases for 2013 and 2014 under the Patient Protection and Affordable Care Act, but only if they sign an attestation form confirming they're eligible for the raise, state officials say.
    • Private Payer Round-Up, May 2013
      In case you missed these — here is a roundup of useful items from health care payment plans’ newsletters and updates, compiled by TMA’s reimbursement specialists. If you have questions about billing and coding or payer policies, contact the specialists at paymentadvocacy@texmed.org for help, or call TMA Knowledge Center at (800) 880-7955.
    • Changes Coming July 1 for Aetna and Cigna
      Aetna and Cigna are making changes to their procedures on July 1 that will affect your practice.
    • Novitas Requires Certain Forms for Paper Documentation
      Starting May 1, 2013, Medicare administrator Novitas Solutions will return all faxed or mailed documentation that is not submitted with approved Novitas forms.
    • Medicare Fees Reward Some, Punish Others
      Total Medicare payments to family physicians could increase 7 percent and fees for other physicians providing primary care could rise 3 to 5 percent, due mostly to a proposal to create new payment codes for outpatient discharge care management. Payments to some specialists would decrease in the Centers for Medicare & Medicaid Services' (CMS') proposed 2013 Medicare Physician Fee Schedule. However, unless Congress intervenes again, CMS will slash overall Medicare payments 27 percent next year because of the Sustainable Growth Rate formula.
    • Workers' Comp Rules Change
      New recertification rules for designated doctors in the state workers' compensation system took effect Sept. 1. The new rules include changes to the testing and training requirements for current designated doctors.
    • RAC Audits: Alive and Well
      The top problem uncovered by the Medicare Recovery Audit Contractor (RAC) for Texas’ Region C involves showing medical necessity for cardiovascular procedures, according the Centers for Medicare & Medicaid Services (CMS).

  • Medicare Updates