Need help with Medicare payment issues or with Medicare coding? Do you need information about Medicare enrollment or about participation options? Or are you looking for information about the future of Medicare – what about the payment update, new provisions in the federal Affordable Care Act, new bonuses or new compliance requirements?
Do you have questions and need quick answers? Contact Novitas Solutions with questions.
(855) 252-8782Mon.-Fri. (8 am-5 pm)
Use these Novitas website links for quick information:
IVR Flow Guide: Easily navigate Novitas' phone system.
Medical Policy Search: Search by CPT and ICD-9 code or key word.
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You can also contact the TMA Knowledge Center at (800) 880-7955, or read the latest Medicare E-Tip from TMA.
Avoiding RAC Audits - On-demand webinar1 AMA PRA Category 1 Credits™ (Enduring)1 ETHICS1 TMLT
Presented by: Jonnie Massey, CPC, CPC-P, CPC-I, CPMA in the TMA Education Center
Did you opt out of Medicare (by signing a valid opt-out affidavit) on or after June 16, 2015? If so, under the Medicare Access and Reauthorization Act (MACRA), your opt-out will automatically renew every two years unless you cancel the renewal. You’ll do this by notifying, in writing at least 30 days before the start of the next opt-out period, all Medicare administrative contractors (MACs) with which you filed an affidavit.
An error on the part of the Centers for Medicare & Medicaid Services (CMS) penalizes some physicians, forcing those affected by the blunder to appeal a potential payment cut by Dec. 16. The hassle caused by CMS means those physicians who took part in PQRS and VBM have to dust off their quality and cost reports to determine whether they're among the thousands at risk of incurring payment penalties.
How Will Value-Based Modifier Affect Your 2017 Medicare Payments?MACRA's not here yet, but the Value-Based Payment Modifier program still is. Are you ready? As TMA fights to improve the draft rule implementing the Medicare Access and CHIP Reauthorization Act (MACRA), you need to remember that the old Medicare quality measurement laws are still in place for now.
TMA Says Future Medicare Requirements Are Wasteful, CostlyTMA is "very concerned that many of the compliance, documentation, and reporting requirements that will be implemented in the future Medicare system are wasteful, costly, and do little or nothing to improve care quality or increase efficiency," TMA President Tom Garcia, MD, told CMS.
AMA, TMA Tell Feds to Speed Up Release of MACRA FundsThe federal government needs to kick it in gear and release funds for "the development of quality measures and technical assistance to small practices" authorized by the Medicare Access and CHIP Reauthorization Act (MACRA). That's the gist of an Oct. 7 letter from the AMA to CMS Acting Administrator Andrew Slavitt. TMA signed on to the letter in support of expeditious release of the critical funding.
SGR Is Gone. Now What?Physicians will have to prepare to participate in one of the new payment systems that will replace Medicare's SGR formula, which Congress eliminated in April via the Medicare and CHIP Reauthorization Act. Come 2019, physicians can participate in one of two major payment tracks: the fee-for-service Merit-Based Incentive Payment System, which boosts or docks physician pay based on their quality and cost performance; or one or more alternative payment models, such as accountable care organizations, medical homes, bundled payments, or other initiatives.
TMA believes the patient-physician relationship must be preserved regardless of patients’ health conditions, ethnicity, economic circumstances, demographics, or treatment compliance patterns. Unfortunately, many pay-for-performance strategies, commonly referred to as “value-based payment models,” that intend to contain health costs could undermine this relationship.
Eliminating the constant threat of Medicare payment cuts means that we can focus our energies on improving this new law. We can focus our energies on removing the bureaucratic impediments that get in the way of good patient care.
Got Medicare questions? Call the Knowledge Center.
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Use TMA’s free tool to screen physicians from whom you receive order/referrals to make sure they are enrolled in the Medicare program.
More than ten million Medicare beneficiaries currently receive their Medicare coverage through Medicare Advantage (MA); a program in which Medicare contracts with and pays private health plans to provide coverage for Medicare benefits.