EmblemHealth to Provide Medicare Advantage Benefits to Former Affinity Members

Beginning January 01, 2019, EmblemHealth will provide Medicare Advantage benefits to approximately 10,000 members who were previously in Affinity's Medicare Advantage plan....



Order Requirements When Prescribing Practitioner is Also the

Supplier and is Permitted to Furnish Specific Items of DMEPOS

Background: This clarifies CMS requirements for a written order when the prescribing

practitioner is also the supplier, and is permitted to furnish specific items of DMEPOS...



Reminder for Your Patients in UnitedHealthcare Oxford Commercial Plans

If you have patients who employers are renewing their health coverage with a United-Healthcare Oxford commercial plan, you’ll see some differences in their new member identification (ID) card thar we want to remind you about...



Emblem Health-GHI Plans-Modifier 25 with Evaluation and Management Services Reported with Procedures

Modifier 25 is used to define a substantial, separately identifiable evaluation and management (E/M) service that was performed at the same time as a procedure...



Medicare Will Likely Face Pushback on Physician Pay Changes

Federal officials will likely encounter some resistance to a proposed overhaul of

Medicare's payment for evaluation and management (E/M) services, which could

raise this reimbursement for some specialties while lowering it for others...

News Alerts


This section provides the latest and essential industry updates as they become available.



2019 MIMEDX Code Update

The following changes will go into effect January 01, 2019:



CMS Announces 2019 Medicare

Parts A&B Premiums and Deductibles

Medicare Part B covers physician services, outpatient hospital services, certain home health services, durable medical equipment,

and certain other medical and health services not covered by Medicare Part A...



Prior Authorization for Select Foot

Surgery-UnitedHealthcare Commercial

Effective Jan 01, 2019, All Savers members on

policies 908867 and 908868 and Oxford Individual members on policy 908410 will require prior authorization for select ...



Duplicate Claim Submission Reminder

National Government Services has an important reminder regarding duplicate

claim submissions. Services that have been processed for payment or denial

should not be refiled as a new claim to correct submissions errors...

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