INDUSTRY NEWS

  • UHC Pre-Authorizations on "Buy & Bill" Drugs

    2/27/19

    A general warning to any practices that purchase drugs administered to patients and then bill the patients’ health insurance for reimbursement. We have recently seen United Healthcare deny certain drugs for "no authorization on file" despite the practice’s pre-authorization inquiry confirming that no authorization is required for the specified drug. It seems that the "loop hole" being employed by UHC is that the practice did not specifically ask about the "buy and bill" allowance for the given drug.

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  • 2019 Medicare Physician Fee Schedule

    2/27/19

    The 2019 Medicare Physician Fee Schedule goes into effect with service dates on and after January 1, 2019. The 2019 MPFS conversion factor is increasing slightly from $35.9996 to $36.0391. CMS has also confirmed it will not apply the multiple procedure discount to office visits and other services provided at the same visit. As always, we encourage a review of specialty specific CPT codes to ensure you are aware of any notable changes in the reimbursement for those services most important to your practice.

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  • MultiPlan Contract Ammendment to Watch For

    2/27/19

    MultiPlan began sending notice of a contract amendment in December 2018 that will auto-enroll contracted practices with a third party service called Simplicity, effective March 22, 2019. The Simplicity service will directly pay patients’ out of pocket responsibilities (deductible, coinsurance, etc) for a fee of 7% of the total allowed amount of the claim. For most practices, this fee does not justify the service being offered.

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WHAT OUR CLIENTS HAVE TO SAY

As a small internal medicine practice, we are deeply indebted to HuTech for their support in applying for meaningful use and receiving payment!  Without HuTech’s assistance, the medical home submission process would have been even more laborsome.  HuTech's education to our clinical and support staff on Allscripts' EHR has developed efficiency and improvement in documentation.  We thank them for their knowledge, dependability, and experience.

- Advanced Practice Nurse in Illinois