Humana settlement deadline is Feb. 28!
Under a settlement negotiated by the American College of Emergency Physicians, Humana is accepting resubmission for separate payment of 12 Lead ECG interpretations (CPT 93010) with dates of service from October 1, 2009 through March 31, 2010. Don't miss this opportunity to get significant incremental reimbursement for your practice. Your ACC, working with the Managed Care Advisory Group, is ready to assist with your filing. They can be reached at 800.355.0466, or at physicianservices@mcaginc.com. Resubmitted claims received by Humana after Feb. 28 will not be reprocessed. Get the details.
United HealthCare (UHC) extension:
Due to delays in notifying cardiologists of whether they qualified for UHC's UnitedHealth Premium designation, the ACC and other physician organizations worked to secure a two-week extension from UHC for those physicians seeking reconsideration of their status. Physicians now have until Feb. 26 to submit their reconsideration requests in time for any changes to be reflected by the March 30 display date. Requests received after this date will be reviewed on an expedited basis, however, results of the review may be posted in subsequent display dates. For additional information, view UHC's official announcement. For any additional concerns, please contact ACC Advocacy at 800-435-9203.
New Jersey Blue Cross Blue Shield (BCBS) radiopharmaceutical payment policy overturned!
Thanks to the efforts of your ACC, the ACC New Jersey Chapter, the American Society of Nuclear Cardiology and the Society for Nuclear Medicine, Horizon BCBS of New Jersey will eliminate its payment policy restricting the number of reimbursable radiopharmaceutical units (A9500 and A9502) administered as part of a multiple SPECT MPI study (CPT code 78452). Horizon has also agreed to automatically reprocess and repay all claims with applicable interest for the reimbursement of radiopharmaceuticals from the policy's effective date of September 2009. Members are encouraged to review their Horizon claims and explanations of benefits to ensure the claims were reimbursed correctly. For any additional questions, please contact ACC Advocacy at 800-435-9203.
Self referral win in Utah!
"Medical Practice Self Referral" Legislation (S.B. 91) before the Utah Senate failed to pass out of the Health and Human Services Committee this week. The bill would "require disclosure and reporting by a health care provider when the health care provider refers a patient for imaging services and the provider has a financial interest in the imaging services." As the fight to ensure cardiovascular professionals are able to provide in-office imaging services moves to state capitols across the country, this is a very important victory. Your ACC worked with the Utah Chapter and the State Medical Association to educate legislators on the importance of patient access to quality imaging services. We will continue to monitor this and similar legislation in other states.
Eliminating inequities in CV care
was the subject of a special Capitol Hill briefing this week sponsored in part by your ACC. ACC CEO Jack Lewin, M.D., spoke at the briefing and specifically addressed reducing inequities through quality measurement. He said the keys to reducing disparities include performance measure-based quality improvement and provider and patient education. This was a great opportunity to highlight the benefits of registry use, as well as the work of credo (Coalition to Reduce Disparities in CV Outcomes). Read more.