Online Scheduler Training to Come in July |
As we upgrade our billing software, new functions will become available in scheduler. One of the major changes is that your demographic information will now be live! This means you will be able to view and update patient contact information from the scheduler. Some of the other changes will include:
- Enhancements to the template creator
- Right-click menu on the appointment book
- Additional shortcuts
- Additional department configuration options
- Schedules within specific time ranges
- Updated detailed appointment schedule report
IPC will be providing online training seminars to introduce you to the new scheduler features. This live training will allow you to ask questions and see the answers on your own screen. Classes will be scheduled as needed, so contact [email protected] to sign up. |
Authorization Cont'd |
Aetna - Most Aetna patients in West Michigan are PPOM and - as long as you partipate - you may see patients without a referral. However, certain plans such as Aetna Select, Elect Choice, and Managed Choice POS require a referral by the PCP. The PCP is responsible for notifying Aetna and if they have not done so, your services will be denied.
CareSource - CareSource is a Medicaid HMO and requires a primary care authorization in order to be paid. This payer can be very difficult to work with so we advise getting the auth BEFORE you see the patient. Click to access the CareSource prior authorization request form. Health Plan of Michigan - Referral from the PCP is required for ALL specialty services. The authorization form can be obtained on the Health Plan of Michigan website. Molina - The name of the PCP and a referral are required for all claims. If the patient is unable to provide this information, call 1-888-437-0606. Referral and service request (authorization) forms can be found in the resources tab of the Molina website.
Priority Medicaid - Not only do you as a specialist need a PCP referral to see Priority Health Medicaid patients, you may also need to obtain an authorization directly from Priority Health for certain services you provide. If you do not participate with Priority Health Medicaid you must have all of your services preapproved in writing.
Priority Health - Click to view a list of services requiring authorization. Priority Health also requires a referral from a Spine Center of Excellence for certain services. Authorizations can be requested and tracked easily online at the Priority Health Provider Website.
Don't jeopardize your payments! When in doubt, obtain an authorization or PCP referral. |
Medicare Scam Alert! |
CMS is warning providers of a scam where perpetrators posing as a Medicare Carrier fax fraudulent questionnaires to physicians. The fax instructs physician staff to respond to prevent a gap in Medicare payments. This is a fraud! Do not respond to this questionnaire. IPC warns clients to always verify identities before giving out any information. Scams like this one can be carried out not only by fax, but also by e-mail or phone. If you receive a request for information, please check with IPC before responding. |
About Us |
If you have any questions regarding this newsletter, you can contact us at:
Mary Ellen Duffy [email protected] Patricia Nevala [email protected]or call us at 616-459-6867 or 800-606-1455
Please feel free to forward this newsletter to your staff and peers.
Innovative Practice Concepts, LLC -- A full service medical billing company
Your Bottom Line is our Top Priority!
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