- October 20, 2009 Faster Way to Send Medical Documentation for an Electronic Claim Beginning November 2, 2009, you will be able to fax medical documentation for Medicare Part B Electronic Claims!CMS website
- March 2009 Attention Part B Pennsylvania and New Jersey MCE customers: Limited Time
Left to Use MCE Migration Utility
Pennsylvania and New Jersey Medicare Claims Express (MCE) customers should now be migrated to the PC-ACE Pro32 software program. Highmark Medicare Services no longer provides software technical support for the MCE software product. If you have not migrated from MCE to PC-ACE Pro32, please take the necessary action provided in your migration letter to enroll for the PC-ACE Pro32 software product or contact another Vendor for Medicare billing software. If you cannot locate your migration letter, details on how to complete the necessary steps to migrate from MCE to PC-ACE Pro32 can also be found on pages 2-3 of the February 2009 Part B EDI Xchange located at http://www.highmarkmedicareservices.com/partb/edi/pdf/xchange/xchange_2009-02.pdf
The current PC-ACE Pro32 Version 1.98 includes a MCE migration utility with the PC-ACE Pro32 software download to assist you in migrating Patient Information, Referring Physician, and Facility Information from your MCE software to the PC-ACE Pro32 software. The PC-ACE Pro32 Version 2.12 scheduled to be released on April 28, 2009, will NOT include the MCE migration utility which means you would need to migrate Patient Information, Referring Physician, and Facility Information manually from your MCE software to the PC-ACE Pro32 Version 2.12 software. Therefore, we encourage you to migrate from MCE to PC-ACE Pro32 Version 1.98 using the MCE migration utility in order to make your migration to PC-ACE Pro32 easier and less time-consuming.
PC-ACE Pro32 Quick Steps, to help you become familiar with the software after it has been installed, can be found on pages 3-4 of the February 2009 Part B EDI Xchange located at: http://www.highmarkmedicareservices.com/partb/edi/pdf/xchange/xchange_2009-02.pdf
Highmark Medicare Services
Medicare EDI Services
1-866-488-0546, option 1
http://www.highmarkmedicareservices.com/partb/index.html - March 2009 Medicare now considers intradiscal electrothermal therapy (IDET) procedures
"noncovered". Medicare Report (March 2009) The decision was released in December but will be retroactive to September 29,2008.
The CPT codes for IDET include 22526, 22527, 0062T and 0063T. Any claims for these
codes submitted after September 29th will be denied. You will not be able to bill the
patient unless they were informed ahead of time that they would be financially
responsible for the charges.
For any future IDET procedures performed on Medicare patients, be sure to have them sign an Advanced Beneficiary Notice (ABN). - April 2008 Aetna Reverses Decision on Anesthesia Reimbursement
Aetna has announced that, based on input from the AGA Institute and discussions with a number of gastroenterologists, it will not implement Clinical Policy Bulletin 0740 on April 1, 2008, as planned. This policy would have restricted the use of an anesthesia professional in standard upper or lower endoscopic procedures, including colonoscopy, for average-risk patients. HealthAmerica announces they will also continue reimbursements.
- Advanced Practice Nurse PowerPoint Presentation – This PowerPoint Presentation describes the roles and reimbursement rules that apply for CRNAs who bill for services provided to Medicare beneficiaries.
See more information on the Medicare Learning Network (MLN)
- Medicare Part B Reference Manual - This manual contains all the information you will need in your day-to-day interaction with Highmark Medicare Services and the Medicare Part B Program.
- Physician Quality Reporting Initiative - The 2006 Tax Relief and Health Care Act (TRHCA) (P.L. 109-432) required the establishment of a physician quality reporting system, including an incentive payment for eligible professionals (EPs) who satisfactorily report data on quality measures for covered services furnished to Medicare beneficiaries during the second half of 2007 (the 2007 reporting period). CMS named this program the Physician Quality Reporting Initiative (PQRI).
- Sign up for Highmark/Medicare email alerts - Mailing lists have been setup to allow Highmark Medicare Services to send emails to everyone who joins them. The messages may be about things we want to tell you in a hurry, system outages, or general updates. General Education list subscribers will receive an email every time we update our web site. This allows us a way to notify you of important changes in the Medicare program.
- The Most Influential Trends in Healthcare Affecting the Practice of Nurse Anesthesia—A Perspective
Mary A. Golinski CRNA, PhD.
PDF file - The Business of Anesthesia
Larry Hornsby, CRNAPDF file - Medical Malpractice and the CRNA – Focus on Patient Safety
Louise E. Hershkowitz, CRNA, MSHA. PDF file - Professional Liability Insurance Issues for CRNAs
Louise E. Hershkowitz, CRNA, MSHA. PDF file - Understanding Anesthesia Billing in the Hospital Setting
Fred Ackler, CRNA, MS.PDF file