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Insurance issues dealing with CMS to private insurance.

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PIP Law Update – Allstate Case Set to Be Heard by the Florida Supreme Court
Monday, 02 May 2016
Many of you have been keeping up with the various Allstate cases on interpretation of the policy provisions that incorporate (or don’t incorporate) the 2012 changes to the PIP statute – specifically, incorporation of the PIP fee schedule in clear and unambiguous language, into the policy of insurance.  
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Potential Denials Reported on Bills by Sole Proprietors/Practitioners
Tuesday, 15 December 2015
Some sole proprietors and some incorporated sole practitioners are reporting being denied reimbursement because they are not billing as a group (business) in field 33. Although an official explanation has not been obtained that describes what is occurring, this appears to involve the need for a second NPI number. 
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PIP Denial Based Upon ICD Code?
Tuesday, 17 November 2015
It has now been over a month since ICD-10 went into effect. Are the PIP carriers accepting ICD-10 codes? With some ambiguity in the PIP statute, most auto carriers announced they would only accept ICD-10. However, not all auto carriers announced how they interpreted the PIP statute.
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PIP ALERT – ICD-9 or ICD-10?
Wednesday, 16 September 2015

As you all should know, HHS is switching to ICD-10 as of October 1, 2015.  Many of your billing software systems are set up to incorporate that change.  But, what about PIP?  Does that billing switch to ICD-10 as well?  The short answer is, who knows based upon the ambiguity in the statute, but, probably, YES.  Based upon conversations between ChiroCode and Auto Carriers, you should likely switch to billing with ICD-10.   

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PPACA Update: New FAQs replace previous document containing objectionable language
Monday, 08 June 2015

ACA Efforts Result in Federal Agency's Clarification of PPACA Language on Access to Non-MD/DO Providers

From an ACA Release of June 3, 2016, Arlington, Va. - At the urging of the American Chiropractic Association (ACA), the Centers for Medicare & Medicaid Services (CMS) has clarified a section of the Patient Protection and Affordable Care Act (PPACA) that led some states to improperly limit patient access to chiropractic physicians and other qualified non-MD/DO health care providers. 

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