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Medicare/CMS
Medicare: New ABN form 2017
Medicare/CMS Forms & Resources
Monday, 17 April 2017

ABN Updated for Medicare: Effective as of June 21, 2017

 The Advance Beneficiary Notice of Noncoverage (ABN), Form CMS-R-131 and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. The effective date is June 21, 2017.

 

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ABN Form CMS-R-131 Renewal
Medicare/CMS Forms & Resources
Tuesday, 04 April 2017
March 2017:  The ABN, Form CMS-R-131, and form instructions have been approved by the Office of Management and Budget (OMB) for renewal. While there are no changes to the form itself, providers should take note of the newly incorporated expiration date on the form.  With the 2016 PRA submission, a non-substantive change has been made to the ABN. In accordance with Section 504 of the Rehabilitation Act of 1973 (Section 504), the form has been revised to include language informing beneficiaries of their rights to CMS nondiscrimination practices and how to request the ABN in an alternative format if needed.  The effective date for use of this ABN form is 6/21/2017. Read more to download the form.
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Websites Providing Medicare Information
Medicare/CMS Forms & Resources
Friday, 27 January 2017

Additional websites of interest for regular Medicare information are:

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Strategic Health Solutions Begins Audit of Medicare Chiropractic Records
Medicare/CMS News
Friday, 06 January 2017
Many doctors have been notified of a Medicare audit conducted by Strategic Health Solutions. Strategic Health Solutions has been contracted to perform and provide medical review functions of Medicare and Medicaid programs.  Strategic Health is currently performing medical review of records through the project Y4P0434 for Chiropractic Services.
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What are the 2017 Medicare Fee Schedule Allowances for Chiropractic Services?
Medicare/CMS FAQ
Friday, 06 January 2017
The 2017 Chiropractic Fee Schedule is now available for our members.
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What Happened to PQRS in 2017?
Medicare/CMS Forms & Resources
Friday, 06 January 2017
With Medicare’s Merit-based Incentive Payment System (MIPS) beginning in 2017, many are asking about PQRS in 2017.  Although it seems clear that PQRS ends on 12/31/2016, the G-code quality reporting will continue under MIPS.
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Medicare Audits in Florida Have Arrived
Medicare/CMS News
Thursday, 08 December 2016
The FCA Help Desk has received several calls this week regarding a request for records from StrategicHealthSolutions, an audit contractor for CMS (Medicare). Please be aware of a potential request for records and do NOT ignore. The FCA Help Desk is gathering Information to assist our members in responding. If you wish to discuss this with Mollie Frawley, FCA Help Desk Coordinator, please email her at insurance@fcachiro.org with your best contact information AND your FCA member number or your Florida DC license number.
 
Read more for helpful steps to take if you receive an audit letter. 
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Medicare Updates and Reminders: Time Sensitive
Medicare/CMS Forms & Resources
Wednesday, 19 October 2016
In addition to the September 12th change in billing First Coast, there are at least 3 other changes that are time sensitive in nature. October 1 begins the need for more specificity in coding ICD-10.  November 30th is the last day to appeal your PQRS status for 2015.  Failure to respond to re-validation requests may require re-enrolling in Medicare with no grace period for billing.  For more information, read on.
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FAQ’s and Coding Tips for Billing Medicare After the 09/12/2016 LCD Change
Medicare/CMS FAQ
Tuesday, 20 September 2016
The September 12, 2016 coding and billing changes by First Coast Service Options (FCSO) have raised several common questions listed below.  These questions are better understood with a better understanding of both the documentation AND billing underlying mandates for covered chiropractic services:
  • Does the September 12th date apply to dates of service or claims submission dates?
  • Do you have a list of common NMS codes we can use?
  • Do I have to have a NMS condition for each subluxation region billed?
  • Can I use the same NMS condition for the different subluxation regions billed? For example low back pain for lumbar, sacrum and ilia?
  • In what order must I bill the diagnoses on the bill?
  • How do I bill when the primary insurer is PIP or Workers’ Compensation and they require different codes and billing instructions than Medicare?
  • Why can I only point to ONE diagnosis code in Field 14 on the bill? When did this start?

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ALERT: Mandatory changes related to Medicare billing effective 9/12/16
Medicare/CMS Forms & Resources
Wednesday, 31 August 2016
Florida Regular Medicare Billing Information for September 12, 2016

The First Coast Local Coverage Determination (LCD) for Chiropractic Services has been updated, to be effective for dates of service on and after September 12, 2016.
 
Of immediate importance are the primary diagnosis codes which have changed for billing.     

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