The problem with our website and the online forms has been fixed.  Providers can again submit patient info and billing via the online forms.

Thanks,

Steve

Website and Online Forms Currently Unavailable

  Our website...and the online forms...are currently unavailable.  We are awaiting a fix from our hosting company.

  Once the issue has been resolved and the website...and online forms...are again available, we will post an update in the News section of the Support Suite.

Thanks,

Steve 

Copay Type on Billing Form

  On our billing form if a patient pays a copay a provider can select Cash, Check or Credit Card.

  There are times when your office may mistakenly select one of those fields.  As some have discovered, you cannot uncheck a selection...so if you selected one of those options you then must enter a copayment amount of $0.00.

  To help in situations like this, we have added an option for NONE as Copay Type.  You should only select this option if you mistakenly have selected one of the other options and the patient had NOT paid a copayment for that date.

  If a patient has not paid a copayment, you do NOT have to select None as the Copay Type UNLESS you have mistakenly selected Cash, Check or Credit Card.

Thanks,

Steve 

Old Forms Now Searchable

  For providers enrolled in the View and Search feature of our online forms, we have imported the old forms submitted under the old forms platform.

  Some dates may appear off on the forms as there was an issue with some (but very few) date fields on some forms...However, over 99.5% of the forms have accurate dates entered.

  Some practices that enrolled for the View and Search feature had changed their office name on the old forms after they logged in.  For the most part we have been able to match these forms to your current user account for the online forms, but some forms may be missing if you changed your office name and we could not match it up.

DUPLICATE PATIENT FORM CHECK

• Some offices mistakenly submit patient forms more than once for the same patient.  Remember, if a patient changes insurance, you must submit a support ticket in the Support Suite and provide the following information:
  • New insurance payer name
  • New ID # and Group #
  • Effective Date of the new coverage
  • Insured Name and DOB, if not the patient
  • If an auto or work comp accident, you must also provide the payer's claim address, phone #, fax #, claim # and date of injury.
• To prevent against duplicate patient submissions, if you attempt to submit a patient form for a patient for whom your office previously submitted a form the form will not go through.  Instead you will receive a big message at the top of the form that says
  • There was a problem with your submission.  Please review the fields below.
  • And below that you will see below the patient's name the message that reads:  A duplicate entry was found.
  • When you receive such a message, it is a reminder to you that that patient already exists in our database and you must instead submit a support ticket with the information mentioned above.

Thanks,

Steve 

Personalized Video Demo of Revenue Performance Advisor Portal and Support Suite

     Many of our clients are not utilizing the Revenue Performance Advisor Portal and some are not using our Support Suite.

     With the RPA Portal you are able to see all claims we submitted, if the claims were accepted or rejected and you can see ERA files (electronic EOBs).

     With the Support Suite, providers should be logging in EVERY DAY to see if there are any open tickets that require a response.

     To help providers we are offering to produce and provide you a personalized video demo of the Revenue Performance Advisor Portal.

     In the demo I will use your practice's live data to show you how to:

• Find Claims
• Show you how to see the details of the claims that were submitted
• See if the claims were accepted or rejected
• If rejected, show you how to view the rejection reason
• If a claim was paid via an ERA file I will show you how to view the EOB for that claim
• I will show you how to search ERA files in the Portal.

     All you have to do is send me an email and request that I provide you a video demo of RPA.  IF YOU WANT A VIDEO DEMO OF THE SUPPORT SUITE, INCLUDING THAT IN YOUR EMAIL.

     Note:  Because we do expect demand for this service...and because the videos generally will only be produced during the weekends, we cannot provide the videos immediately but will work as quickly as possible to fulfill the requests.

Thanks,

Steve 

To assist providers in learning how to use our new online patient form and billing form AND how to search forms previously submitted under the new forms system, we have created a tutorial video. 

Click https://youtu.be/jcRUazxsM1A to view the video.  REMEMBER, forms submitted under the old forms system are not currently available in the new forms system (although we are hoping to import them into the new system later in May).

Thanks,

Steve

New Online Forms Are Active

  Our new online forms are active.  A few things about the new forms:

• The new forms can be accessed from the links on our website OR by clicking the Login to Online Forms Button on our website.

• If you arrive at our old forms site, you should NOT submit forms on the old site (the site is https://forms.mbpros.com for the old site).  If you clicked a link and wound up at the old site, you may have to clear your cookies and reboot to access the new forms.

• For those who are enrolled for the View and Search feature of the forms, we will be importing the old data into the new forms system.  However, we do not anticipate this will be active until mid-May.

• If you attempt to access a patient form or billing log without first logging in, you will receive a pop-up notification in your browser asking if you are sure if you want to complete the form without logging in.  For those who forgot to log in, say No and then you can log in.

• For the benefit of our providers who are doing telehealth, we have added a field at the top of the billing form asking if all visits on the form are for telehealth.  This is a required field!  If only some of the entries on the form are telehealth, say no and as per the past enter (02) in parentheses after the procedure codes for those patients you did see via telehealth.

• We have added an email address field to the patient form.  HOWEVER, this field is only to be completed by our clients who are enrolled for BillFlash Electronic Patient Statements.  If your office is NOT enrolled for BillFlash but you enter an email address, we will ignore this entry and not enter the patient's email address in our Medisoft software.

• For providers under the View and Search Feature of the Online Forms, if you provided us a new password to use during the past week you should now be using the new password.

• Many of our providers who are enrolled for the View and Search Feature of the Online Forms has not yet provided me a new password per the notices we have sent during the past week.  For these providers we will be working the next few days to set you up with a password that meets the new criteria.  We will then both email you the password to use and also create a ticket in the Support Suite with the new password.If you have any questions, feel free to email me.

Thanks,

Steve 

There is an ongoing problem with the Online Billing Forms where the app suddenly stops responding when trying to submit a form.  We are aware of the issue and to date the developer cannot diagnose the problem.

We are going to be having our online forms completely redone but it will probably take 2-3 months for this to complete as it is a major project.

In the meantime, when you submit an online billing form be sure you come to the confirmation page where you can see the link for the PDF version of the form you submitted.

If you do not get to the confirmation page as the form continues to "buffer", let us know so we can reset the online forms.

If you are ever unsure if your form went through, just go to Search Billing Forms (assuming you subscribe to the View and Search Feature).  ALWAYS SEARCH THE BILLING FORMS FIRST PRIOR TO CHECKING WITH US.

Thanks,

Steve

New BillFlash Collection Service

  Over the years providers have always asked if we offer a collection service to help collect balances patients owe.  Now we are happy to announce that such a service is available via BillFlash.

  For providers who are enrolled for the BillFlash Patient Statements you can easily add on BillFlash Collection Service.  All you would have to do is log in to your account and select which patients you would want enrolled for the Collection Service (you can choose all patients or only certain patients or you can choose patients by past-due range).

  IF YOU WANT TO SCHEDULE A PRESSURE-FREE DEMO WITH OUR BILLFLASH REP, GIVE ME A CALL!  

  If you are not currently sending out patient statements each month, YOU MUST DO SO in order to avoid possible financial problems with payers.  You should definitely consider BillFlash Patient Statements AND then for your "problem" patients BillFlash Collection Service.

  For more information about BillFlash Patient Statements, visit:  www.mbpros.com/billflash.html.

  For more information about BillFlash Collection Service, visit:  http://www.mbpros.com/billflashcollectionservices.pdf.

  Remember if you are not doing anything now for your patient statements, you must change how you are running your practice.  So let's schedule a pressure-free demo with our BillFlash Rep.  Just give me a call so we can schedule a time!

Thanks,

Steve 

NEW PROCEDURE FOR ANNUAL PREPAYMENT OPTION RENEWALS

For our providers who are currently submitting under an Annual Prepayment Option (or who want to convert from the standard rate to an Annual Prepayment Option) from now on we will be emailing you an Annual Prepayment Option Renewal Agreement.

  This agreement will allow you to digitally sign the agreement in which you indicate you want to purchase a renewal and that you undertstand the terms of the Annual Prepayment Option.

  We will send this email to you approximately 3-4 weeks prior to you running out of claims under your current prepayment option.

  If you do not digitally sign the agreement within 3-4 days we will send a second notice.

  If you do not digitally sign the agreement after another 3-4 days we will send a third and final notice.

  If you still do not digitally sign the agreement you will automatically be converted to the standard per-claim rate once you run out of claims under your current prepayment option.

  In this agreement providers will have the option to check a box for Automatic Renewal of the prepayment option.  This will allow you to continue to take advantage of the discounted Annual Prepayment Option rates without having to complete this agreement each time you run out of claims.

  It is important that providers check their emails every day.  When you receive a notice from Adobe Sign about the Annual Prepayment Option agreement, make sure you immediately click the link in the email to complete the agreement.

  You then will receive via email an executed copy for your own records.

  And for those that ask, no, this agreement cannot be faxed to you.  It can only be emailed so you can digitally sign the agreement and so we have the history via Adobe Sign.

Thanks,
Steve

New EAP Billing Option for Behavioral Health Providers

     For payers that require EAP billing to be submitted on a proprietary form that includes clinical documentation, we now are going to offer EAP claim submissions.

     Please note that this notice does NOT apply to payers (such as United Healthcare and Cigna) which allow for electronic claim submissions via the ANSI 837P format (the usual electronic claim format).  This notice only applies to payers (such as Magellan) that require EAP billing to be submitted on a form that includes clinical documentation.

     In order for us to submit EAP billing to payers like this, there are some important things to consider:

• Many payers have an EAP form or packet they provide you when authorization is given.  You must scan this packet (or form) and upload into your EMR.  This will also provide us the authorization number, the dates allowed under the auth and the number of EAP visits allowed.

• We must have access to your EMR.  If we do not already access your EMR, you would have to provide us a login and password.

• We must have access to that form or packet in your EMR.

• We must also have access to the notes for the patient so we can determine how to answer the various questions.  For example, in TherapyNotes, we must be given the role of Clinical Administrator.  If you do not want us having access to all notes for all patients, then when you want us to submit EAP billing you can print the notes as a PDF and attach to a ticket in the Support Suite.

• Your notes must provide all required information needed on the form.  If any information is missing (for example, Magellan asks various questions about percentage improvements), we will submit a ticket in the Support Suite and ask you the questions.  You should log in every day to the Support Suite to see if there are any tickets you have to respond to.  However, if all info that we need is in the notes, then we will not have to create a ticket.

• We will need login information for some websites (such as Magellan and Beacon Health Options).  We will notify you when we need such login information.

• Some EAP payers want billing submitted only at the end of treatment.  Others allow for interim submissions.  If billing is to be done only at the end of EAP treatment, notify us at the outset to hold billing until the end.  Then once we see the patient has used the last visit allowed we will submit the EAP billing.  For example, if John Smith has 5 visits allowed, we would submit after the 5th visit if you notify us to hold until the end.  Otherwise, we will submit EAP billing after each visit.

• Because EAP billing takes significantly longer when doing these specific EAP forms that include clinical documentation, the fee per EAP submission will be $14.95 per submission.  In addition, these EAP submissions will not count as free claims for providers who enrolled under an introductory special.

• Generally we will do EAP billing on the weekends, not during the week, because of the time required to complete the forms.

If your office wants us to submit EAP billing for you, let us know!

Thanks,

Steve

Free Telehealth Platform

  A number of providers have contacted us regarding the issues all offices are facing now during the coronavirus pandemic.  Many patients simply do not want to come to your office to be treated to avoid the risk of becoming infected with the virus.

  For many of our clients, telehealth is the best option.  This is especially true for behavioral health providers.  Even if you are scared of technology changes, we strongly encourage providers to check out www.doxy.me.  They offer 3 different levels of telehealth platform including a FREE service option.  For most providers the free option will serve your purpose, although the quality of the video is Low Definition Video.  If you want High Definition or Standard Video, you can upgrade to the Professional Edition for $35/month for individual providers.

  Keep your patient load busy by offering telehealth services to your patients.  For chiropractors and physical therapists, you still can offer some services via telehealth.

  Remember, when reporting billing to us, if you performed telehealth services make sure to let us know that the Place of Service code is 02.  You can do this on the billing log by entering 02 in parentheses after the CPT code.

EXAMPLE:  John Smith     3/24/2020     90834 (02).

     If all patients on a billing log were seen by telehealth, instead of the above you can indicate in the Additional Information section of the billing log that "All patients seen by telehealth."

     If you have any questions during these trying times, do not hesitate to contact me

Thanks and stay healthy!

Steve 

The Medisoft Version 24 upgrade is complete.  Providers can again connect to the Medisoft network.

NOTE:  When you connect you will see a message for registering the program.  CLICK REGISTER LATER.  We will be having our Medisoft reseller register the program for us this week.

Thanks,

Steve

Insurance Verifications for Existing Patients

    This notice is for our Platinum Service providers only!  A number of providers have asked us about verifying insurance benefits for existing patients.  As you know under the Platinum Service insurance verification is included in the per-claim fee for new patients OR for patients who change their insurance coverage.  However, verification has not been available for existing patients.

     Who would you want to verify benefits for existing patients?

• At the beginning of a benefit year you will want to know if the patient's copay and/or deductible has changed.
• During the benefit year you will want to know if the patient has met his/her deductible.

     Therefore, we will now offer an OPTIONAL Insurance Verification Service for existing patients.  If you want us to verify benefits for an existing patient, just submit the request as you do now by sending us an email.

     The fee for insurance verifications for existing patients will be $7.95 per verification.  If you submit a request for an insurance verification for a patient and the patient is not a new patient (or the patient has not changed insurance coverage), you will be charged the $7.95 per verification fee.

     A second option for providers is to enroll for the Eligibility feature in the Revenue Performance Advisor Portal.  The fee is an additional $18 per month ($29.95 instead of $11.95/month).  This fee allows for up to 50 verifications per month (additional verifications are 42 cents per verification).  Your office can then check the benefits and deductible in real time for over 400 payers.

     If your office is interested in adding the Eligibility feature to the Revenue Performance Advisor Portal, let us know.  Note that many payers do require enrollment for eligibility so we would enroll you with those payers.

     If you have any questions, do not hesitate to ask.

Thanks,

Steve 

For providers who submit claims to Medicare, remember that all claims submitted must have the patient's MBI listed.  We have already seen claims reject because providers are failing to provide us a patient's MBI.  Below are some important reminders:

• It is YOUR responsibility to ensure that we have MBI numbers for all of your Medicare patients.  Do NOT send an email with the patient's MBI.  Make sure you always log into the Support Suite to submit a ticket with the patient's MBI.

• For providers using WebPT or TherapyNotes or ICANotes, do NOT just enter the MBI in the software program.  You must also submit a support ticket with the name of the patient and the MBI.

• It is your responsibility to ensure that every day you log into the Revenue Performance Advisor Portal to review your rejected claims.  If you fail to provide us an MBI for a Medicare patient, the claims will reject electronically and you will find the rejection in the RPA Portal.  If you have not been using RPA, you will want to make sure it is part of your daily routine.

• We will also be submitting tickets in the Support Suite for our Premium, PremiumPlus and Platinum Service providers when we see claims reject in the RPA Portal because an MBI was not listed.  Make sure every day you log into the Support Suite to view your open tickets and that you promptly reply back with the patient's MBI.

• Remember we can provide you a report of all of your Medicare patients in our Medisoft software so you can determine if we have the patient's MBI number or the old Medicare number.  The fee is only $5.95 for the entire report (not per patient).  If you want us to send you this report, just send us an email.

• Finally remember that if you do not have the patient's MBI bu do have the patient's Social Security number, we do offer an MBI lookup service.  The fee is $4.95 per patient for us to research and obtain the patient's MBI.
  • Simply send us an email with the names of the patients and request the MBI lookup service.
  • Do NOT send an email asking us to look up the MBIs for all of your patients.  You must list the names of those patients for whom we do not already have an MBI number.  If you are unsure if we have an MBI or not, you will want to request the report we have of all of your Medicare patients.
  • If you submit a request but we do not have the patient's Social Security number, we will create a ticket in the Support Suite and advise you to reply back with the patient's Social Security number.

     Make sure claims don't reject by acting now.  If you want us to provide you a report of all Medicare patients we have on file for you to review, simply send us an email asking for a Medicare patient report.

Thanks,

Steve 

Medisoft Network Server Upgrade Complete

New Server Login and Password Required

     Our upgrade to our new server is complete.

• Providers should still go to https://www.medicalbillingclaims.com to connect.
  • HOWEVER, if you go to that site and do not get our login screen, you can clear the cookies in your browser and try again.  If you still have an issue with getting to the server login screen, you can go to https://www.medicalbillingclaims.com/rdweb to connect.

• Providers should use the new Server login and password you recently created.
• PROVIDERS MUST ENTER mbpros2\ prior to your Server login.  For example, if your login is abcchiro you would enter mbpros2\abcchiro as your Server login.
  • Note that previously you entered mbpros\ prior to the Server login.  Make sure now you enter mbpros2\ prior to your Server login.
• If you do not recall your Server login or Server password, please submit a Support Ticket (do not send a regular email).
• Some of our practices that access the Medisoft Network never submitted tickets with your new Server login and password requests.  These practices will be unable to access the network until you comply with the notice we first sent notice about on September 10, 2019.

• Any custom grids you created in Medisoft in Transaction Entry, Claims Management or the Ledger must be recreated.  Medisoft has been reset to its default settings.

Thanks,

Steve 

MBI Required for Medicare Patients as of January 1, 2020

     For our Medicare providers, as of January 1, 2020 you MUST report the new MBI (Medicare Beneficiary Identifier) for your Medicare patients.  The date of service is irrelevant.  Even if services took place in 2019 you must report using the MBI.

     A number of our clients have not provided us MBI numbers for all of your Medicare patients.  Remember, ALL of your Medicare patients have their new MBI cards by now.

     When this requirement becomes effective, it will be your office's responsibility to ensure that you have provided us the MBI number for your patients.  We will NOT be checking every patient to ensure we have an MBI number on file.

     If you are not sure if you have provided MBIs for us, do NOT submit a ticket requesting if we have an MBI on file.  Instead, we can provide you a report of all of your Medicare patients with their demographic info, including ID # ($5.95 fee for this report).  You can then use this report to review and for those patients where we do not have MBIs listed you can then submit a ticket (do NOT send a regular email) with the new MBI numbers.

     NEW MBI LOOK-UP SERVICE:  Don't have time to look up MBI numbers for your patients.  We will be offering an MBI Look-up Service.  For $4.95 per patient we will research and obtain the patient's new MBI.  For this we must have the patient's name, DOB and Social Security number.  For most Medicare patients we already have this info on file.

     If you do want us looking up MBIs for any of your patients, you must submit a support ticket, request the MBI Look-up Service and list the names of the patients.  If for any reason we cannot obtain an MBI (for example, we do not have the patient's SS number), you will be notified.

     If you see patients in a nursing home, it is your responsibility to ensure you obtain updated face sheets with the MBI number listed from the Business Office of the nursing home.  Again, we can look up MBIs if you request us to do so.

     If you do not provide an MBI to us OR request that we look up the MBI, the claim will reject (presumably on an EOB) in 2020.  When it rejects a ticket will be created in the Support Suite and you will be notified to provide us the MBI for the patient so we can rebill.

     Beginning in 2020 for any offices that submit a patient form and list an old Medicare number rather than an MBI you will be instructed to submit a new patient form and enter the patient's MBI number.  For any practices that see patients in nursing homes and in 2020 provide face sheets with an old Medicare number you will be instructed to submit an updated face sheet with the patient's MBI number.

Make sure claims don't reject by acting now.  If you want us to provide you a report of all Medicare patients we have on file for you to review, simply send us an email asking for a Medicare patient report.

Thanks,

Steve 

Important Info Regarding Insurance Verifications for Platinum Service Providers

  For our Platinum Service Providers, insurance verifications have been performed by my daughter.  However, she will be out on maternity leave through early December.

  During this time I will be doing the verifications, usually by the next business day.  HOWEVER, when I am traveling to conferences, NO INSURANCE VERIFICATIONS will be performed during that time.  If time is of the essence for verifications during this period of my daughter's maternity leave (especially when I am out of town at a conference), your office should verify benefits yourself.

   For example, this week I will be out of the office Tuesday-Friday at a conference and next week I will also be out Tuesday-Friday at another conference.  If you need to have benefits verified during this time, you should verify benefits yourself.

Thanks,

Steve 

New Server Passwords Required

     This notice is only for those providers who access our Medisoft Network.  We will be switching to a new, faster server in the next few weeks.

     As part of this change, we will be setting up users brand new with higher security requirements for passwords.

     Therefore, if your office currently connects to our Medisoft Network, you should log into our Support Suite and submit a ticket with new server passwords for each server login you currently have.  Make sure you list the Server login and then the Server password you are requesting.  The Server password must meet the following requirements:

• Minimum of 6 characters
• At least 1 capital letter
• At least 1 lower case letter
• At least 1 number
• At least 1 special character

     Again, please submit a ticket with your current Server login and the requested new password for each login your office has.

     There will be NO changes to the Medisoft logins and passwords.

     The new passwords will NOT take effect until we notify you of the change to the new server.  You will keep using your current password until notified otherwise by us.

Thanks,

Steve

The Medisoft Network is again available after repairs to the network.  For those who experienced slowness this week, we have moved to a temporary server that is much faster.  

In the next few weeks we will be moving to an even faster server as part of a new network.  With this new network, providers will have new logins to our server.  We will notify you when you will have to select new logins and passwords.

Thanks for your patience during the troubles this past week.

Steve

Return of the Platinum Service

    Last Friday we sent the below notice.  There will be two minor changes from the below notice.  

• First, we will automatically follow up on any claims that are denied in error OR which remain open after 30 days.
• Second, there will NOT be a fee if we follow up on a claim where the payer had paid you and your office had failed to provide us a copy of the EOB.

HOWEVER, we will be enforcing the below rule that was in effect previously:

• Providers must provide copies of all EOBs to us AT LEAST once a week.  Ideally every day providers should upload scanned copies of EOBs to the Support Suite.  For practices that do not submit copies of EOBs AT LEAST once a week, follow-up of claims will be suspended.

The reason for the above rule is simple.  Providers want us to focus on following up on claims that require follow-up attention and not on claims that have already been properly processed.

Again, see below for the notice sent last Friday and just remember the minor changes (indicated above):

You spoke, we listened.  We have heard from a number of former Platinum Service providers who have requested that we reinstate the Platinum Service.  The primary reason for this request is certainty of fees.  By paying one low fee that includes insurance verification and follow up, providers are better able to esimtate their monthly fees.

     With that in mind, we are effective immediately reinstating the Platinum Service.  As a reminder the Platinum Service includes:

• Claim Submission
• Posting of all payments
• Insurance Verification for new patients and for patients who change insurance
• Follow-up of oustanding/denied claims
• Authorization and Benefit Tracking.

FEES:

     The fees will be the same as before:

• $3.99 per claim ($199.95 per month minimum fee)
• 1000 claim prepayment for only $3.65 per claim

     THERE WILL BE ONE IMPORTANT CHANGE, HOWEVER.  Because 80% of the claims we previously followed up on were paid to the providers but the providers had failed to provide us copies of EOBs, we will now provide 2 options for providers:

• Automatic Follow-Up of Claims (we will automatically follow up upon any claims denied in error or open after 30 days)
• Your office advises which claims to follow up upon (we will advise when claims deny in error AND we will provide an aging report showing claims open at least 30 days old)
• In addition, for payers that do not offer Electronic Remittance Advice, if you provide us a login and password to the payer's website on a weekly basis we will log into the payer's website to download any EOBs.
• THEN if we do follow up upon a claim and it is determined that the claim was processed to you on an EOB but your office failed to provide us that EOB, a follow-up fee of $7.95 per claim shall be assessed.  Again, this fee will only be charged in the rare times when we follow up on a claim and it is determined that you had already received the EOB from the payer but failed to provide it to us.
• HOWEVER it is strongly recommended that every day providers scan EOBs they receive that are not in the RPA portal and provide them to us.  If your office makes this part of the daily routine you should rarely encounter the instance of when a claim has been paid, we have followed up and it was determined you had already received the EOB.  
• IN ADDITION, the follow-up service will only be available for providers enrolled under the Platinum Service.  Follow-up will no longer be available as an a la carte option for PremiumPlus providers.

HOW TO SWITCH TO THE NEW PLATINUM SERVICE

• To switch to the new Platinum Service simply send us an email requesting the change which will take place the day you send the email.  The new service will only apply to claims submitted on and after the date of your switch to the new Platinum Service.
• In addition, you must advise if you want the Automatic Follow-Up option OR if you will advise on a claim by claim basis which claims we should follow up upon.
• For our former Platinum Service providers, you will NOT automatically be converted back to the Platinum Service.  You must re-enroll for the Platinum Service.
• For those providers who are under a PremiumPlus prepayment option, ask for the fee difference for you to convert to the Platinum Service.

 IF YOU HAVE ANY QUESTIONS, DO NOT HESITATE TO ASK.

Thanks,

Steve 

The Medisoft Version 23 upgrade is complete.  The only bug known at present is you will receive a pop-up to register Medisoft Reports Professional.  Just click REGISTER LATER.  We will address this issue with our Medisoft Reseller on Monday.

Thanks,

Steve

Return of the Platinum Service

     You spoke, we listened.  We have heard from a number of former Platinum Service providers who have requested that we reinstate the Platinum Service.  The primary reason for this request is certainty of fees.  By paying one low fee that includes insurance verification and follow up, providers are better able to esimtate their monthly fees.

     With that in mind, we are effective immediately reinstating the Platinum Service.  As a reminder the Platinum Service includes:

• Claim Submission
• Posting of all payments
• Insurance Verification for new patients and for patients who change insurance
  
• Follow-up of oustanding/denied claims
• Authorization and Benefit Tracking.

FEES:

     The fees will be the same as before:

• $3.99 per claim ($199.95 per month minimum fee)
• 1000 claim prepayment for only $3.65 per claim

     THERE WILL BE ONE IMPORTANT CHANGE, HOWEVER.    Because 80% of the claims we previously followed up on were paid to the providers but the providers had failed to provide us copies of EOBs, we will now provide 2 options for providers:

• Automatic Follow-Up of Claims (we will automatically follow up upon any claims denied in error or open after 30 days)
  
• Your office advises which claims to follow up upon (we will advise when claims deny in error AND we will provide an aging report showing claims open at least 30 days old)
  

• In addition, for payers that do not offer Electronic Remittance Advice, if you provide us a login and password to the payer's website on a weekly basis we will log into the payer's website to download any EOBs.
  
• THEN if we do follow up upon a claim and it is determined that the claim was processed to you on an EOB but your office failed to provide us that EOB, a follow-up fee of $7.95 per claim shall be assessed.  Again, this fee will only be charged in the rare times when we follow up on a claim and it is determined that you had already received the EOB from the payer but failed to provide it to us.
• HOWEVER it is strongly recommended that every day providers scan EOBs they receive that are not in the RPA portal and provide them to us.  If your office makes this part of the daily routine you should rarely encounter the instance of when a claim has been paid, we have followed up and it was determined you had already received the EOB.  
  
• IN ADDITION, the follow-up service will only be available for providers enrolled under the Platinum Service.  Follow-up will no longer be available as an a la carte option for PremiumPlus providers.

HOW TO SWITCH TO THE NEW PLATINUM SERVICE

• To switch to the new Platinum Service simply send us an email requesting the change which will take place the day you send the email.  The new service will only apply to claims submitted on and after the date of your switch to the new Platinum Service.
• In addition, you must advise if you want the Automatic Follow-Up option OR if you will advise on a claim by claim basis which claims we should follow up upon.
  
• For our former Platinum Service providers, you will NOT automatically be converted back to the Platinum Service.  You must re-enroll for the Platinum Service.
• For those providers who are under a PremiumPlus prepayment option, ask for the fee difference for you to convert to the Platinum Service.
  
  

IF YOU HAVE ANY QUESTIONS, DO NOT HESITATE TO ASK.

Thanks,

Steve

Submitting EOBs via the Support Suite

     For our PremiumPlus providers who are submitting EOBs to us via the Support Suite, when you create a new ticket for submitting the EOBs be sure to select the Department EOBs/Explanation of Benefits when submitting the ticket.

   You will see when you create a ticket a field for Departments.  The default may be Support/Patient Information.  If you are submitting EOBs, make sure you change this and select the field EOBs/Explanation of Benefits. This will ensure your ticket is routed correctly for payment posting.

Thanks,

Steve 

New ICD10 Codes Effective October 1st 

A number of claims are rejecting that providers are submitting due to invalid ICD10 codes.

  As a reminder, as is the usual annual procedure, the ICD10 codes have been updated effective October 1st.  A number of codes that had been valid previously may now not be valid because they may be truncated codes (for example, M79.1 is no longer a valid code for billing as you must list complete diagnosis codes).

  For our Premium, PremiumPlus and Platinum Service providers, if claims reject due to an invalid ICD10 code, we will correct the code and resubmit.  No action is needed on your part EXCEPT you must review the report and ensure you no longer submit billing with the invalid ICD10 code.

  For our Medisoft Network Basic Service providers you must correct the ICD10 code on the claim and resubmit.

Thanks,

Steve 

THIS NOTICE IS ONLY FOR OUR MEDISOFT NETWORK BASIC SERVICE PROVIDERS.  THIS NOTICE DOES NOT APPLY TO OUR PREMIUM, PREMIUMPLUS OR PLATINUM SERVICE PROVIDERS.  Providers should access the Payer List page at www.officeally.com to see which payers are consider par payers and which ones are non-par payers.  OfficeAlly has DRAMATICALLY increased the number of non-par payers.  

See below notice from OfficeAlly:

UPDATE:  Aetna Prior Auth Requirement for DCs in PA, NY, DE and WV effective September 1, 2018--Policy Applies Only to Certain Aetna Plans!

    WE HAVE AN UPDATE TO THE BELOW NOTICE.  One of our clients was kind enough to share with us information about this new policy.

• First, the new policy only applies to patients who have Medicare Advantage plans OR Full Insured plans.
• Second, you must call Aetna on EVERY patient to determine if the patient has a Medicare Advantage or Full Insured Plan so you know if prior authorization is needed.  You cannot determine this information from the patient's card or online (you should be able to determine if it is a Medicare Advantage plan from the card!).
• If Aetna says it is NOT a Medicare Advantage or Full Insured Plan, it is best to just confirm on the phone that prior authorization is not needed.
• So the below policy would only apply if the patient has a Medicare Advantage or Full Insured plan.

This notice is only for our chiropractic clients in PA, NY, DE and WV.  This is a reminder that as of September 1, 2018 ALL chiropractic services for Aetna and Coventry patients must be pre-authorized.  You can review the information at:  https://www1.radmd.com/all-health-plans/aetna.aspx.

     A few things to keep in mind:

• It is your responsibility to ensure you have obtained prior authorization prior to seeing an Aetna or Coventry patient.  
• It is strongly suggested that you have the patient sign essentially what is an Advance Beneficiary Notice in which the patient indicates that he/she will be responsible for the charges if Aetna denies prior authorization.
• YOU SHOULD NOT SUBMIT ANY BILLING FOR AN AETNA PATIENT WITHOUT FIRST OBTAINING PRIOR AUTHORIZATION.  IF YOU SUBMIT BILLING TO US, WE WILL ASSUME THAT YOU HAVE OBTAINED PRIOR AUTHORIZATION AND WE WILL SUBMIT THE CLAIM TO AETNA.
• If we do submit the claim to Aetna and they deny because of no prior authorization, at that time the charges must be written off.  You CANNOT then collect anything from the patient, even if the patient signed an agreement prior to the services being rendered.  That's why it is best to NOT submit billing for an Aetna patient until you have received the decision from Aetna as to the prior authorization.  If you do NOT submit a visit for that date and Aetna denies the prior authorization request BUT you have had the patient sign an agreement, then you will not bill Aetna for that visit but instead consider the patient a cash patient.
• It is also strongly suggested that you contact your state Chiropractic Association about this new practice.  I know the Pennsylvania Chiropractic Association is looking into this new policy and they are urging their members to contact them regarding any issues that may arise with Aetna.

 Thanks,

Steve

REMINDER:  Aetna Prior Auth Requirement for DCs in PA, NY, DE and WV effective September 1, 2018

     This notice is only for our chiropractic clients in PA, NY, DE and WV.  This is a reminder that as of September 1, 2018 ALL chiropractic services for Aetna and Coventry patients must be pre-authorized.  You can review the information at:  https://www1.radmd.com/all-health-plans/aetna.aspx.

     A few things to keep in mind:

• It is your responsibility to ensure you have obtained prior authorization prior to seeing an Aetna or Coventry patient.  
• It is strongly suggested that you have the patient sign essentially what is an Advance Beneficiary Notice in which the patient indicates that he/she will be responsible for the charges if Aetna denies prior authorization.
• YOU SHOULD NOT SUBMIT ANY BILLING FOR AN AETNA PATIENT WITHOUT FIRST OBTAINING PRIOR AUTHORIZATION.  IF YOU SUBMIT BILLING TO US, WE WILL ASSUME THAT YOU HAVE OBTAINED PRIOR AUTHORIZATION AND WE WILL SUBMIT THE CLAIM TO AETNA.
• If we do submit the claim to Aetna and they deny because of no prior authorization, at that time the charges must be written off.  You CANNOT then collect anything from the patient, even if the patient signed an agreement prior to the services being rendered.  That's why it is best to NOT submit billing for an Aetna patient until you have received the decision from Aetna as to the prior authorization.  If you do NOT submit a visit for that date and Aetna denies the prior authorization request BUT you have had the patient sign an agreement, then you will not bill Aetna for that visit but instead consider the patient a cash patient.
• It is also strongly suggested that you contact your state Chiropractic Association about this new practice.  I know the Pennsylvania Chiropractic Association is looking into this new policy and they are urging their members to contact them regarding any issues that may arise with Aetna.

Thanks,

Steve 

The problem with the Medisoft Network has been resolved.  Providers can again connect to the network.

Thanks,

Steve

CORRECTION--New Aetna Requirement for Prior Authorization for DCs and PTs in PA, WV, NY and DE

     For our chiropractic and physical therapy clients in PA, WV, NY and DE, effective September 1st Aetna will be requiring you to obtain prior authorizations.  For information about this, visit:  https://www1.radmd.com/all-health-plans/aetna.aspx. (Note:  an earlier version of this notice listed NJ as a state; that is not correct.  WV should be listed instead of NJ).

     For our Platinum Service providers and for our PremiumPlus providers enrolled in authorization tracking, once you obtain authorization you must submit a ticket in the Support Suite with the authorization number, the date range of the authorization and the number of visits (if listed) that are allowed.  If you mistakenly submit billing without providing this info, we will place the claims on hold and advise you to submit a ticket with the required information.

     For our Premium and PremiumPlus providers who are NOT enrolled in authorization tracking, if you submit billing for an Aetna patient we will assume you have authorization and we will submit the claim to Aetna.  It is your responsibility to ensure you have prior authorization PRIOR to seeing the patient.  If you do not have prior authorization and we submit the claim, the claim will deny and you may not be able to resubmit if Aetna then denies back-dated authorization.  So as a matter of practice make sure you do NOT see any Aetna patients without first having the required prior authorization.

Thanks,

Steve

CHANGES TO INSURANCE VERIFICATION PROCESS
 
            For our Platinum Service, Premium and PremiumPlus Service providers who request insurance verifications, we are making some changes to make the process easier for you.
 
Increase in the Number of Verifications Allowed Per Month
 
            First, we are INCREASING the number of allowed verifications per billing month to 40 (from 20).  (The fee for verifications in excess of 40 per billing month remains at $9.95 per verification).  Very few practices have more than 40 new patients per month so this change will greatly improve your ability to obtain accurate eligibility and benefit information.
 
You No Longer Are Required to Provider a Copy of the Patient’s Insurance Card
 
            Second, we have required in the past that your office provide us a scanned PDF copy of the patient’s insurance card in order for us to provide the verification.  However, some offices want the verification done prior to the patient coming to the office the first time and they obviously do not have copies of the insurance cards at that time.
 
            Therefore, although we still prefer copies of the insurance cards, we will ATTEMPT to verify insurance benefits contingent upon the below:
 

• For providers who complete our online patient form, you MUST enter the insurance payer’s phone number on the back of the patient’s card.Since you will not have a copy of the card if the patient calls to make an appointment, the patient must provide you this information.
• In addition, you must ask the patient if there is a separate phone number for your specialty.
• For example, there may be a phone number for mental health benefits.If so, you should list this second phone number in the Additional Information Section (for example:Mental Health Benefits Phone Number—800-555-1212)
• If it is a Blue Cross Blue Shield plan and it is an out of area plan, you must indicate the plan info in the Additional Information section of the form.For example, if you are in Texas but the patient has Blue Cross Blue Shield of Florida, you would indicate in the Additional Information section of the form Blue Cross Blue Shield of Florida.
•  If your office is using an approved EMR like TherapyNotes or ICANotes, we will log into your EMR to obtain the patient demographics.You must ensure that in your EMR that you enter the above required info (payer phone number, any other phone number on the back of the card that is relevant such as for behavioral health benefits, and indicate if it is an out of state BC BS plan)

 
            AGAIN WE PREFER THAT YOU PROVIDE A COPY OF THE PATIENT’S INSURANCE CARD, BUT IF YOU CANNOT WE WILL STILL ATTEMPT TO VERIFY IF YOU COMPLY WITH THE ABOVE.  If we are unable to verify based upon some incorrect information, at that time you will be notified that we will need a PDF copy of the front and back of the patient’s insurance card to verify.
 
            In addition, we are trying to do the verifications faster for you so you can have the information by the time the patient comes to your office.  Generally we will provide the information to you by the next business day.  However, we are attempting to provide the information to you the same day.  In addition, verifications presently are not being done on Tuesdays so if you request verification on Tuesday (or late on Monday) the results will not be returned to you until  Wednesday.
 
                                                                                                Thanks,
 
                                                                                                Steve

NEW ADDED SECURITY IN MEDISOFT

     This notice is for our clients who access Medisoft on our Network.  Some practices keep Medisoft open even when you are not actively working in the program.

     So as to ensure compliance with HIPAA, we will be enabling the Auto Log Off Feature in Medisoft.

     By default, the program will automatically log you off after 15 minutes of inactivity.

     If your office believes this is too short of a period of time, we can change it to any number up to 59 minutes.  HOWEVER, we strongly encourage you for HIPAA compliance reasons to keep the default of 15 minutes.

    If you still would like to change the number from 15 minutes, please submit a ticket and advise how many minutes you would like (up to 59) before Medisoft automatically logs you off.

Thanks,

Steve 

Report Missing ERA Files in Payment Manager

     As we previously advised, Change Healthcare had a problem in mid to late April with Payment Manager.  We were advised once the access problem was fixed that they were going to do a refresh of all our client Payment Manager accounts so any ERA files missing from Payment Manager would then appear.  It appears, however, that they have not done the refresh as instructed.

     Instead, what we have to do is report one or two missing ERA files per each of our clients and have Change Healthcare then do a refresh.

     Therefore, if you have access to Payment Manager and know some ERA files are missing from April (probably around April 20th through the 25th), please report only one or two missing files to us (do not at this time report all missing files; please report only one or two).

     Please complete the Missing ERA File form at https://www.mbpros.com/missingera.html.  Again, only complete one or two forms.  AND REMEMBER only list EOBs you have received from payers for whom you have received ERA files in the past (do not list any EOBs from payers that do not offer Electronic Remittance Advice).

Thanks,
Steve

Medisoft Version 22 Service Pack 1 Released

     For our providers who access Medisoft on our network, we have upgraded to Medisoft Version 22 Service Pack 1.  Among the changes providers will see a new field on the Policy 1, 2 and 3 tabs of the case. 

     The Policy Number field has been renamed to Policy Number/MBI.  If the payer is Medicare, Medisoft will ensure that the ID # is in a format to match EITHER the legacy Medicare ID or the new MBI.  If what you enter does not match either format, you will see a warning sign below the Policy Number/MBI field.

     Although either the current Medicare ID or the new MBI is allowed on claims now, as of April, 2019 all claims must have the new MBI.  For our Basic Service providers you can turn on an Account Alert Setting in Program Options now to ensure that you request the patient's new MBI when the patient checks in.

Thanks,
Steve

Medisoft Network Providers Must Update Windows Now

     With the latest Windows update release, all providers must update Windows now in order to be able to connect to the network.

     If you had problems connecting this past week and disabled automatic downloads and installs of Windows updates, please re-enable automatic downloads and installs.  Then have your computer check for the latest Windows updates, install the updates and reboot

Thanks,
Steve

Due to forced Windows update issues affecting our users, we are currently upgrading our servers.  Thus, the Medisoft Network is not available.  We will post a follow-up when the Network is again available and advise at that time what Windows users must do to upgrade their computers.

Thanks,

Steve

Missing ERA Files in Payment Manager

     When Change Healthcare had a problem with Payment Manager not being available a couple of weeks ago, it was then discovered that many ERA files that should have been posted in Payment Manager are missing.

     A support ticket has been opened with Change Healthcare asking them to refresh all of our client databases so these missing ERA files can then be found in Payment Manager. 

     Once they refresh the databases we will post a follow up notice.  If then you believe some ERA files are still missing from Payment Manager, at that time we will request that you provide us the check number, check date and check amount.  However, DO NOT PROVIDE THAT INFO TO US NOW.  Let's wait and see if a refresh of the databases helps.

     For our Platinum Service providers, we are holding off on following up on claims on the aging report until this issue is resolved.  The reason for this is simple--there is no reason to follow up on claims that were actually paid so we want to wait for a refresh of the databases to see if the claims on the aging report were paid.  However, we WILL continue to follow up now on claims that we believe denied in error on EOBs.

     Thanks for your understanding.

Steve

Change of Policy for Prepayment Purchases

     Effective June 1st any prepayment purchases including renewals will be for a term of one year.  Any claims not used within one year of the date of purchase will be lost.

• This new policy only affects any prepayments purchased on or after June 1, 2018.  This will NOT affect any current prepayment options purchased.
• For the new policy, the one year time period will begin the date your office purchases a new prepayment option.
• HOWEVER, if you are renewing a prepayment option, the one year time period will begin the date of the last submitted claim under the current prepayment.
  
  • EXAMPLE:  On July 1st you purchase a 1000 claim renewal.  At that time you have 20 claims remaining under your current prepayment option.  You run out of the 20 claims on July 5th.  The one year time period will begin on July 5th, not July 1st.
• Again, if you do not use the claims purchased within one year, the remaining claims are lost.
  Your office will receive at least 2 notices prior to running out of claims OR when you are approaching the one year time period.  It will be your office's responsibility to purchase a renewal or you will be automatically converted to the standard per claim rate.
  • EXAMPLE:  On July 1st you purchase a 1000 claim renewal.  You submit your first claim under the renewal on July 5, 2018.  Your one year time period begins July 5, 2018.  By July 5, 2019 you have submitted 970.  The remaining 30 claims are lost and are not carried over to a renewal.
• All providers who submit under prepayment options will be required to complete a Prepayment Renewal Form for any purchases/renewals beginning June 1, 2018.  This form will include your understanding that the claims you purchase must be used within 1 year of the date of purchase (or the date your office runs out of claims under your current prepayment option if you are renewing).
• For providers who submit less than 1000 claims per year, when you run out of your current prepayment option you will want to be converted to the standard per claim rate rather than purchasing a prepayment option and risk losing claims under the prepayment.
• If you are currently under a 2500 claim prepayment option but submit less than 2500 claims per year, when you run out of your current prepayment option you will want to either purchase a 1000 claim prepayment option or convert to the standard per claim rate.
• PROVIDERS MAY CONTINUE TO PURCHASE PREPAYMENT OPTIONS THROUGH MAY 31, 2018 IN WHICH THERE WILL BE NO TIME PERIOD WITHIN WHICH TO SUBMIT THE NUMBER OF CLAIMS PURCHASED.  If you want to purchase a renewal by May 31st under the current policy, please let me know.

Thanks,
Steve

Payment Manager Issue Resolved

     It is our understanding that the issue with Payment Manager has been resolved.  Without becoming too technical, Change Healthcare had mistakenly changed the account settings for each our our client accounts, which prevented access to the program.

  Back-end support at Change worked yesterday on correcting the account setting for each of our client accounts.  It is possible that they may have failed to correct for select clients of ours, but for the most part the issue should be fixed.

     THEREFORE, I AM REQUESTING THAT ALL OF OUR CLIENTS WHO UTILIZE PAYMENT MANAGER PROMPTLY LOG INTO THE PROGRAM.  

     IF YOU ARE UNABLE TO LOG IN AND RECEIVE THE SAME ERROR MESSAGE AS PREVIOUSLY THAT YOU HAVE NOT PURCHASED ANYTHING, PLEASE LET ME KNOW SO I CAN NOTIFY SUPPORT AT CHANGE HEALTHCARE.

     Thanks for your patient and understanding this week during these frustrating times.

Steve

Payment Manager is currently not available.  If you attempt to log in, you will receive an error that says you have not purchased anything.

Change Healthcare is aware of the issue and they are working on it now.  I am not sure if the issue will be resolved today or tomorrow or later this week but once resolved we will place an update notification in the News section of the Support Suite.

Thanks  for your understanding.

Steve

The problem with the online forms has been fixed.  Users who log in will not receive the warning about having to enter the captcha box.

For users who do NOT log in, the updated Captcha box has been added to the forms.

Thanks,

Steve

AS AN UPDATE TO THE PROBLEM WITH THE ONLINE FORMS:  The problem only affects users who log into the online forms system.  For our clients who do not subscribe to the View and Search Feature of the forms (and do not log in), there is no problem with submitting.

So, until the problem is resolved, for those clients who normally do log into the Online Forms, if you do not want to wait for the problem to be resolved, you CAN submit forms but do NOT log in first.  HOWEVER, this advice is being given with two important caveats:

• You MUST print a PDF copy of the form on the Confirmation Page after you submit the form.
• You will NOT be able to find the form when searching the forms later.  This is because only forms submitted under your login are able to be searched, not forms submitted by your practice without logging in.

AGAIN, providers may submit forms to us without logging in but you must print the PDF version of the form after submission and you will not be able to later search and view that form.

Thanks,

Steve

We have discovered that there is a problem with our online forms.  The Captcha box at the bottom of the forms was updated.  For users who log in, they should not have a captcha box on the form.  However when they try to submit the form they get an error saying to complete the captcha box. 

We have notified our web designers of this issue but are unsure when it will be fixed.  As soon as it is fixed, we will post a notice in the News section of the Support Suite.

Thanks for your patience,

Steve

The problem with our website has been fixed by our web hosting company and providers may again access www.mbpros.com.

Thanks,

Steve

Our website is currently down.  We are having our web hosting company look into this but are not sure when the issue will be fixed.  During the outage providers will be unable to submit any new patient forms or billing logs.

Once the issue has been fixed, we will post an update in the Support Suite.

Thanks,

Steve

IMPORTANT REMINDER--New Medicare Beneficiary Identifier Starting in April

     Beginning in April, Medicare is going to begin replacing current Social Security based ID numbers for Medicare recipients with new 11 character length Medicare Beneficiary Identifiers (MBI).  For more information about the new MBIs, check out:  https://www.cms.gov/Medicare/New-Medicare-Card/.

     Therefore, beginning April 1st every practice must have a system in place for asking your Medicare recipients if they have received their new Medicare card containing an MBI.  You should keep a spreadsheet in your office of each Medicare patient to ensure you obtain the new MBI AND report it to MBPros.  If a Medicare patient comes in three times per week, ask them every visit if they have their new card until they do present you their new Medicare card.

     For our Premium, PremiumPlus and Platinum Service providers only:  When you do obtain the new MBI for a Medicare patient, you must promptly report this to us.  (For our Basic Service providers, you must obtain and enter the information in Medisoft beginning April 1, 2018).

• Providers must log into the Support Suite and submit a ticket with the patient's name and the new MBI.
• Do NOT submit another patient form for that patient if the patient is an existing patient for whom we previously billed.
• I will repeat that.  Do NOT submit another patient form for that patient if the patient is an existing patient for whom we have previously billed.
• You MUST, MUST, MUST log into the Support Suite and submit a ticket with the name of the Medicare patient and the new MBI.  If you have multiple patients to report, be sure to enter them all in one ticket (you do not have to do separate tickets per patient).
• On the spreadsheet your office creates to track if the Medicare patient has presented his/her new card with the MBP you should include a column to indicate the date you submitted a ticket to MBP with the new info.
• If your office is using an EMR which we access to obtain patient info and billing (such as TherapyNotes, WebPT or Practice Fusion), you still must log into the Support Suite and submit a ticket with the new MBI.  Do NOT just update the information in your EMR.

Thanks,
Steve

New Medicare Beneficiary Identifier Coming Soon

     Beginning in April, Medicare is going to begin replacing current Social Security based ID numbers for Medicare recipients with new 11 character length Medicare Beneficiary Identifiers (MBI).  For more information about the new MBIs, check out:  https://www.cms.gov/Medicare/New-Medicare-Card/.

     Therefore, beginning April 1st every practice must have a system in place for asking your Medicare recipients if they have received their new Medicare card containing an MBI.  You should keep a spreadsheet in your office of each Medicare patient to ensure you obtain the new MBI AND report it to MBPros.  If a Medicare patient comes in three times per week, ask them every visit if they have their new card until they do present you their new Medicare card.

     For our Premium, PremiumPlus and Platinum Service providers only:  When you do obtain the new MBI for a Medicare patient, you must promptly report this to us.  (For our Basic Service providers, you must obtain and enter the information in Medisoft beginning April 1, 2018).

• Providers must log into the Support Suite and submit a ticket with the patient's name and the new MBI.

• Do NOT submit another patient form for that patient if the patient is an existing patient for whom we previously billed.

• I will repeat that.  Do NOT submit another patient form for that patient if the patient is an existing patient for whom we have previously billed.

• You MUST, MUST, MUST log into the Support Suite and submit a ticket with the name of the Medicare patient and the new MBI.  If you have multiple patients to report, be sure to enter them all in one ticket (you do not have to do separate tickets per patient).

• On the spreadsheet your office creates to track if the Medicare patient has presented his/her new card with the MBP you should include a column to indicate the date you submitted a ticket to MBP with the new info.

• If your office is using an EMR which we access to obtain patient info and billing (such as TherapyNotes, WebPT or Practice Fusion), you still must log into the Support Suite and submit a ticket with the new MBI.  Do NOT just update the information in your EMR.

Thanks,
Steve

New Insurance Credentialing Service

     After requests from numerous providers we are happy to announce that we are now offering an insurance credentialing service.  If you have held off accepting patients from certain insurance companies because you are not in-network with them and you fear the hassles of getting set up as a network provider, let us handle the worries for you.

     If you are currently set up individually but tied to an old group you were associates with but now you are on your own and need to get set up with your new practice information we can handle that for you also.

     Here's how it works.  You complete the form on our website:  https://www.mbpros.com/credentialingenrollment.html.  You may have to provide us copies of relevant documents (such as state license or malpractice insurance or driver's license) but we will advise when necessary.

     For some payers we can do everything online.  For other payers we may have to print out the required forms and send to you to sign and submit.

     FEES: 

• The fee is $399.95 per payer. 
• HOWEVER, for clients of our Premium, PremiumPlus or Platinum Services, we offer a reduced fee of $199.95 per payer*. 
• Upon completion of the form referenced above you would be invoiced 50% of the fee per payer. 
• Upon payment from you of the 50% deposit we would begin the work with credentialing with the payer.
• The remaining 50% is not payable until after the payer finalizes the credentialing.  If a payer denies your request for credentialing for any reason (for example, they have too many providers in your specialty in your area), you only pay the 50% deposit and are not responsible for the balance.

     Feel free to contact us with any questions about this new service.

Thanks,
Steve

Yesterday we sent notice that BC BS of Florida was denying 97140 when billed with a CMT (they also were denying 97112). 

These denials were clearly in error and it appears BC BS of FL recognized this as they have reprocessed the denied claims for payment.

Thanks,

Steve

For our chiropractic clients, BC BS of Florida has begun denying 97140 when billed with the 59 modifier saying:

• "Use of modifier 59 (crosswalks to 59), is not typical for procedure 97140. Check loop/segment 2400/SV101-2 Procedure Code; and 2400/SV101-3- SV101-6 Procedure Modifier."

This is clearly incorrect as CCI Edits do require the 59 modifier for 97140 when billed with codes such as 98940, 98941 and 98942 to indicate that the manual therapy (97140) was done to a different area than adjusted.

However, because they have this policy in place we will stop using the 59 modifier with the 97140 and we will resubmit any denied claims without the 59 modifier.

If the claims continue to deny, your office will have to contact BC BS to appeal OR try billing with a different code.

Thanks,

Steve