CareHarmony’s Post

Attention #MedicareAdvantageOrganizations: New requirements released by CMS discuss supplemental benefit encounter data submissions via EDS. Don't get caught off guard by the complexities. Learn how to navigate the process smoothly with our expert guidance. https://bit.ly/4a9ebtZ #MedicareAdvantage #supplementalbenefits #CMS #EDS

CMS' proposed changes to the No Surprises Act's IDR are complex, yet, paradoxically, will likely make the process more efficient. My latest blog walks payers and providers through how the IDR would work according to the proposed rule. Complete w/ helpful timeline illustrating proposed IDR deadlines! Check it out here: https://lnkd.in/e7B8RB7h

CMS has updated the 2025 FMV compensation amounts to Agents for Medicare Advantage and Prescription Drug sales, removing the $100 increase. See the updated amounts below. #medicare #commission #empowerbrokerage #fyi

📢 Important Update for SNFs from CMS 📢 Mandatory Off-Cycle Revalidations Are Here Heads up, SNF providers! CMS just announced that mandatory off-cycle SNF revalidations kick off on October 1, 2024, and run through the end of December. To keep billing Medicare, you'll need to submit an updated CMS provider enrollment form that covers not only SNF ownership but also any "Additional Disclosable Parties" (ADP). Yep, this affects 100% of SNFs. Expect a letter from your MAC starting October 1st, giving you 90 days to respond and submit everything through PECOS. The new form is now 20 pages long (up from 14), so there's more to cover, especially for ADPs. Here's what you need to know: When: Letters roll out between October and the end of the year. What: You’ll have 90 days to respond. Who: This applies to all SNFs, no matter your size or structure. What’s changed: The new enrollment form covers initial enrollments, revalidations, reactivations, and changes of ownership (CHOW). ADPs include anyone involved in operational, financial, or managerial control, or those providing services like management or accounting. Make sure you’re ready to provide detailed info! Reach out if you need any support – we’re here to help! 👋

Medicare sent an email earlier today with a reminder about upcoming system modernization activities. "This is a reminder that due to system modernization activities, there will be outages to the following Coordination of Benefits & Recovery (COB&R) applications and operations: - Medicare Secondary Payer Recovery Portal (MSPRP) - Commercial Repayment Center Portal (CRCP) - Benefits Coordination & Recovery Center (BCRC) and Commercial Repayment Center (CRC) Call Centers The outages are currently scheduled for the following days and times: Date: Friday, June 28, 2024, through Monday July 1, 2024 Time: 2:00 PM ET Friday through 7:00 AM ET Monday Additional Information: Call Center Will Not Be Available; Operations Will Resume on Monday, July 1 at 8:00 AM ET. We apologize for the inconvenience." Seems like all those Medicare announcements from the 1st half of 2024 are being built into the system this weekend. 

A guide to mastering MIPS 🏆 ✅ Navigating the complexities of Medicare’s Merit-based Incentive Payment System (MIPS) can seem overwhelming, but we’re here to simplify the process and help you optimize your performance. Read our latest comprehensive guide that will walk you through each step, from understanding the basics to successfully submitting your data, so you can boost your Medicare reimbursements with confidence. 🔗 Read the guide here: https://lnkd.in/e-UDKTJb 

🚀 Dive into the future of quality reporting with our latest blog post! Discover why eCQMs are the strategic choice for ACOs, offering better alignment with CMS goals, incentives, and simplified data management. 📊 #HealthcareInnovation #ACOs #QualityMeasures #Medisolv https://hubs.li/Q02TYw9H0

📣 Navigating the Medicare maze? Here's your quick guide to ensuring your claims are 💯 spot-on and payment-ready! 1️⃣ Accuracy is Key: Double-check patient info like name, DOB, and Medicare ID. A tiny error can derail the entire process! 2️⃣ Full Docs or Nothing: Skimping on documentation is a no-go. Complete records are a must for seamless claim approval. 3️⃣ Coding with Precision: Get those ICD-10 and CPT/HCPCS codes right. Aim for specificity to avoid claim delays. 4️⃣ Modifiers Matter: They're not just add-ons but crucial for detailing the nuances of the services provided. Use wisely! 5️⃣ Watch the Clock: Stick to Medicare’s filing deadlines to dodge penalties. Remember, you've got a year from the service date. 6️⃣ Provider Enrollment Check: Only enrolled and credentialed providers can bill. Navigate the incident-to and split/shared billing with care. 7️⃣ Guidelines Galore: Stay updated with LCDs, LCAs, and NCDs for what’s covered and what’s not. 8️⃣ Go Digital: Embrace EDI for faster, more accurate claim submissions. Say goodbye to paperwork errors! 9️⃣ Integrity First: Keep your billing honest—no upcoding or unbundling. Medicare’s watching! 🔟 Be Responsive: Quick replies to Medicare’s requests can mean faster claim processing. 💡 Stick to the guidelines and watch your Medicare claims process smoothly and accurately. Here’s to getting it right and getting paid! 💰📈 #HealthcareBilling #MedicareClaims #MedicalCoding #HealthcareTips

Keep your organization up to date by learning how the 2024 Physician Fee Schedule Final Rule impacts the Medicare Shared Savings Program in this Moss Adams article by me and Pat Oungpasuk. The article examines the most notable impacts to the MSSP including moving ACOs toward a digital measurement of quality, refinements to ACOs’ financial benchmarking methodology, adding a third step to the beneficiary assignment methodology and modifications to Advance Investment Payment (AIP) policies.

Attention #MedicareAdvantageOrganizations: New requirements released by CMS discuss supplemental benefit encounter data submissions via EDS. Don't get caught off guard by the complexities. Learn how to navigate the process smoothly with our expert guidance. https://bit.ly/3wP9yHp #MedicareAdvantage #supplementalbenefits #CMS #EDS