Optum Health will begin covering the VA for states essentially east and north of Texas. If youâre a provider in VA CCN Regions 1, 2, or 3 and youâre transitioning to Optum for the new CCN contract, you can still accept TriWest Read more…
California Blue Cross Claims submitted on or after October 1, 2019 will be subject to a ninety (90) day timely filing requirement, and Blue Cross will refuse payment if submitted more than ninety (90) days after the date of service. Read more…
Recent claims for VA under the PC3 program We have noted recent payment denials for manual therapy 97140 and massage 97124 even with GP and 59 modifiers. It appears the VA is adopting the CCI edits and bundling both codes Read more…
Horizon BCBSNJ previously announced plans to collaborate with American Specialty Health (ASH) to implement and administer their Chiropractic & Physical Medicine Services Program for acupuncture, chiropractic, occupational therapy, physical therapy and speech therapy, effective January 1, 2020, subject to regulatory Read more…
Please be advised the information received from ASH earlier this week relating to the transition was misquoted by ASH provider relations and that the transition to using ASH with Blue Shield of California is going forward for 2020. As more Read more…
2020 ICD10-CM Updates 71,932 codes in ICD10-CM 2018 72,184 codes in ICD10-CM 2019 273 New Codes 21 Deleted Codes 30 revisions As occurs every October 1 there are additions and deletions to the ICD10 code set. This year is had Read more…
We have received information from sources with direct contact with ASH representatives that stated that the contract between ASH and Blue Shield of California will not go through if there is not a high enough percentage of providers who enroll Read more…
The latest update for 2020 Blue Shield of California ASH Plans, directly from ASH 1. The Blue Shield PPO plans to move to ASH January 1, 2020, are as follows: ⢠Individual and Family Plans (IFP): on-exchange and mirrored. The Read more…
The latest information is indicating that the visit threshold will be 5 visits whether a provider is in our out of network and allowances will be the same for in and out of network services. Patients may have lesser copays Read more…
Guidelines for Imaging in Low Back Pain Blue Cross and Blue Shield have made policy changes in reference to imaging for lower back pain as highlighted below. Note for chiropractic claims there is indication of no routine films in absence Read more…