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NEWSLETTERVolume XV, Number 6 June 2010
MANAGED CARE NEWSMultiplan has finalized their acquisition of the Viant network. The Viant network consists of Beech Street and Texas True Choice. Multiplan will integrate Beech Street and Texas True Choice into their Multiplan network gradually over the next 2 years. If you would like more information visit the Multiplan website at www.multiplan.com or call 800-950-7040. Medicare: The 2010 health care reform bill tightens up the deadline for submitting Medicare Part B claims. Under the new law, you must file claims for service furnished on or after Jan. 1, 2010, within one calendar year after the date of service, or you won’t get paid. In addition, you must file claims for services provided before Jan. 1, 2010, by no later than Dec. 31, 2010. Found in Section 6404 of the PPACA, it is one of many provisions aimed at curbing fraud, waste, and abuse in the Medicare program.
CMS is also revoking Medicare enrollment for physicians failing to report address changes. Medicare regs require all Medicare providers and suppliers to resubmit and recertify the accuracy of their enrollment information every 5 years. In addition, when that info changes, suppliers (including physicians) must report the enrollment changes to Trailblazer within 30 days for a change of ownership, any adverse legal action, or a change in practice location, and within 90 days for all other enrollment information. The biggest danger is when a physician group closes an office or opens a new office to replace the old office. In either event, the physician must notify the carrier within 30 days by filing a Form 855B Change of Information. (**Please beware that CMS has identified physicians who they think may be at fault and are making site visits to the old address to determine the physician is no longer furnishing services at the old address and revoking the enrollment of the physician). IPA OFFICE SCHEDULEThe PA office will be closed Monday July 5, 2010 for the 4th of July holiday!
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