A MONTHLY REPORT BY YOUR PEPS TEAM
A MONTHLY REPORT BY YOUR PEPS TEAM
TO:
GLMS Members & Practice Staff
FROM: Physician Education & Practice Support( PEPS) Stephanie Woods, GLMS Practice Resource Specialist
RE:
Monthly Update
We look forward to sharing with you each month the most recent news and activities from the GLMS Physician Education and Practice Support Department.
4TH ANNUAL GLMS MEDICAID ROUNDTABLE
The 4 th Annual GLMS Medicaid Roundtable was held April 20, 2017 at the Foundation for a Healthy Kentucky Building, 1640 Lyndon Farm Court, Louisville, KY 40223. Approximately 30 medical practice staff members attended the 90-minute roundtable. Representatives from Aetna Better Health, Anthem KY Medicaid, Humana CareSource, Passport Health Plan, WellCare and the Kentucky Department of Medicaid Services participated and addressed previously submitted questions on current issues with Medicaid.
HIGHLIGHTS OF THE DISCUSSION INCLUDED: »»
Passport has recently corrected a system error that was denying Gardasil( CPT 90651) for male patients since October 2016 for“ wrong gender.” They are still working on auditing their system and will pay claims that were denied in error.
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Aetna Better Health was made aware of one of their Provider Relations Representatives that was failing to respond to calls from providers. The Department for Medicaid Services also found these complaints disturbing since the MCOs are contracted to provide“ support” to practices. Aetna Better Health promised to address this issue.
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Anthem Medicaid has joined other MCO’ s and KY Medicaid; and will only pay for two Level 4 or Level 5 services per patient / per provider / per year as of February 1, 2017. Subsequent claims for 99214 or 99215 visits will be paid at the 99213 rate. This policy is a Kentucky Administrative Regulation 907KAR3:10( 4)( 1). However, Anthem Medicaid previously paid these services without limitations.
Click here for a copy of all issues discussed at the Roundtable http:// bit. ly / 2rm8Mhr.
The Greater Louisville Medical Society wishes to thank all practice staff members for their participation, and the Foundation for a Healthy Kentucky for use of their training room for the Roundtable.
The PEPS Department can assist you with any practice or physician support question. Contact Stephanie Woods, Practice Resource Specialist at 502 – 736-6350 or email physician. education @ glms. org.
GLMS NEWS APRIL 2017 5