Medicare Payment Guidelines When Secondary To Other Insurance
Circumstances under which Medicare payment may be secondary to other insurance include: 1. Group Health Plan Coverage * Working Aged;*...
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Physician Quality Reporting System
The Physician Quality Reporting Initiative (PQRI) was first implemented as a voluntary pilot program in 2007. The PPACA (Patient Protetion...
Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer
The Centers for Medicare & Medicaid Services (CMS) finds that the evidence is adequate to conclude that the use of...
2011 Physician Quality Reporting System (Physician Quality Reporting) Measure Specifications Manual for Claims and Registry Release Notes CMS is pleased...
Medicare e-prescribing penalties
The following information is about the CPT G Codes for E Prescribing: The law requires a penalty phase for eligible...
What Is The PQRI Group Practice Reporting Option
The GPRO is a reporting option available to large group practices beginning with the 2010 PQRI. The PQRI GPRO is modeled after...
What is a Qualified eRx System?
A qualified eRx system is one that is capable of ALL of the following: 1. Generates a complete active medication...
United HealthCare – Discontinued Procedure Policy
The term “discontinued procedure” designates a surgical or diagnostic procedure provided by a physician or other health care professional that...
Types of Healthcare Coverage in U.S.
Flexible Spending Account (FSA) Flexible spending accounts allow members to use pre-tax dollars for certain eligible medical and dependent care...
United HealthCare T Status Codes Policy (2021)
“There are RVUs and payment amounts for these services, but they are only paid if there are no other services...
UHC Insurance Reimbursement For Increased Procedural Services
The term “increased procedural services” designates a service provided by a physician or non-physician that is substantially greater than typically required for...
United HealthCare (UHC) insurance ‘B’ Bundle Codes Policy
UnitedHealthcare will not separately reimburse for certain Current Procedural Terminology (CPT®) and Healthcare Common Procedure Coding System (HCPCS) codes identified...