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Claims, Coding, Payment

In the “Current” tab, you’ll find news published during the past year. Use the “Archive” tab to view news going back an additional two years.

2/12/24 Billing reminder: RSV vaccine for pregnant women
1/4/24 Updated payment policies now available
12/13/23 Preparing for HEDIS 2024 medical record collection
11/9/23 CPT 97535 now reimbursable via telehealth
11/2/23 COVID-19 payment policy updates
11/1/23 Coming soon! January 1 monitored anesthesia care claim edits
11/1/23 Reminder: Obstetric E/M services not separately reimbursed
10/31/23 Reminder: Incidentals related to emergency room visit
10/18/23 COVID-19 labs with outpatient surgery not separately reimbursed
10/2/23 Updated payment policies now available
10/2/23 Fourth quarter 2023 hospital outpatient drug fee schedule posted
9/29/23 Billing guideline updated with HIV PrEP-related diagnosis code
9/6/23 Reducing cost barriers to improve access to mental health care
9/1/23 Revised medical necessity criteria for benign skin lesions
8/24/23 Learn to use our CDT lookup tool in just 3 minutes
8/21/23 How to request and bill for ketamine and esketamine
8/10/23 Save time by looking up CDT codes online!
8/3/23 Services related to outpatient surgery not separately reimbursed
8/1/23 Reminder for January 1 monitored anesthesia care claim edits
8/1/23 We will no longer reimburse specimen collection code 99001
7/1/23 Third quarter 2023 hospital outpatient drug fee schedule posted
6/30/23 Updated payment policies now available
6/1/23 We’ve simplified our ABA authorization response process
5/1/23 Important inpatient billing guidelines
3/31/23 Updated payment policies now available
3/31/23 Second quarter 2023 hospital outpatient drug fee schedule posted
3/24/23 Bill primary insurer first for tribal health program enrollees
3/22/23 New Equian addresses for pre-payment review
3/13/23 Submit rendering provider site address in box 56
3/9/23 Help us improve dental billing with more than one insurer
3/9/23 Medicare cost share changes under the Inflation Reduction Act