Initially mentioned in December and repeated in January; BCBSM has announced big changes for the way DME claims will process. With the changes indicated as effective March 1st, 2018, below are some highlights and our open list of questions. DME Payment Policy Changes Capped rentals will move from 10 months to 13 months rental RUL for capped rentals moves from 3 years to 5 years New definitions have been published for: “capped rental” “purchase only” “rent forever” “short-term rental” New fees are available, that will surely stretch the budget tighter over 13 months Open Questions for BCBSM If you have access to a representative, please get involved! M
CMS released their annual update to Beneficiary premium, copay, and deductible rates for 2018. Here’s what we learned: Copay continues to be 20%. 2018 Deductible amount will continue to be $183.00 a year, same as last year. NOTEWORTHY: Deductibles will be applied broken up over two months, instead of one lump sum. What does that mean for you in HDMS? Nothing changes. We recommend that you verify insurance and record the information in patient demographics before each service or sale. Based on your eligibility check, we’d recommend that you only indicate “deductible is met” when eligibility verifies that the full $183.00 has been spent. An indication t
Medicare Plus Blue Changes in Michigan effective Jan 1, 2018 Action Items? YES Bottom line: Blue Cross of Michigan is contracting with Northwood to manage their Medicare Plus Blue DME benefits starting Jan 1, 2018; and you may have an action item to take care of before then! Vocab: Blue Cross refers to their Medicare Advantage insurance product (Medicare Plus Blue) as MAPPO which stands for Medicare Advantage PPO. FAQs: Where to send claims: continue submitting claims to BCBSM, but this will change in the future; date TBD. Where to get auth’s from: continue requesting prior authorization from BCBSM, but this will change on a future date TBD where Northwood w
Attention Medicare Providers: We have been alerted to an issue by several of your peers regarding an issue with QMB Claims processing that will affect claims from October 2nd until December 8th. Details: If you had claims that were processed during this time, they may have received a new indicator that triggered Autoposting to post the payment, but reduce the claim line to zero by applying a second MAC W/O rather than creating COInsurance. The new indicator used during this time frame by DME MACs in your ANSI835 payment files is OA209, however because these claims are also paid, you will not be able to identify these claims using your Rejection Report becaus
Just a quick ShoutOut as we wrap up today to Apria & Home Reach for getting the new DMERC CMN forms into Universal Support so that we can get those updated for everyone. We appreciate it! If you had that on your to do list, cross it off and thank your friends listed above! Forms will be available shortly, we’ll keep you updated.
Everything you need to know about the Medicare MBI Change starting April 2018 What’s going on? Medicare is finally re-issuing Medicare Cards that don’t contain Social Security Numbers to their beneficiaries. For the rest of this post we will refer to that number as the Medicare Beneficiary ID or MBI. When does this start? In April 2018 cards start getting mailed to Medicare Beneficiaries. What’s different about these cards? New MBI’s will still be 11 characters long, but will be non-intelligent letters and numbers. Digits 2, 5, 8, &9 will always be an alpha character. Example: 1EG4TE5MK73 or 1A34B67CD11 Is HDMS ready to accept t
Yesterday we hosted the Sneak Peek for HDMS v3.18 which is now publicly released. Yes, it’s here! As usual, me and the Universal Team were overjoyed by the insightful questions & comments that come from our talented group of Clients & Partners! If you attended, please know that we appreciate the time it takes out of your day to join us. Below you will find a copy of the Presentation with Q&A transcripts. We recorded the session as well and that can be reviewed from our YouTube page below, along with some other useful links! Review PowerPoint of HDMS Sneak Peek v3.18 Watch Recorded HDMS Sneak Peek v3.18 Video Some of the New HDMS Feat
Universal Software Solutions, Inc., (USSI) has announced the release of HDMS Scheduler in December 3.18. This tool brings increased interoperability between departments where existing applications often create division. The product was created to help DME Companies better allocate time and space for the excellent patient care that they rely on by their various professionals like Orthotists, Assistive Technology Professionals, Certified Mastectomy Fitters, and Respiratory Therapists. The HDMS Scheduler brings staff and facility calendars together into one application, that will significantly reduce the time and effort needed create and manage appointments. “B