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March 2015 Edition Articles


Billing procedures for credentialed Certified Registered Nurse Practitioners P
Changes coming to NaviNet® in March P, F, A
Claim submission requirements when billing with place of service code 22 P, F
Clarification: Injectable hyaluronate acid products being removed from the Direct Ship Injectables Program P
Highlighting HEDIS®: Appropriate testing for children with pharyngitis P
Important billing information for modifiers 25 and 59 P
Join us for the next What’s Up Wednesday call on March 18, 2015 P, F, A
Medical and claim payment policy activity posted from January 24 – February 20, 2015 P, F, A
New CAQH recredentialing process now in effect* P
Non-emergent outpatient radiation therapy to be reviewed for medical necessity P, F
POA indicator and properly filling out claims F
Prescription drug updates P, F, A
Professional Injectable and Vaccine Fee Schedule updates effective April 1, 2015 P, F, A
Proper screening colonoscopy billing for Medicare Advantage members P, F
Select Drug Program® Formulary updates P, F, A
Stay informed during our transition to a new platform P, F, A
Updated Provider Manual now available P




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