Blog

Jun
16
Fidelis Parent Company Completes Wellcare Purchase and More News You Need Today

Centene, the parent company of Fidelis, has completed its purchase of some of the Wellcare lines of business. Effective 6/1/2020, Centene has completed the transition of all Wellcare members under NY Medicaid/CHP/Essential Plan and MLTC to Fideliscare of New York. As of that date all Fideliscare providers can begin to see the Wellcare members. Those claims would then be billed to Fideliscare and Fideliscare will honor all previously obtained authorizations. Providers only participating with Wellcare but not Fidelis will not be able to see those Medicaid Members transitioned after 6/1/2020. Wellcare Medicare members will remain as is and can continue to be seen by Wellcare Providers. If you a...


May
21
Need to Reduce Expenses Due to COVID-19? Start with Your Malpractice Carrier


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COVID-19’s financial impact on physician practices has been severe. Here is some news that may help take some of the sting out of the economic losses you may be facing. If you made changes to your practice in response to the crisis – shorter hours, hiatus on surgery or procedures, or even closing your doors for a period of time – you may be entitled to financial relief from your malpractice carrier.


Physicians Reciprocal Insurers (PRI), one of the larger malpractice insurers in New York State, confirmed with E Central Medical Management that they are offering several options to assist their insured practices during this challenging time.


Among the options they are offering...


May
06
CMS Now Reimburses Telephone E/M Visits on Par with Office Visits

CMS has recently announced updates to its reimbursement strategy to further accomodate physicians who are providing remote care due to the coronavirus outbreak. A broad range of clinicians, including physicians, can now provide certain services bytelephone to their patients. These changes are retroactive to services provided since March 1.


According to CMS' published guidelines:


Medicare payment for the telephone evaluation and management visits (CPT codes99441-99443) is equivalent to the Medicare payment for office/outpatient visits with established patients effective March 1, 2020.

When clinicians are furnishing an evaluation and management (E/M) service that wouldotherwise be reported as an ...


Apr
27
April 27 Update: Register NOW for Reimbursement for COVID-19 Care to Uninsured Patients

Beginning today, April 27, you may register for reimbursement for caring for uninsured COVID-19 patients. Reimbursement rates will be based on Medicare payment rates. Physician services provided to uninsured patients, such as office and emergency visits, including those provided via telehealth, may be eligible for reimbursement through this program. Click here to register.



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To participate, providers must attest to the following at registration:



  1. You have checked for health care coverage eligibility and confirmed that the patient is uninsured;

  2. You have verified that the patient does not have any coverage, including individual, employer-sponsored, Medicare or Medicaid;

  3. You confirm that no other pa...

Apr
26
HHS Additional Grant Money Available - Must File TODAY!

As a physician, you have made extraordinary efforts during this pandemic.


E Central Medical Management continues to make every effort to support and assist you by keeping you updated on the rapidly evolving funding landscape. Our understanding today is that the latest round of HHS grant dollars are quickly being depleted. Therefore, we strongly encourage our clients to apply for this additional HHS grant funding today.


The application process is simple; it should only require 15-30 minutes of your time.


It is absolutely necessary for you to apply today - Sunday, April 26, 2020! Call us if you need additional information or projections.



Please click this link to begin the process: https://covid...


Mar
29
COVID-19 TELEHEALTH BILLING UPDATES

In our continuing effort to simplify the information being distributed by top insurers during this pandemic regarding their current adjusted billing rules, we are providing this summary. It contains information taken directly from each insurer’s website, augmented by our telephone conversations with representatives of the various companies. Additionally, for further clarity we are providing links to the most complete explanations each payer has distributed to date. We have highlighted certain points in bold to facilitate your ability to quickly review the information. We must caution this is a guide based on the most current information available to us.


Please reach out to us if you are...


Mar
19
Breaking News: CMS Allows E/M Codes to be Billed for Telephone Visits During Covid-19 Outbreak

Here is the latest information, simplified. Click here to view the CMS Medicare Telemedicine Health Care Provider Fact Sheet


Understanding the Difference Between Telemedicine, Telehealth, Virtual Check-ins, E-visits



  • Telemedicine is audio only (99441-3) based on time see attached – established patients only

  • Telehealth is audio AND video (99201-99215 new and established patient E/M). Audio could be anything from Skype to Zoom to Doxy.me to iChat etc.

  • Virtual check-in is audio - CMS only (G2012) established patients only

  • E-visit is online (99421-3 for MD & G2061-3 for non-MD, qualified professional)

  • Modifier to use for any of the above is 95 and place of service is 02

  • Document consent of pati...

Mar
18
Can I Bill for Telephone Consults?

As social isolation becomes a reality for increasing numbers of us, many physicians are wondering whether telephone check-ins are reimbursable by private payers, Medicare and Medicaid.


While commercial carriers have been reluctant to reimburse for telephone check-ins in the past, more recently both Medicaid and some private carriers have indicated that they will reimburse for these virtual visits. Here at E Central Medical Management, we are tracking carriers and gathering data so that we can confidently advise our clients on whether or not these claims are actually being honored.


Medicaid and Commercial Carriers


CPT offers codes to report telephone services provided by a physician or other qua...


Sep
30
Doctor? Manager? Leader? You are All Three

Remember all those management and leadership classes you took in medical school? Of course not. Learning how to diagnose and treat disease left no time in your schedule for anything unrelated to medicine.


The only problem is that today, you may find yourself wearing two hats – not just a clinician, but the owner of a small business, your medical practice. In that second role, leadership and management skills are essential.


Owning your practice means that in addition to being a clinician, you are also an entrepreneur, a boss, a manager and a leader. Cultivating some basic management and leadership skills, and understanding the difference between the two, will help ensure that your practic...


May
30
Aetna Opt Out

Click here to download the Aetna Opt Out form.