Effective Jan 1, 2023, MaineCare implemented a new “rounding” rule for billing timed codes. In order to bill for a 15-minute timed code, you must perform the intervention for 80% of that 15 minutes (12 minutes). (Old rule allowed you to bill if you provided the treatment for more than 50% of the time). Please …
Attention Maine Providers: Please complete our Prior Authorization Questionnaire on your experiences with AIM/Anthem prior authorizations. We need this information for the bill we have in the Maine Legislature to regulate prior authorization practices by payers.
Managing Security Breaches Member Webinar, January 27, 2023 It can happen to anyone. Your EMR company reports a security breach exposed some of your patient records. You accidentally send a group email to patients without using the Blind Copy box. You disclose records to someone without having a signed HIPAA Authorization. All of these accidental …
Guide to Hiring Employees We offer the following Employee hiring guidance_2022-11-17as a checklist when you start to hire employees, whether they will be PRN, part-time or full-time. We do not guarantee that this Guide covers everything you need to do. Always check for state laws that might apply to you depending on the size and …
11/11/2022: This Client Alert_RE CMS 1490S form instructions & sample form_2022-11-11 provides new instructions on how patients can submit a claim to CMS on form 1490S just to get a denial so a secondary or supplemental payer will reimburse claims they cover. Follow these new instructions instead of the instructions in the 9/15/2022 webinar.
Can a cash practice see a workers’ compensation patient? Maybe. State laws govern workers’ compensation. If your state laws allow the employee to choose their heath care providers, versus allowing the employer to direct what providers see their injured workers, then you should be able to see the patient. State work comp laws may …
Beginning Jan. 1, 2020, private practices have to use the CQ modifier (for PTAs) and CO modifier (for COTAs) on each CPT code where the PTA or COTA provided more than 10% of the service independent of the PT or OT. For t15-minute timed codes, this equates to 2 minutes or more of the time. …
Question: I need to work at another private practice to supplement my income while building my cash practice. The practice sees and bills Medicare under the practice’s NPI number. They will require me to enroll as a Medicare provider to treat their patients. Will this cause any issues for my cash practice? Will I have …
How to Appeal AIM Denials_Manual_Maine_2021-02-15 – Manual on how to file appeals with Anthem when AIM denies additional visits. Applies to Maine Anthem plans. Includes a sample appeal letter
CLIENT ALERT – MAINE CLIENTS (posted 1/18/2021) Maine’s new Earned Paid Leave law went into effect on January 1, 2021 and can be found at 26 M.R.S. 637. In addition to the statutory framework, the Department of Labor has promulgated rules interpreting this law. If this new law applies to your organization, you should amend …
New Maine Earned Paid Leave Law, effective 1/1/2021 Read More »
