Optum Announces Coverage for Routine Chiropractic Services

If you have patients that are part of a  Medicare Advantage plan managed by Optum, you will want to check out the Optum Policy Number 0069 Supplemental/Routine Chiropractic Services prior to submitting claims for active or maintenance care.  

We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We'd love to help you come under our umbrella of care and protection with membership. Click here to learn more.

BCBS Low Back Imaging Requirements

BCBS of Illinois released a Tip Sheet on Use of Imaging Studies for Low Back Pain.  Based on the intent to improve quality of care, they are recommending that providers avoid imaging in the first four weeks of new-onset of back pain. These recommendations are based on NCQA’s HEDIS Measures. A similar notice was posted in early 2022 by BCBS of Texas and in July by BCBS of NC. 

We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We'd love to help you come under our umbrella of care and protection with membership. Click here to learn more.

Provider Impact on Coding 98943

Optum rolled out a revised Chiropractic Manipulative Treatment Reimbursement Policy in May of 2022. Although at first glance it may appear as nothing has changed, the revision table says otherwise. And now a few months later, providers who perform extraspinal CMT are feeling the impact.

We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We'd love to help you come under our umbrella of care and protection with membership. Click here to learn more.

Daily, Routine Office Visits: Documentation Lite!

In this helpful video, KMC addresses the most common questions we get about what goes in the documentation for an ROV. She explains what auditors are looking for in this documentation, and as usual, makes it easy to understand and to duplicate. Watch this short explanatory video and watch the documentation of ROVs in your practice go from good to great!

We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We'd love to help you come under our umbrella of care and protection with membership. Click here to learn more.

Attention all Out of Network Providers!

Have you been wondering what is required of you with regard to the No Surprises Act? CMS issued a new FAQ that addressed the Balance Billing Protection law as it relates to out of network providers.

We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We'd love to help you come under our umbrella of care and protection with membership. Click here to learn more.

Medicare Part C/Advantage Plans Have Rules—Please Follow Them!

Hot Topics from the KMC University HelpDesk | July 14, 2022 So many calls to our HelpDesk revolve around questions about these privately managed Medicare plans. Some providers and team members have never even heard of these plans. Cash-based practices are often confused because it’s Medicare but is it really? KMC explains these rules, and…

We consider that KMC University members are under our care and protection, which includes keeping them up to date on important changes, updates, and news that can affect their reimbursement and compliance. This content is meant for members. We'd love to help you come under our umbrella of care and protection with membership. Click here to learn more.