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.

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.

Required Compliance Components of the No Surprises Act

It is vital that providers identify what portion of the law applies to them and immediately make changes to be compliant.  

Our members enjoy one hour of continuing education credit (in participating states) per quarter, and we foot the bill! Unfortunately, it's not included in your level of membership, but we'd be happy to provide you with more information on how you, too, can enjoy this and many other benefits in our Library or 1-on-1 training program. Click here to learn more.

FAQs: Can I Charge My Patient for Non-Covered Services?

Library members, visit the Helpdesk FAQ on your dashboard to watch a short but helpful video from KMC on this topic. Additionally, Library members can also find an extensive number of resources to guide them through proper billing for non-covered services. See the links below when you’re logged into your member dashboard.

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.