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.   OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC…

Payer Updates

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.  OOPS, this page contains content reserved…

Payer Updates

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. OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in…

Payer Updates

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. OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library….

Payer Updates

Aetna Update!

Aetna Rolls Out Code Review Program. Beginning June 1, 2022, you may see new claim edits OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.

Payer Updates

VA Update!

Providers who render services to veterans within the Patient Centered Community Care (PC3) network can resolve referral and claim issues until September 30, 2022. OOPS, this page contains content reserved for KMC University members. We’d love to welcome you to the KMC University family because there is an amazing amount of helpful content in the trainings and resources of the KMC University Library. Click here to learn more.

Payer Updates