PPR Services :: Chart Audits

Over the next few months PPR will be rolling out a new service for our clients; Chart Auditing. The chart audit service was developed to ensure our clients are meeting all their documentation requirements. During this process we will also be providing our clients with suggestions that will help them manage and grow their practices more efficiently.

We will provide you with more information as we continue to roll out the program. In the meantime, if you have any questions or concerns, please feel free to contact your PPR representative. As always our goal at PPR is 100% client satisfaction.

Billing News :: CMS Delays PECOS Edits Until 2011

The Centers for Medicare & Medicaid Services (CMS) announced last week that it will delay scheduled edits to the Provider Enrollment, Chain and Ownership System until Jan. 3, 2011.

The Internet-based PECOS allows physicians and other practitioners to enroll in Medicare, check on the status of an application or make a change in their enrollment information. Under the edits, if ordering/referring physicians or other non-physician practitioners listed on DME claims are not in PECOS, those claims will reject. CMS had originally set Jan. 4 as the effective date for the edits, but later pushed the date out to April 5.

We will begin sending letters to our clients notifying them of their status.

Billing News :: Ford Hourly and Salaried Retirees Now Have the Same Benefits

As of March 1, 2010 certain Ford non-UAW Hourly Retirees will have the same benefits as Ford Salaried Retirees. New ID cards have been sent to the approx. 700 members affected by this change. Deductibles for these members will reset as of March 1, 2010. For further information, please call the numbers on the back of the new ID card.

Billing News :: MPSERS Members No Longer Covered Under PFFS

Michigan Public Service Employees Retirement System and State of Michigan members returned to Medicare Supplemental coverage effective Jan. 1, 2010. Some providers continue to bill these members under their former Medicare Plus Blue PFFSSM contract numbers, which causes claims for these members to reject.

Be sure to ask for a member’s ID card at every visit to ensure that claims are submitted correctly and with the most current contract number. Submit claims for MPSERS and SOM members first to Medicare; in most cases the claims will automatically crossover to BCBSM once Medicare processes the claim. You can verify eligibility and benefits using web-DENIS or by calling 1-800-676-BLUE (2583).