March 7, 2018 -- Volume 7, Number 10
|
|
Humana Will Pay Denied Vitrectomy Claims – ASRS Working to Reverse Denials from Other Commercial Payers
|
|
ASRS has confirmed that Humana will reverse its denials and continue to pay for vitrectomies as it had prior to the Centers for Medicare and Medicaid Services (CMS) change request (CR) 10318, Transmittal Request (TR) 2005, dated January 18, 2018.
As previously reported, Medicare Administrative Contractors have been instructed by CMS to process vitrectomy claims during the Agency's review of the issue. However, commercial payors were not informed of the CMS review and have subsequently used TR 2005 as a premise for vitrectomy denials. ASRS alerted UnitedHealthCare, HealthNet and WellCare to the CMS review and urged them to suspend vitrectomy denials.
Until ASRS hears from these other commercial payors, please hold any new claims.
If you would like ASRS to assist you in appealing related denials, or you have any questions about the vitrectomy NCD 80.11, please contact
[email protected]
.
|
|
Earn Full Credit for MIPS Improvement Activities by Participating in a Study
The consulting firm, Abt Associates, is studying the burdens clinicians experience with reporting MIPS quality measures in year 2 of the program. The goal of the study is to:
- Study clinical workflows and data collection methods using different submission systems;
- Understand the challenges associated with collecting and reporting quality data; and,
- Recommend changes to try to lower your burden, improve quality data collection and reporting, and enhance clinical care.
If you or your group are eligible for MIPS and you participate successfully in the study, you will earn full credit for the 2018 MIPS Improvement Activities performance category.
Applications for the study are accepted through March 23, 2018
. You will be notified by email in spring 2018 if you are selected. Read about the study
here
and for more information email
[email protected]
.
|
|
Anthem Commits to Collaborate with AMA, Medical Societies
Last week, Anthem and the American Medical Association (AMA)
announced a joint commitment
to continued collaboration. This new announcement followed Anthem’s decision to forego a policy that would have reduced payments for E&M services reported with CPT modifier 25. Anthem has pledged to work with the AMA, state medical associations, and national medical specialty societies to address physician concerns with other policies and guidelines as well.
We are pleased to report that Anthem has now agreed to pursue collaboration in the following areas:
- Enhance consumer and patient health care literacy;
- Develop/enhance and implement value-based payment models for primary and specialty care physicians;
- Improve access to timely, actionable data to enhance patient care; and,
- Streamline and/or eliminate low-value prior authorization requirements.
The ASRS has been working on the modifier 25 issue as well as elimination or reduction of burdens associated with prior authorization, and will continue to work with the AMA and others to pursue opportunities for potential collaboration with Anthem in these areas.
|
|
For the 2017 MIPS Performance Period, there are a number of upcoming deadlines. MIPS- eligible clinicians can earn payment adjustments of +/-4% in 2019.
- March 16, 2018: Deadline for 2017 data submission for groups reporting via the CMS web interface
- March 31, 2018: Deadline for 2017 data submission for all other MIPS reporting
- April – December 2018: CMS provides feedback to MIPS eligible clinicians
- January 1, 2019: CMS begins to apply payment adjustments to each Medicare claim
|
|
How Do Your Treatment Choices Compare?
|
|
Get instant benchmarking data: Complete the PAT Survey now
- What is the most important factor indicating recurrent wet-AMD disease activity during the maintenance phase?
- If cost and payer coverage are not an issue, what is your treatment choice for patients with new-onset DME?
- What is your opinion of intraoperative OCT?
When you’ve finished the survey, you can
instantly see real-time results
comparing your answer to each question with those of your ASRS colleagues who have responded to date.
The more responses, the more powerful the data.
|
|
Join the ASRS FIT Section for a luncheon and discussion panel at the 2018 ARVO Annual Meeting on Monday, April 30 at the Hawaii Convention Center at 1:30 PM. The luncheon will provide fellows an opportunity to learn more about the ASRS FIT Section and how to navigate post-graduation employment opportunities.
If you are interested in attending the reception, please RSVP to
Sam Zerang
by March 29.
|
|
The ASRS Women in Retina section invites you to a reception on Sunday, April 29, from 6:30-8:30 PM at the ARVO 2018 Annual Meeting. The reception will feature fellow WinR members presenting their ARVO research papers and posters and will provide an opportunity to learn more about the WinR mentoring program.
If you are interested in presenting your paper or poster, please let us know by April 6. We will accept requests to present on a first-come, first-served basis.
If you are not interested in presenting, you are still welcome to join us for the recpetion. The event is complimentary and open to all WinR members. Please RSVP by March 29 to
Sam Zerang
.
|
|
Deadline Extended! Submit Your 3D Video for the Annual Meeting
|
|
The ASRS is soliciting 3D videos to be showcased on dedicated kiosks at the upcoming Annual Meeting. The top 3D video will receive the coveted Rhett Buckler Award, an impressive 8-pound, 24-carat-gold-plated, Oscar-like statuette. Deadline for video abstracts is March 18.
Note: A maximum of
two
2D films and/or 3D videos may be submitted by an ASRS member as the first author (presenting author).
|
|
Not too Late to Register for the
Business of Retina!
|
Register now
for the 2018 Business of Retina Meeting, March 10-11 at the Four Seasons in Dallas, TX. Enjoy this unique gathering of retina colleagues and vitreoretinal practice administrators. Share information and experiences and hear the latest on coding, practice trends, business principles, regulatory developments and more. Check out this year's
program
.
|
|
|
Accepting Nominations for the Image of the Year
|
Submit your nomination for the Retina Image Bank Image of the Year Award.
There are two ways to nominate an image:
For complete details on the eligibility and nomination process visit the
ASRS website
. The winner will be recognized at the 36th Annual Meeting in Vancouver this July.
Don't miss the chance to have your images considered for the top prize.
Upload your best images
by April 30 for the chance to be considered.
|
|
Congratulations to Olivia Rainey, from Retina Specialists of Michigan
in Grand Rapids, Michigan
, w
hose image
Cytomegalovirus Retinitis
has been selected as the Image of the Week.
|
|
|
|
|
|
|
