May 01 , 2020
Dear CMG Providers,
Essential updates for today:
- Please see today's summary from the CDC and DPH here.
- We urge all of our Pediatric members to reach out to our members of Congress to ensure that pediatricians, pediatric medical specialists and pediatric surgeons receive immediate financial relief. You can take action by visiting federaladvocacy.aap.org and find "Provide Needed Financial Support for Pediatricians Impacted by COVID-19 Crisis" under Key Issues.
- Anthem is in the process of updating its systems for telehealth services. In the interim, you may receive a claim denial indicating that a provider is not certified by Anthem for telehealth services. Please be assured that Anthem will reprocess those telehealth claims once the system changes are complete with no action required on the part of the provider.
- Additional Round of Sweeping Changes to Support U.S. Healthcare System During COVID-19 Pandemic Issued: On April 30th, the Centers for Medicare & Medicaid Services (CMS) issued another round of regulatory waivers and rule changes to deliver expanded care to the nation’s seniors and provide flexibility to the healthcare system. These changes include making it easier for Medicare and Medicaid beneficiaries to get tested for COVID-19 and continuing CMS’s efforts to further expand beneficiaries’ access to telehealth services. To read the press release, click here.
- Click here to read an interesting article published in the New England Journal of Medicine about Cardiovascular Disease, Drug Therapy, and Mortality in COVID-19.
- COVID-19 Cost Share/Deductibles/Copays: Although most payers initiated policies waiving cost-share for covid related visits and televisits, this may not apply to all patients. Self insured employer groups determine their own benefit plans, including participant cost-share obligations. Each of these groups had the option to include these policies and not all chose to do so. We wanted to remind our groups that checking for Eligibility and Benefits will indicate if the employer group opted out. Claims will be processed per standard benefit plan design with customer cost-share. Patients that are part of these plans will be responsible for payment to your office. If the patient has an issue they will need to go back to their companies Benefits Administrator to discuss their policy.
- CMG is looking to see if any practices would be interested in taking on new patients. We have been contacted by several employers who are looking to connect their employees who do not have providers with new clinicians. There will likely be some need to manage patients with COVID related symptoms. The office must be capable of doing telemedicine and/or seeing patients in person. If you have not reached out already, and this is something you are interested in please email Genesis Aquino.
Stay safe. Be well. God bless.
Joseph L. Quaranta, MD
Joseph L. Quaranta, MD
President, Community Medical Group