A MONTHLY REPORT BY YOUR PEPS TEAM
A MONTHLY REPORT BY YOUR PEPS TEAM
TO :
GLMS Members & Practice Staff
FROM : Physician Education & Practice Support ( PEPS ) Stephanie Woods , GLMS Practice Resource Specialist
RE :
Monthly Update
We look forward to sharing with you each month the most recent news and activities from the GLMS Physician Education and Practice Support Department .
4TH ANNUAL GLMS MEDICAID ROUNDTABLE
The 4 th Annual GLMS Medicaid Roundtable was held April 20 , 2017 at the Foundation for a Healthy Kentucky Building , 1640 Lyndon Farm Court , Louisville , KY 40223 . Approximately 30 medical practice staff members attended the 90-minute roundtable . Representatives from Aetna Better Health , Anthem KY Medicaid , Humana CareSource , Passport Health Plan , WellCare and the Kentucky Department of Medicaid Services participated and addressed previously submitted questions on current issues with Medicaid .
HIGHLIGHTS OF THE DISCUSSION INCLUDED : »»
Passport has recently corrected a system error that was denying Gardasil ( CPT 90651 ) for male patients since October 2016 for “ wrong gender .” They are still working on auditing their system and will pay claims that were denied in error .
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Aetna Better Health was made aware of one of their Provider Relations Representatives that was failing to respond to calls from providers . The Department for Medicaid Services also found these complaints disturbing since the MCOs are contracted to provide “ support ” to practices . Aetna Better Health promised to address this issue .
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Anthem Medicaid has joined other MCO ’ s and KY Medicaid ; and will only pay for two Level 4 or Level 5 services per patient / per provider / per year as of February 1 , 2017 . Subsequent claims for 99214 or 99215 visits will be paid at the 99213 rate . This policy is a Kentucky Administrative Regulation 907KAR3:10 ( 4 ) ( 1 ). However , Anthem Medicaid previously paid these services without limitations .
Click here for a copy of all issues discussed at the Roundtable http :// bit . ly / 2rm8Mhr .
The Greater Louisville Medical Society wishes to thank all practice staff members for their participation , and the Foundation for a Healthy Kentucky for use of their training room for the Roundtable .
The PEPS Department can assist you with any practice or physician support question . Contact Stephanie Woods , Practice Resource Specialist at 502 – 736-6350 or email physician . education @ glms . org .
GLMS NEWS APRIL 2017 5