As we approach a busy period in healthcare billing, it’s crucial to stay informed about healthcare billing updates that could impact your facility’s processes. Here are some critical reminders and changes to be aware of:
Nebraska Total Care Transitioning to Availity
Nebraska Total Care is transitioning to the widely recognized Availity platform, simplifying claims submissions, eligibility checks, and payment collections for providers. This move aims to streamline transaction processing, reduce administrative errors, and accelerate payments. Stay updated on communications from NETC and contact Availity.com if you need assistance with any new requirements or workflow changes.
Eligibility Checks
It’s crucial to regularly verify patient insurance eligibility before services are rendered. Staying updated with healthcare billing updates is essential for reducing claim denials and ensures timely payment. By keeping up with eligibility verification, your facility can significantly improve the accuracy and efficiency of your claims.
Nebraska Heritage Health Open Enrollment
The Nebraska Heritage Health open enrollment period runs from November 1 to December 15. During this time, patients have the opportunity to make changes to their coverage. Staying informed about healthcare billing updates helps ensure coverage changes are accounted for, reducing potential billing issues. Direct your patients to Nebraska Heritage Health for more information and assistance during the enrollment period.
Medicare Open Enrollment
The Medicare Open Enrollment period runs from October 15 to December 7 each year. During this time, beneficiaries can review and make changes to their Medicare health and drug plans for the upcoming year. Since plans may change their cost, coverage, or network providers, it’s important for Medicare recipients to review their “Evidence of Coverage” (EOC) and “Annual Notice of Change” (ANOC) materials. If a plan still meets their needs, no action is needed. Information on new plans is available starting in October, and beneficiaries can compare options at Medicare.gov or by calling 1-800-MEDICARE.
Communication from Payers
Please make sure to send all communications from payers—including EOB’s, denials, inquiries, notices, and updates—to our billing team. Keeping track of healthcare billing updates and payer communications ensures accurate and timely claims processing.
Medicare Enrollment Revalidation for SNFs
The Centers for Medicare & Medicaid Services (CMS) recently announced that as part of the ongoing healthcare billing updates, CMS has introduced off-cycle enrollment revalidations for SNFs. These revalidations are necessary to update Medicare with accurate provider information, including ownership and managerial relationships. It’s important to respond promptly to these notices to avoid disruptions in Medicare billing. Read more about this article here.
UnitedHealthcare Prior Authorization for Outpatient Therapy Services
UnitedHealthcare now requires prior authorization for outpatient therapies. Ensure that you have the necessary authorizations in place before providing services, as this will help prevent claim denials and ensure timely reimbursement. Read more about this article here.
If you have any questions or need assistance navigating these updates, please don’t hesitate to contact us. Our team at HHS Solutions is here to support you every step of the way.