ConnectiCare | Office Visit - February 2017
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Submit taxonomy codes to make sure claims are paid correctly
Here's a tip that can make a difference in how quickly your claims are paid: submit your taxonomy codes in both your paper and electronic claims submissions. Taxonomy codes allow your claims to be priced according to the Centers for Medicare & Medicaid Services' established rates. The submission of taxonomy codes is required for all Medicare claims submissions, and it is highly recommended for commercial claims.
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Reminder: Use new Medicare Advantage ID numbers
All ConnectiCare Medicare Advantage patients have new identification cards with new ID numbers. Please use those new ID numbers for any date of service after Jan. 1, 2017, to avoid claim denials.
- The member identification (ID) numbers on newly issued cards (Ex. M99988877701) (See samples of new cards.)
- Payer ID number 78375
For more information about how to submit Medicare claims submission, you can read this Provider Headline article.
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Claims payment policies updated as of Jan. 31, 2017
We have made a number of updates to our claims payment policies that went into effect with claims processed on and after Jan. 31, 2017. The updates apply to commercial and Medicare Advantage plans, unless otherwise specified.
The updates are:
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Commercial medical record reviews have started
From now through April, you may receive a call from Inovalon about reviewing the medical records of your patients with ConnectiCare commercial plans, including plans purchased on Access Health CT, the Connecticut exchange.
Inovalon will conduct chart reviews on our behalf as part of the 2016 benefit year review of medical records. As a health plan, we must submit detailed documentation for each patient on an ongoing basis to the U.S. Department of Health and Human Services (HHS). All charts must be received at Inovalon by April 15, 2017.
Inovalon will contact you to arrange a convenient way of obtaining copies of our members' medical records for dates of service in 2016. As our partner and "business associate," as defined by the Health Insurance Portability and Accountability Act of 1996 (HIPAA), Inovalon is fully HIPAA compliant and is required to protect, preserve and maintain the confidentiality of any protected health information (PHI) it obtains from clinical records provided by medical practices.
We truly appreciate your help with this medical records review. If you have questions, please call a ConnectiCare provider education and service representative at (860) 409-2468. Notice of the need for these reviews and your required compliance are included in your contractual agreement with ConnectiCare.
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