I'm trying to set up alerts in Workflow to send reminders 15 days prior to the expiration date. I've looked at Workflow definitions and I *believe* I set up an alert but I'm not sure if it will be activated correctly. Thoughts?

As of January 1, 2021, Medica IFB will have a new Payer ID (87726) . You will need to submit all claims for dates of service (DOS) on or after 1/1/2021 to this new Payer ID.

Please visit our Live Updates page for information regarding this upcoming change.

Has anyone heard if the payers are extending the Covid - 19 Telehealth waivers that are due to expire at the end of the year? 

Thanks

Does anyone know why some PMAPs pay different rates from MA for the same service/provider? 

It seems like they should be the same since the PMAPs follow MA guidelines. 

Thanks!

Question about the functionality of the Diagnosis tab as it relates to Inpatient (Residential calendar) billing.  The Diagnosis tab on the Change Client window has the capacity to record detailed, extensive patient diagnosis history, but when it comes to billing inpatient/residential claims through the residential calendar in the time module, all the distinctions from that tab are lost - it seems the full history is pulled in to the claim, regardless of program, date, or status.  Is there a way to use the full capacity of this tab and not have most/all (including duplicates) pull into the claim?

We received information from Availity stating there may have been an issue with some ERAs from Anthem recently,

Please go to our Live Updates page for more information.

Thank you!

Is there's a setting in Procentive that would prevent it from sending an email to me for ticket-related items?  I'm in the program all day, so emails related to tickets assigned, changed, or commented are really redundant.  I have a rule in my email to delete them automatically, but it would be better to cut them off at the source, if possible.

Just a notice to our Dr. First users:

Dr. First is performing scheduled system maintenance on Saturday October 31st, 2020 from 11:59 PM ET to Sunday November 1st, 2020 4:00 AM ET. During this maintenance period Dr. First will be switching over production environment traffic to a secondary site.

You shouldn't see any interruptions but we wanted to make you aware of the maintenance. 

Please see our Live Updates page for more information.

Procentive Team

Hello,

We are having claims deny using the Value Code 24 (99920) that we were first instructed to use for SUD Room and Board claims back in 2019.  All claims have paid up until now, all are now denying as a non covered charge.  I have spoke with the provider help desk and they do not see the code we are using on the list.  They also said there have been no updates to the list since it came out in 2019.  I do have the code that they are saying we should be using and will be updating our system and I have set up a case with the state to review.  

I wanted to know anyone else is having this same issue?  We were thinking that it may have something to do with direct access starting 10/01/2020,

Thank you!  

We received an alert from the Office of Civil Rights (OCR) that we wanted to share with you:

October 29, 2020

Cyber Alert: Ransomware Activity Targeting the Healthcare and Public Health Sector

The Cybersecurity and Infrastructure Security Agency (CISA), the Federal Bureau of Investigation (FBI), and the U.S. Department of Health and Human Services (HHS) have credible information of an increased and imminent cybercrime threat to U.S. hospitals and healthcare providers.

CISA, FBI, and HHS have released AA20-302A Ransomware Activity Targeting the Healthcare and Public Health Sector that details both the threat and practices that healthcare organizations should continuously engage in to help manage the risk posed by ransomware and other cyber threats. The advisory references the joint CISA MS-ISAC Ransomware Guide that provides a ransomware response checklist that can serve as a ransomware-specific addendum to organization cyber incident response plans.

In addition to these materials regarding the most recent ransomware threat to the Healthcare and Public Health Sector, the HHS Office for Civil Rights’ Fact Sheet: Ransomware and HIPAA provides further information for entities regulated by the HIPAA Rules.

CISA, FBI, and HHS are sharing this information in order to provide a warning to healthcare providers to ensure that they take timely and reasonable precautions to protect their networks from these threats. CISA encourages users and administrators to review CISA’s Ransomware webpage for additional information.