Aug 3, 2022 | Insurance & Reimbursement
The federal Consolidated Appropriations Act requires that health plans and insurers verify the demographic information for providers every 90 days. BCBSVT has been sending emails requesting this update/verification to providers this year; you may get similar requests from MVP, Cigna, or other health insurers–IT IS NOT SPAM.
If you are on the BCBSVT panel, you will get an email at the email address you gave BCBSVT at enrollment (or updated email address), and the email will be from noreply@bcbsvt.com. Please check your spam/junk folder for these previous emails and designate that email address as legitimate or “not junk,” depending on your email service.
The email will contain a link to your practice information/provider(s) which will allow you to accept or change the reported data.
For questions about the process or any technical difficulties you have updating or approving your information, you can contact BCBSVT Provider Relations by email at providerrelations@bcbsvt.com or phone them at (888) 449-0443, option 1.
If you have questions about the details related to your information, you will need to contact Provider Files either by email at providerfiles@bcbsvt.com or phone them at (888) 449-0443, option 2.
If you don’t respond to the requests for updated information, you can be removed from the provider directory, and the IRS, HHS, and in some cases your patients can enforce these requirements (usually with a hefty monetary fine).
Jul 5, 2022 | News
In 2020, Congress designated the new 988 dialing code to be operated through existing National Suicide Prevention Lifeline. This provides a universal entry point so that no matter where you live, you can reach a trained crisis counselor who can help. This is a step towards a transformed crisis care system in America.
What does this mean? On July 16, 2022, Vermont will join the rest of The United States in launching 988, the new three-digit number for the National Suicide Prevention Lifeline. This service will provide compassionate, accessible care and supports for anyone experiencing mental health related distress. Access is available 24 hours, seven days a week.
Source: United Counseling Service
Mar 23, 2022 | Insurance & Reimbursement
Providers submitting reconsideration requests to Gainwell Technologies should use the new form that is now located on the Vermont Medicaid website (http://www.vtmedicaid.com/#/forms). This form is to be used for non-timely filing reconsideration requests only; there is a separate form for timely filing reconsideration requests. Effective 4/25/2022, old versions of the Reconsideration Request Form will no longer be accepted and will be returned to the provider.
Mar 23, 2022 | Insurance & Reimbursement
The Payment Error Rate Measurement (PERM) audit has commenced and will examine sampled claims from July 1, 2021, through June 30, 2022. Providers with a sampled claim will receive a medical record request letter from NCI Information Systems, Inc., and are required to submit all requested claim medical records and documentation.
The first request letters are expected by early April. Providers have 30 days from date of receipt of notice to submit required claims medical records and adjoining documentation to NCI Information Systems, Inc. If additional information is needed, providers have 14 days from the date of receipt of notice to send in the information. DVHA will enforce a 10% withholding from all providers that do not submit the required medical record and adjoining documents within 30 days or the additional documentation within 14 days.
Beginning in March, providers with a sampled claim may be contacted by a state representative to confirm the correct contact information prior to the request letters going out.
NEW: CMS will be hosting a few webinar sessions for providers focusing on the below topics:
• The PERM process and provider responsibilities during a PERM review
• Recent trends, frequent mistakes and, best practices
• The Electronic Submission of Medical Documentation, esMD program
These sessions will be held on:
• Tuesday 4/12 1pm-2pm
• Wednesday 4/13 3pm-4pm
• Thursday 4/14 3pm-4pm
Please see https://dvha.vermont.gov/providers/audits/payment-error-rate-measurement for a link to register for the webinar. Registration closes April 10th.
Mar 16, 2022 | News
If you’re looking for the new Medicaid rate schedule, you can find it here: http://www.vtmedicaid.com/#/feeSchedule. Click on the green “Open Menu” button in the upper left part of the page, and you can search by CPT code in the blank box at the top of the table.
