AMCNO Third Party Payor Seminar Provides Valuable Updates

The Academy of Medicine of Cleveland & Northern Ohio (AMCNO) was pleased to host its twenty fifth annual “Solving the Third Party Payor Puzzle” seminar on Thursday, November 18 where presenters from Ohio’s largest insurance companies shared reams of useful information with more than 50 attending practice managers and physicians. Returning presenter organizations included CIGNA Healthcare of Ohio, Medical Mutual of Ohio, Palmetto GBA, the Ohio Department of Job and Family Services (ODJFS), UnitedHealthcare, and Anthem BC/BS. There also were first-time presenters from the Centers for Medicare and Medicaid Services (CMS) and the Ohio RAC contractor, CGI, speaking via teleconference on the topic of the Recovery Audit Contractors (RAC). A detailed summary of this presentation and the Power Points provided will be posted on the AMCNO web site once the summary is completed.

A common-thread key initiative shared by presenters was the ability to offer user friendly, highly robust web portals to better meet service needs and aid in things such as claim submissions and status, precertification, electronic remittance and more. Other valuable tools and resources include free e-courses, download of forms, and fee schedules. These things minimize provider administrative costs and offer solid cost-saving benefits, which promoted the vital importance of electronic viability to practitioners.

Too, Palmetto GBA summarized the new Medicare 2010 payment and policy changes, and discussed things you need to know about the Medicare administrative contractors, e-prescribing, ICD-10-CM, ANSI Version 5010, PQRI and more. The Ohio Department of Job and Family Services (ODJFS) provided updates on Medicaid Managed Care and various physician provider agreements and technology. UnitedHealthcare spoke about its 2-star physician designation program and its restructure with physician advocates, the realignment of its provider service center and how the overall restructure will benefit providers. The final presentation by Anthem B/C & B/S incorporated an overview of Availity, a new one-stop-shop web portal for physicians.