Medicare Part B Deductible 2017

It has been announced that the new fee schedules for 2017 are ready to be downloaded but on all the websites we visited there has been nothing about the new 2017 Part B deductible.   This was only announced on the CMS website for 2017 which is funny that all the other intermediary websites don’t think we need to know.  The deductible like everything else except reimbursement has gone up to 183.00 per calendar year.  Also noting that the premium for Part B has gone up but our Seniors cannot get a COL raise.

The new premium minimum is 134.00 per month which is taken directly out of their Social Security Check.   We here at DBMA keep a close watch on those things to try and keep our Providers informed.  We will be downloading and organizing the new reimbursement rates for 2017 in the next few weeks and will announce here when they are ready for delivery.

CPT Codes and United Behavioral Health

Just in case you are not aware of it this is the only insurance company that requires an authorization for you to use the code 90837.  According to their Medical Policies the 60 minute session is not medically necessary.   You would have to supply a dissertation to get this code allowed.  Any time you bill this code you will get a denial of course unless you have an authorization.

Provider Enrollment Bottleneck

We provide a lot of Provider Enrollment services to our customers.  Most of this entails submitting the applications for individuals to get them enrolled as providers in the various Networks so that they can provide services to clients with different insurance companies.  In recent months since Humana changed from LifeSynch doing the provider enrollment and credentialing pieces there has been a bottleneck and providers are not getting credentialed for more than 120 days.  You cannot even find out status of a provider request until it has reached 120 days from the time you submitted it.    On another front we are also seeing another bottleneck with Aetna after the providers are approved it is taking anywhere from 30-120 days before the contract is received.    I suspect a lot of this has to do with the mergers and acquisitions going on in the industry and new management taking over.   Provider Enrollment is a tedious mission and the follow up is time consuming.  So this is just a little heads up to let you know what appears to be going on in the Industry.