December 2017 Updates:
- Cast and Splint Applications and Associated Supplies Provided in the Office Setting
- Genetic Testing (Independence Administrators)
- Laboratory Services for Members Enrolled in Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Products
- Obstetrical Ultrasounds for Members Enrolled in a Health Maintenance Organization (HMO) or Health Maintenance Organization Point-of-Service (HMO-POS) Product
- Percutaneous Discectomy
- PPO Network Rules for Provision of Specialty Services for Durable Medical Equipment and Laboratory, Radiology, and Physical Medicine and Rehabilitative Services
- Reconstructive Breast Surgery
- Reimbursement for Services Performed by Certified Registered Nurse Practitioners (CRNPs) or Physician Assistants (PAs)
- Services Paid Above Capitation for Health Maintenance Organization (HMO) and Health Maintenance Organization Point-of-Service (HMO-POS) Primary Care Providers
- Spinal Discectomy
- Transcranial Magnetic Stimulation (TMS) for Medical Conditions
- Wound Care: Skin Substitutes for the Treatment of Burns and Chronic, Non-Healing Wounds
- X-rays Associated with Fractures in the Office Setting
- Daptomycin (Cubicin®)
- Digital Breast Tomosynthesis (Independence)
- Ecallantide (Kalbitor®)
- Lanreotide (Somatuline® Depot)
- Omacetaxine mepesuccinate (Synribo®)
- Oxaliplatin (Eloxatin®)
- Pegloticase (Krystexxa®)
- Plerixafor Injection (Mozobil™)
- Solid Organ Transplantation and Procurement Cost of Organs and Tissues
- eviCore Lab Management Program
- Denervation of the Spinal Nerves for Chronic Pain
- Epidural, Paravertebral Facet, and Sacroiliac Joint Injections for Spinal Pain Management
- Musculoskeletal Services
- Sleep Disorder Testing and Positive Airway Pressure Therapy Services and Supplies
- Treatments for Complex Regional Pain Syndrome (CRPS)
Policy Alerts monitors Commercial and Medicare medical policies for changes. While Payers typically update medical policies annually, there are many reasons why a Payer might review or update a policy. When reviews occur out of cycle, they may go unnoticed. Policy Alerts keeps you informed of upcoming and unexpected coverage changes affecting your product. Quickly understanding the changes Payers make can help you adjust reimbursement strategies impacting your business.
Policy Alerts continuously monitors Commercial and Medicare Payer coverage information to keep you up-to-date on Payer decisions in real-time. Whenever changes occur, email notifications containing a summary of those changes are delivered to your inbox. Clients can access detailed coverage reports and medical policies on the interactive Dashboard portal. Save time and keep focused on the important Payer medical policy reviews and coverage decisions affecting your product!
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Health economic and reimbursement information provided by Policy Alerts is gathered from third-party sources and is subject to change without notice as a result of complex and frequently changing laws, regulations, rules and policies. This information is presented for illustrative purposes only and does not constitute reimbursement or legal advice.