Thank you for attending our 2020 Third Party Payer Day! All post-conference resources can be found on this page.

Presentation Slides & Handouts

• Medicare Administrative Contractor (MAC) - Mary Muchow, WPS Government Health Administrators
• Blue Cross Blue Shield of Michigan - Heather Peterson, BCBSM
• Medicare Plus Blue - Becky Harris, BCBSM
• Navigate Appeals Successfully: Details Make a Difference - Joe Rivet, Esq., Rivet Health Law
• Payer Panel: DIFS - Emily DeLaGarza
  • Prior Authorization Request Form for Prescription Drugs
  • Clean Claim Report
  • Medicaid Clean Claim Report
  • Treating Provider Certification for Experimental/Investigational Denials
  • Health Care Appeals – Request for External Review
  • Health Insurance Complaint Form
• Payer Panel: Priority Health - Jorri Smith
• Payer Panel: UHC - Susan Anspaugh
• Navigating the Latest Telehealth & Telemedicine Reimbursement Rules - Toni Elhoms, Alpha Coding Experts, LLC

CEUS

• ACMPE: Follow the instructions in our ACMPE Credit Worksheet to submit your ACMPE CEUs.
• AAPC: Personalized AAPC certificates have been emailed to all registered attendees. Please reach out to info@mimgma.org if you have not received yours.

Q&A

During the conference, some presenters may have taken questions that could not be immediately answered. Any answers that are provided to us by presenters will be posted below.

• Priority Health

  • Q: Are remote monitoring devices ie. at home blood pressure cuffs, etc. covered via telemonitoring? What equipment is covered by remote monitoring? Cpt code 99453

    • A: For our contracted providers, they can do a telehealth visit for any code within their fee schedule if, in their professional judgement and discretion, they feel it can reasonably be performed via telehealth. Our telehealth medical policy has a section on remote devises, so I recommend reviewing that document for more details about coverage: https://www.priorityhealth.com/-/media/priorityhealth/documents/medical-policies/91604.pdf?rev=3d1f1b90deee4f799768b8416ab6564b

• Blue Cross Blue Shield of Michigan

  • Q: How can we find out who our provider rep is?

    • A: Providers can find their Provider Consultant on our website. Here is the link- https://www.bcbsm.com/providers/help/contact-us/bcbsm-provider-contacts-physicians.html#content8d85e46b-6140-4def-873d-e5e6bdbf3a03.