NCMS Morning Rounds 7-30-21

T.G.I.F! Enjoy your NCMS Morning Rounds.

July 30, 2021

AmeriHealth Caritas North Carolina Moves to EFT Payments through ECHO Health

AmeriHealth Caritas North Carolina (ACNC) offers electronic claims payment solutions to increase payment efficiency and to reduce the risks associated with paper checks. ACNC has contracted with Change Healthcare and ECHO® Health Inc. to administer electronic funds transfer (EFT) payments. Using EFT is convenient and can reduce administrative overhead while allowing access to your funds more quickly. After 09/13/2021, any clinician who has not registered for EFT will be paid via Virtual Credit Card (VCC). Normal credit card transaction fees will apply to VCC payments.

If you already receive payments from another ECHO Health payer, you may be able to enroll for EFT with AmeriHealth Caritas North Carolina using your existing account. Please make sure you have an ECHO Health draft number and corresponding payment amount so your enrollment request can be validated. A draft number is listed as the EPC draft number on ECHO Health’s explanation of payments. If you need assistance locating an ECHO payment in order to register, you can contact ECHO at 1-888-834-3511 Monday-Friday from 8 am – 6 pm ET.

To enroll please visit here.

If you have never received a payment through ECHO Health for any payer, then you must wait to enroll for EFT after your first ECHO Health payment is received. Your first payment from AmeriHealth Caritas North Carolina will be made via paper check. Please use the information on the Remittance Advice and the check stub to register for EFT by 9/13/2021. To enroll, please visit here.

Update Your Payer IDs and Electronic Remittance Advices

If you are currently receiving EFT payments through the ECHO Health platform, you may need to update your Payer IDs and Electronic Remittance Advices to help ensure that you are all set to receive electronic payments from AmeriHealth Caritas North Carolina.

  • If you use a practice management system, to help ensure continued receipt of Electronic Remittance Advices (ERAs), you will need to update your software to accept the new ECHO Payer ID 58379 in addition to the AmeriHealth Caritas North Carolina Payer ID 81671.
  • All generated ERAs will also be accessible to download from the ECHO Health Provider Portal. Changes to the ERA enrollment or ERA distribution can be made by contacting the ECHO Health Enrollment team at 1-888-834-3511.
  • Payment will appear on your bank statement from PNC and ECHO as “PNC – ECHO”

Medicaid Transformation Update: Details on Common Error Message on Accreditation Page

It has come to the attention of NCTracks that some clinicians are receiving the following error message on the Accreditation Page during their Enrollment, Re-enrollment or Manage Change Request (MCR) applications:

Please add/edit taxonomy required [accreditation, certification or license] with current/future expiration date.

The accreditation, certification and license sections display exactly which agency/type is required for each taxonomy code. If the incorrect agency or type is selected, the error message displays. To avoid the error message, clinicians should ensure the appropriate agency and type is selected.

CMS Releases CY 2022 Medicare Physician Fee Schedule Proposed Rule 

On July 13, the Centers for Medicare & Medicaid Services (CMS) released the CY 2022 Medicare Physician Fee Schedule (MPFS) proposed rule (proposed rule and fact sheet). While CMS notes in its press release that the MPFS is one of several proposed rules that reflect a broader Administration-wide strategy to focus on accessibility, quality, affordability, empowerment, and innovation, it does not address how the proposed conversion factor reduction will cause adverse financial consequences for already struggling independent physician practices and the patients they serve. Comments on the proposed rule are due September 13, 2021. For a detailed summary of the rule, please click here.

Key proposals are highlighted below:

Impact of Proposed Rule 

The Physicians Advocacy Institute (PAI) is extremely concerned with the negative impact that changes to the conversion factor will have on physician payments. PAI is particularly concerned with the following rule changes:

  • The proposed reduction will result in lower payments that could threaten patient access to vital treatments and procedures. Appropriately valuing and paying for evaluation and management services provided is especially important as the country continues to respond to the risks and challenges of COVID-19.
  • While PAI is supportive of the extension of telehealth flexibilities until the end of 2023, the use of audio-only services being limited to only mental health disorders could have a negative impact on patients in need of other audio-only services.
  • PAI believes it is vital to permanently extend audio-only services for other clinical services beyond the initial COVID-19 PHE, as many physician practices and the patients they serve will remain reliant on telehealth in the long-term. Extending audio-only services will increase access to physicians and physician services, especially for vulnerable, underserved, urban, and rural patient populations.

PAI will continue its advocacy directly with the Department of Health and Human Service (HHS) on this proposed rule. PAI will also work with other physician and patient advocacy organizations to advance policies that protect physician practices from additional payment cuts given the financial challenges brought by the pandemic.

In the News

Could Covid-19 Increase Alzheimer’s Risk? Here’s What Researchers Know So Far, Advisory Board, 7-28-21

Learning Opportunity

National Stakeholder Webinar on Price Transparency: Compliance with Hospital Price Transparency Final Rule: 8 Steps to a Machine-Readable File, Wednesday, August 11, 2021, 2:00-3:30 pm Eastern Time

The Centers for Medicare & Medicaid Services (CMS) will host a webinar on Price Transparency focusing on how hospitals can meet the requirements of the Hospital Price Transparency Final Rule for posting standard charge information in the comprehensive machine-readable file.

Please use the following link to register in advance for this webinar.


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