analyze proposed fee schedules and assess the impact fee schedule changes may have on physician practices based on commonly billed CPT codes.
MEMBER BENEFITS & SERVICES
Medi-Cal Survival Guide: Important Changes and What they Mean to Your Practice There have been a number of changes for Medi-Cal patients and for the physicians who treat them over the past few years. To help physicians understand the impact these changes will have on their practices, CMA has published a Medi-Cal Survival Toolkit. The toolkit contains a summary on many of the changes, important dates, options for physicians and links to important resources. Medicare Enrollment Guide for Individual Physicians Medicare enrollment processes have changed considerably over the years, and even more so with the introduction of national provider identifiers. CMA has developed this document to guide new physicians through the enrollment process, and to assist enrolled physicians who are making changes or who must revalidate their enrollment. Medicare Audit Guide for Physicians The Centers for Medicare and Medicaid Services (CMS) is tasked with preventing inappropriate Medicare payments and preserving the trust fund for the future. Much of the responsibility for this duty is defined in Title 18 of the Social Security Act, Medicare Contract Reform and other regulations enacted over the years.
Review of appropriate billing is conducted by Medicare Administrative Contractors (MAC’s) and other agencies contracted by CMS. This guide describes some of the audits that may impact your practice. Special Investigations Unit Audit Guide This guide will help physicians understand their rights and responsibilities when it comes to health plan refund requests. Payor Solvency Checklist This checklist will help physicians monitor the financial health of their contracted payors. Timely Access Regulation Guide Department of Managed Health Care Timely Access regulations require HMO patients to be seen within certain timeframes for various levels of care. CMA has published a toolkit to help physicians understand these new regulations and what they could mean for their practices. Sample Termination Letter – Patient If the terms of a proposed contract are not acceptable or sustainable, physicians have the right under California law to terminate their agreement with the payor. Physicians who decide to exercise their right to terminate their agreement with a payor are encouraged to communicate their decision to with their patients. CMA has prepared a sample letter physicians can use to notify patients of their decision to terminate their contract.
CMA: Tools and Resources to Empower Physician Practices
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