May 16, 2019, 12:30 PM
Highmark Efficiency Report (Webinar Recordings)
Highmark has launched its Specialist Efficiency Report pilot program, aimed at analyzing and comparing care costs among providers. These webinars provide an overview of the reports and a tutorial of the practice scorecard.
Apr 25, 2019, 12:00 PM
Independence Blue Cross to Update Credentialing, Incident-To Policies for CRNPs and PAs
Both policies will take effect on June 1, 2019.
Mar 7, 2019, 09:00 AM
United Healthcare to Revise Consultation Services Reimbursement Policy
United Healthcare new consultation services policy will be implemented in phases.
Jan 29, 2019, 10:18 AM
Highmark to Implement New Opioid Management Measures, Effective Feb. 1
Effective Feb. 1, 2019, Highmark will implement a 90 MME/day limit for opioid-naïve patients and members currently receiving less than 90 MME.
Jan 15, 2019, 09:52 AM
How Will Highmark’s New Prior Authorization Program Impact Physicians and Patients?
On Jan. 10, 2019, a stakeholder group which included PAMED met with Highmark to discuss the Advanced Imaging and Cardiology Services Program.
Dec 12, 2018, 11:18 AM
United Healthcare to Retire 10 Prior Authorization Fax Numbers
Find out why UHC is eliminating these numbers and what it means for physicians.
Sep 11, 2018, 12:00 PM
Proposed CVS-Aetna Merger Could Jeopardize Patient Safety, Quality of Care in Pennsylvania
PAMED called for a public hearing to explore the possible implications of CVS-Aetna merger.
Jul 26, 2018, 08:55 AM
Pa. Supreme Court Issues Decision in Highmark-UPMC Medicare Advantage Case
In-network access to UPMC hospitals ends June 30, 2019 for certain Highmark Medicare Advantage plans.
May 31, 2018, 08:55 AM
Medical Societies to Independence Blue Cross: Share Data on Modifier 25 Use
PAMED joined a coalition of 47 medical societies who asked for the data that led to the adoption of the IBC's modifier 25 payment policy, so that they could better understand why the policy was implemented.
Feb 12, 2018, 15:22 PM
Applying Topical Fluoride Varnish in the Medical Office Setting for Children
Get guidance on how to provide topical fluoride varnish applications, including training requirements and associated billing/reimbursement.
Oct 2, 2017, 18:45 PM
PAMED Calls for Retroactive Delay of IBC’s Modifier 25 Payment Policy
Effective Aug. 1, 2017, Independence Blue Cross changed its policy on payment when Modifier 25 is used. PAMED strongly opposes this policy change.
Jun 1, 2017, 18:39 PM
Be on the Lookout for Fraudulent Faxed Prescriptions – Here’s What You Should Know
has identified a scam in which fraudulent prescriptions are being faxed to
and practices should be on the lookout for any prescriptions they did not