Hot Issues
ALERT: Blue Cross and Blue Shield Association Data Breach
Claims Workflow Assistant
With this free online tool, you can look up the reasons health insurers reported for denying claims on the ERAs you receive. Then, you can determine the best steps for your practice to reverse the denial. The tool even helps you get started with recommended workflows for top denials and provides numerous template appeal letters that AMA members can easily modify to use in their practices.
What You Need to Know About the New HIPAA Breach Notification Rule
New AMA resources help physicians understand risk assessment and adjustment models
Two new educational resources from the AMA are designed to help physicians understand health insurersâ use of risk assessment and risk adjustment models and how they might affect the physician practice. âAn introduction to risk assessment and risk adjustment modelsâ defines the terms ârisk assessmentâ and ârisk adjustmentâ and provides overviews of the prominent risk assessment and risk adjustment models and their various uses, including profiling physicians and other health care professionals. A second resource, âTerminology used in physician profilingâ helps physicians assess information they receive about physician profiling programs by defining common profiling terms used in health insurersâ physician profiling programs.
Blue Cross Blue Shield settlement fund finally set to pay out more than $131 million
Physicians who filed timely claim forms as part of the Blue Cross Blue Shield (BCBS) settlement are finally scheduled to receive funds from the settlement in July, after a two year delay due to appeals.
Red Flags Rule Resources
Learn more about these FTC issued regulations.
Payer Web sites: Contracted fees and payer payment policies
Visit payer Web sites to access payment polices, contracted fee schedules and claim edits available to physicians.
Join the campaign
Review and reconcile your claims, and join physician practices around the country in the AMA's campaign to cure the claims process.
