MPTA's Payment Committee is continually meeting with health care professionals and various insurance companies throughout the state of Michigan to keep our members notified of any changes coming and to advocate for our physical therapy professionals. As a benefit to our membership, MPTA members are notified immediately of any policy changes or deadlines to an insurance plan or group.

Not all Payment questions can be treated the same way. Please email mpta@mpta.com if you have a specific question as it relates to Payment.

Payment News:
 

BCBSM Announcement - eviCore corePath Program WILL be effective July 1, 2018 for BCBSM commercial products

posted: November 20, 2017

Important Update:  BCBSM has issued a correction to MPTA that the eviCore corePath Program WILL be effective July 1, 2018 for its commercial products.  Additional information and training dates for the corePath program that will become effective January 1, 2018 for the Medicare Plus Blue product is now available on the webDENIS website and HERE

 

BCBSM - eviCore Update 11/7/2017

posted: November 06, 2017

The MPTA Payment Committee met this morning with BCBSM, who provided an overview of the changes to the eviCore program.  Although many more details will be forthcoming, there are several important changes:

1) The new corePath program will replace the existing eviCore program starting January 1, 2018 for the Medicare Plus Blue product and July 1, 2018 for the BCN products.

2) implementation of the eviCore program to BCBSM commercial products will start July 1, 2018.

3) Training for the new corePath program will be made available by BCBSM very soon.  The MPTA believes the corePath program appears to be an improvement on the current program.

 

Final Analysis of Member Survey Regarding eviCore Experience in 2017

posted: August 03, 2017

CLICK HERE to view the final analysis.  Thank you to all who participated in the survey.

 

New APTA Toolkit re: Utilization Management

posted: May 10, 2017

Go to the APTA website for this new resource:

  • Utilization Management Toolkit New

    This toolkit offers an overview of challenges and opportunities for PTs in the commercial sector, strategies to mitigate the current and future impacts of UM use, and ways to foster cooperation between providers and UM vendors so that both parties benefit. 


MPTA Correspondence Re: eviCore
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  • MPTA Letter to BCBSM October 24, 2017
  • MPTA Complaint to Michigan Department of Insurance and Financial Services
  • MPTA Letter to Senator Stabenow
  • eviCore - Update on MPTA Strategies and Related Actions
  • MPTA Letter to BCBSM June 30, 2017
  • MPTA Letter to Priority Health June 6, 2017
  • MPTA Letter to BCBSM May 12, 2017
  • BCBSM Minutes from Meeting March 13, 2017
  • MPTA Letter to BCBSM March 13, 2017
  • MPTA Letter to BCBSM October 17, 2016
  • MPTA Letter to BCBSM June 23, 2016

Important Payment Resources

Medicare Resources

Medicare Claims Update

Fiscal Intermediaries (FI's) process Medicare claims for services provided in facilities such as Hospitals, Skilled Nursing Facilities (SNF's), Outpatient Rehabilitation Facilities (ORF's), and Comprehensive Outpatient Rehabilitation Facilities (CORF's). These FI's have web sites that provide a vast amount of information regarding Medicare coverage and billing. Your billing office will know the identity of the FI that processes your claims.

United Government Services (UGS) is the largest Medicare Part A Intermediary processing over 30 million claims nationwide each year. UGS serves customers in (insert association's state MI or WI) as well as many other states. The following UGS website contains valuable information that includes: the publication "Physical Therapy, Occupational Therapy and Speech-Language Pathology Outpatient Services Educational Update", Frequently Asked Questions (FAQs), Local Medical Review Policies, Medicare Memos (the monthly newsletter from UGS), links to Centers for Medicare and Medicaid (CMS) websites and more.

Medicare Links

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