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:
 

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.

 

Updated MPTA Patient Advocacy Action Center Portal

posted: August 03, 2017

The MPTA Patient Action Center portal has been updated with new messaging.  This portal will allow patients to quickly and easily write letters to the Michigan Department of Insurance and Financial Services about their negative experiences.  CLICK HERE to access the portal.

BCBSM has requested that MPTA no longer use the patient portal for sending letters to BCBSM.  BCBSM requests that patients with complaints about their experience call the number on the back of their insurance card.  MPTA is respecting this request.  Please do encourage your patients to call this number!

However, MPTA feels it is critical to provide additional voice to patient concerns, especially when those concerns are not resolved.  Therefore, MPTA has revised the patient portal, and the letters will instead be sent to the Michigan Department of Insurance and Financial Services.  Please encourage your patients to use the patient portal, and be sure to ask them to customize the letter to their individual experience.

 

 

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. 

 

BCBSM Delays Implementation of eviCore Utilization Management Program for Commercial Products Until Jan 2018

posted: March 22, 2017

MPTA leaders  met with BCBSM on March 13 regarding the eviCore Utilization Management Program currently in use with the Medicare Plus Blue product.  MPTA represented the NUMEROUS concerns expressed by providers and patients alike.

BCBSM stated that the implementation date of the eviCore program for its commercial products will be delayed until January 2018.  MPTA will continue to push for substantial changes to the current program in the short term, and ultimately for its elimination.

 


MPTA Correspondence Re: eviCore
[Click to Login and View]

  • 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

We can help the way your association works. click here.Website Design and Management by: