#ProviderSupport

Department and HMS to refresh portals; automated audits started, complex DRG audits to expand slowly HMS said its RAC website will be pared down during an early-2026 redesign; department staff said automated audits are under way and complex audits (DRGs first) will be rolled out slowly with small claim sets and rebilling safeguards, with more steady activity expected mid to late January.

2 months ago

Exciting changes are on the horizon as the HMS Colorado RAC website gets a major redesign for enhanced usability, while automated audits kick off with complex processes set to expand early next year!

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#CO #HealthcareAccess #CitizenPortal #AuditTransparency #ProviderSupport

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HMS details five automated RAC scenarios; providers press for clarity on records and rebilling HMS presented five automated audit scenarios — duplicate behavioral-health claims, pediatric behavioral therapy place-of-service and provider-type issues, missing ordering providers, and NEMT trips without a qualifying medical claim — and providers raised concerns about FQHC exceptions, record burdens for disputes, and the automated approach to high-volume services.

2 months ago

HMS is shaking up audits with automation that flags duplicate behavioral health claims and pediatric therapy discrepancies—could this change the game for providers?

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#CO #HealthcareAudit #FraudPrevention #CitizenPortal #ProviderSupport

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HCPF investigating provider-portal/CBMS mismatches, EMS denials and specialty long-stay claims HCPF said it is investigating reports of mismatched date-of-death data between the Medicaid provider portal and CBMS that cause claim and payment issues, is analyzing EMS fee-for-service denials potentially routed to managed care, and is reviewing specialty hospital claims with possibly excessive lengths of stay.

2 months ago

Colorado's HCPF is tackling critical issues with Medicaid claims, including mismatched death dates and EMS payment denials that could be affecting providers statewide.

Get the details!

#CO #HealthcareAccess #ClaimIssues #CitizenPortal #ProviderSupport

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State agency to move trading-partner EDI functions to new vendor; providers told to check trading partners Colorado HCPF said it is switching the MMIS trading-partner EDI platform to a new vendor called EdFX, leaving GainWell as the primary MMIS partner for provider enrollments; trading partners must adopt new file-naming conventions and logins ahead of a larger summer rollout.

2 months ago

Colorado's HCPF is revamping its EDI platform with a new vendor, EdFX, and trading partners need to prepare for significant changes this summer!

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#CO #HealthcareInnovation #CitizenPortal #ProviderSupport #DataInteroperability

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Citizen Portal News Michigan

@citizenptnewsmi.bsky.social

4 months ago

Doctor tells House Rules Committee he opposes mandatory implicit‑bias training; committee members seek evidence A physician testified before the House Rules Committee urging repeal of Michigan’s mandatory implicit‑bias training for health‑care licensees, calling it accusatory and ineffective; committee members pressed for empirical evidence and some recounted their own experiences with training.

A Michigan psychiatrist claims mandatory implicit bias training for healthcare professionals is more about indoctrination than education, arguing it could worsen provider shortages and fail to improve patient outcomes.

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#MI #CitizenPortal #HealthcareReform #ProviderSupport

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Citizen Portal News Ohio

@citizenptnewsoh.bsky.social

4 months ago

Physicians and Advocates Tell Committee Recoupment Rules Hurt Practices; Bill Would Shorten Lookback and Bar Appeal Fees Proponents of Senate Bill 162, including the Ohio State Medical Association and behavioral health representatives, told the Senate committee that insurers' "take backs" (recoupments) create financial instability for providers and that the bill would shorten the audit lookback period and bar insurers from charging providers to appeal recoupment.

Ohio healthcare advocates are fighting for Senate Bill 162, aiming to protect providers from unfair insurance recoupments that threaten their practices and patient access.

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#OH #CitizenPortal #HealthcareReform #ProviderSupport #InsuranceRegulation

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Citizen Portal News North Carolina

@citizenptnewsnc.bsky.social

4 months ago

House advances Medicaid rebase funding; companion health investment bill also moves The House passed measures to allow temporary use of Department of Health reserves and a health‑investment option to blunt provider rate cuts while budget negotiations continue. House Bill 491 passed 111-0; a House committee substitute of Senate Bill 405 passed 109-1.

North Carolina lawmakers have taken a bold step to protect Medicaid services, passing critical measures to prevent rate cuts while budget negotiations continue!

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#NC #CitizenPortal #NorthCarolinaHealthcare #ProviderSupport #MedicaidFunding #BudgetNegotiations

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Specialty Wound Care

@specialtywoundcare.bsky.social

5 months ago

Grow your practice with Specialty Wound Care 🩺

📞 1-844-299-9499 | 🌐 specialtywoundcare.com

#SpecialtyWoundCare #HealthcareProviders #GrowYourPractice #ChronicWoundCare #HealthcareNetwork #AdvancedWoundCare #WoundCareSpecialist #BetterHealing #HealingStartsHere #ProviderSupport #HealthcareInnovator

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Specialty Wound Care

@specialtywoundcare.bsky.social

5 months ago

Grow your practice with Specialty Wound Care. 🩺

📞 1-844-299-9499 | 🌐 specialtywoundcare.com

#SpecialtyWoundCare #HealthcareProviders #GrowYourPractice #ChronicWoundCare #HealthcareNetwork #AdvancedWoundCare #WoundCareSpecialist #BetterHealing #HealingStartsHere #ProviderSupport

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Citizen Portal News California

@citizenptnewsca.bsky.social

6 months ago

California Medical Board Discusses Physician Oversight and Healthcare Access Challenges Board members emphasize oversight and solutions for healthcare shortages in underserved areas.

The California Medical Board is tackling healthcare access challenges head-on, with innovative solutions for underserved areas and heated debates over physician rights.

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#CA #CitizenPortal #CommunityEngagement #ProviderSupport

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Citizen Portal News Arizona

@citizenptnewsaz.bsky.social

6 months ago

Senator Shope investigates impact of code changes on behavioral health reimbursement rates Senators discuss payment delays and provider outreach regarding new behavioral health codes.

Arizona's Senate is tackling the crucial issue of new billing requirements for behavioral health services, raising concerns about payment delays and provider stability.

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#AZ #CitizenPortal #ArizonaBehavioralHealth #ProviderSupport #PolicyImpact #MentalHealthServices

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Citizen Portal News Arizona

@citizenptnewsaz.bsky.social

6 months ago

Arizona Office of Inspector General Reports $945M in Cost Avoidance Through Provider Monitoring OIG highlights substantial cost avoidance and improved claims processing for behavioral health providers.

Arizona's relentless fight against fraud in behavioral health has led to an astonishing $945 million in cost avoidance—transforming the landscape for providers and patients alike!

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#AZ #CitizenPortal #ArizonaBehavioralHealth #ProviderSupport #FraudPrevention #HealthServices

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Citizen Portal News Vermont

@citizenptnewsvt.bsky.social

9 months ago

Vermont's VITL establishes standards for health information technology connectivity Vermont Information Technology Leaders certifies meaningful use of health tech for providers

Vermont is setting the bar high for healthcare innovation by certifying meaningful use of health technology for providers!

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#VT #CitizenPortal #HealthInnovation #VermontHealthTech #ProviderSupport #TechStandards

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Citizen Portal News New Hampshire

@citizenptnewsnh.bsky.social

10 months ago

Senate Bill 243 F N overhauls New Hampshire childcare scholarship program for working families SB 243 F N streamlines childcare scholarship applications and improves provider funding stability.

New Hampshire families are set to benefit from groundbreaking changes to the childcare scholarship program, ensuring easier access and support for working parents.

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#NH #EconomicParticipation #CitizenPortal #NewHampshireChildcare #ProviderSupport #ChildDevelopment

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L2uMA

@l2uma.bsky.social

10 months ago

Empowering Providers with Smarter Wound Care Tools
Learn how it works: www.list2u.com/woundgraftso...
#WoundHealing #DigitalHealthcare #ProviderSupport #BiologicGrafts

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Senator Bolden withdraws dental funding amendment amid provider concerns Senator Bolden pauses amendment while discussing concerns over dental care funding transition.

11 months ago

As Minnesota lawmakers grapple with a critical shift in dental funding, concerns mount over the potential fallout for vulnerable patients and essential providers.

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#MN #CitizenPortal #HealthCareAccess #ProviderSupport #VulnerablePopulations #MinnesotaDentalCare

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Minnesota lawmakers push reform on childcare licensing with House File 2617 House File 2617 aims to transform childcare licensing to support quality education and safety.

11 months ago

Minnesota lawmakers are on the brink of a childcare revolution with House File 2617, a bill that promises to transform the licensing system for the betterment of providers and children alike.

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#MN #ChildcareReform #CitizenPortal #ProviderSupport #MinnesotaChildcare

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Minnesota amends child care provider payment regulations for timely billing Minnesota sets new billing timelines and conditions for child care provider payments.

11 months ago

Minnesota's Senate Bill 2937 could revolutionize child care payment processes, ensuring timely compensation for providers and potentially enhancing the quality of care for families.

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#MN #CitizenPortal #ProviderSupport #LegislativeAccountability #ChildCareReform

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Childcare Licensing Committee updates standards for safety and operational efficiency Committee streamlines childcare licensing requirements to enhance provider flexibility and safety measures

1 year ago

Minnesota's new childcare licensing standards are set to revolutionize provider operations and enhance child safety, responding directly to voices from the community!

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#MN #MinnesotaChildcare #ProviderSupport #OperationalEfficiency #ChildSafety #CitizenPortal

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Citizen Portal News Connecticut

@citizenptnewsct.bsky.social

1 year ago

Connecticut psychologists advocate for House Bill 7039 to limit insurance clawbacks Psychologists support bill to restrict insurance clawback periods to one year in Connecticut

Connecticut psychologists are rallying for House Bill 7039, aiming to combat the financial strain of insurance clawbacks that threaten the viability of mental health services.

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#CT #MentalHealthAccess #ProviderSupport #InsuranceReform #CitizenPortal

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Colorado Assembly modernizes medical licensure to reduce stigma for health providers Colorado aims to update licensure applications to support mental health care for providers.

1 year ago

Colorado's House Bill 1176 is set to revolutionize mental health support for healthcare providers by modernizing licensure language and eliminating stigma.

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#CO #MentalHealthStigma #HealthcareReform #ProviderSupport #CitizenPortal

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Citizen Portal News Tennessee

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1 year ago

Tennessee updates TennCare rates to align with Medicare and commercial standards TennCare will adjust reimbursements for key services to match Medicare fee schedules by 2025

Tennessee is on the brink of a healthcare revolution with House Bill 372, aiming to ensure fair compensation for vital medical services and improve access for vulnerable populations.

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#TN #MedicaidReform #ProviderSupport #TennesseeHealthcare #CitizenPortal #HealthcareAccess

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Citizen Portal News North Carolina

@citizenptnewsnc.bsky.social

1 year ago

Medicaid team overhauls provider enrollment processes to improve service access Team implements changes in provider enrollment to streamline access to Medicaid services.

North Carolina's Medicaid team is taking bold steps to overhaul provider enrollment and tackle the barriers to service access—will these changes finally bridge the gap?

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#NC #ServiceDelivery #ProviderSupport #NorthCarolinaMedicaid #CitizenPortal #HealthcareAccess

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