2015 Professional Providers Quality-Based Reimbursement Program (QBRP)
BCBS KS has released the requirements for the 2015 Professional Providers QBRP. Attached you will find the program attachment sent by BCBS KS for your complete review. BCBS of KS is sending out letters to those providers who qualify for any QBRP. If you receive one of these letters, please forward a copy to our office for your files.
Most providers are eligible under Group A, and Anesthesia Billing has set up our clients to meet and be electronic self-service as possible. If you have staff who check eligibility or claim status of your services, it is imperative they utilize Availity as much as possible for these services, rather than make phone calls. The utilization of Availity versus making phone calls will be tracked and used to determine whether you qualify for the additional percentage. If your office needs access to Availity and are not already set up, please contact Bonnie Wendling in our office at (316) 281-3740. She can help direct you in the set up process.
Some of our providers may qualify for the Group B and C additional monies. Please read the attached document to ensure you are meeting the requirements in these two areas in order to capture as much of the additional monies as possible.
Contract Language Amendment
As many of you know, BCBSKS had contractual language stating you could not enter into any agreement with a lesser reimbursement than your BCBSKS allowable; and if you did so, you agreed to inform BCBSKS of such agreement, of which BCBSKS could adjust their rate to the lesser amount. They have deleted that language, effective 1/1/2015, from your agreement, and you are no longer being held to those requirements.
abinsights Contact Information
abinsights readers are invited to submit comments, questions, tips, and suggestions for articles on any subject related to billing, collections, coding, reimbursement, and compliance. Send to: Anesthesia Billing, Inc., P O Box 388, Newton, KS 67114-0388. Phone 316-281-3700. Fax 316-282-4322.
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Reasonable attempts have been made to be accurate. However, medical billing, collections, coding and compliance are part science, part art, and even experts sometimes differ. Neither Anesthesia Billing, Inc., the editors, publisher, contributors, or consultants warrant or guarantee the information contained will be applicable or appropriate in all situations. For information specific to your practice, consult a qualified professional.
The information included in this publication is provided, among other things, to alert you to legal developments and should not be considered legal advice. Specific questions about how this information affects your particular situation should be addressed to your attorney.
Editor: Philip Blann (pblann@anesthesiabilling.com).
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