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March 22, 2007
The FMA E-News is emailed to all members of the Florida Medical
Association semimonthly. The FMA, located in Tallahassee, Fla.,
serves as an advocate for physicians and their patients to promote the
public health, to ensure high standards in medical education and ethics, and
to enhance the quality and availability of health care.
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Do Any of Your Patients Use Health Savings Accounts?
The AMA seeks physicians willing to share their experiences
about providing care for patients enrolled in consumer-driven
health plans such as health savings accounts or health
reimbursement arrangements. Participants will be contacted for a
brief informal interview via phone or e-mail to help shape
further research into this subject. Send an
e-mail to
nisha.nair@ama-assn.org if you are willing to be
contacted.
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The FMA would like to congratulate the following members for
their appointment to the Commission on Cancer:
Gary Bowers, MD, FACS
of Jacksonville, FL received a
three-year appointment as Cancer Liaison Physician at
Baptist Medical Center.
Nicola Ally, MD
of Leesburg, FL received a three-year
appointment as Cancer Liaison Physician at Leesburg Regional
Medical Center.
Cathy A. Burnweit, MD
of Miami, FL received a three-year
appointment as Cancer Liaison Physician at Miami Children's
Hospital.
Cancer Liaison Physicians are an essential part of cancer
programs approved by the American College of Surgeons
Commission on Cancer.
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Extended Acceptance of Old Version of CMS-1500 |
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In September 2006, Medicare announced that it would
implement the revised Form CMS-1500 (08-05) on January 1,
2007 with dual acceptability of both versions until March
31, 2007. Medicare further announced that beginning April 1,
2007, the only acceptable version of the form would be the
Form CMS-1500 (08-05) and that the prior version, Form
CMS-1500 (12-90) would be rejected.
It has recently come to the attention of CMS that there are
incorrectly formatted versions of the revised form being
sold by print vendors, specifically the Government Printing
Office (GPO). After reviewing the situation, the GPO has
determined that the source files they received from the
NUCC's authorized forms designer were improperly formatted.
This resulted in the sale of both printed forms and
negatives which do not comply with the form specifications.
Given the circumstances, CMS has decided to extend the
acceptance period of the Form CMS-1500 (12-90) version
beyond the original April 1, 2007 deadline while this
situation is resolved. Medicare contractors will be directed
to continue to accept the Form CMS-1500 (12-90) until
notified by CMS to cease. At present, they are targeting
June 1, 2007 as that date. In addition, during the interim,
contractors will be directed to return, not manually key,
any Form CMS-1500 (08-05) forms received which are not
printed to specification. By returning the incorrectly
formatted claim forms back to you, CMS feels it will make
physicians aware of the situation which will allow you to
begin communications with your form supplier.
The following will help you to properly identify which form
is which. The old version of the form contains "Approved
OMB-0938-0008 FORM CMS-1500 (12-90)" on the bottom of the
form (typically on the lower right corner) signifying the
version is the December 1990 version. The revised version
contains "Approved OMB-0938-0999 FORM CMS-1500 (08-05)" on
the bottom of the form signifying the version is the August
2005 version. The best way to identify if your CMS-1500
(08-05) version forms are correct is by looking at the upper
right hand corner of the form. On properly formatted claim
forms, there will be approximately a ¼" gap between the tip
of the red arrow above the vertically stacked word "CARRIER"
and the top edge of the paper. If the tip of the red arrow
is touching or close to touching the top edge of the paper,
then the form is not printed to specifications.
Questions may be directed to Brian Reitz at
Brian.Reitz@cms.hhs.gov.
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Incorrect Denials by Medicare for Therapy Claims
Billed with KX Modifier |
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Therapy claims submitted with the KX modifier processed on
or after March 13, 2006, were incorrectly denied with the
following message: PR-119-Benefit maximum for this time
period has been reached. The Medicare claims processing
system was corrected on February 6, 2007. Claims processed
on or after February 6, 2007, will be correct. Providers
do not need to take action at this time. First
Coast Service Options, Inc., the Florida Medicare Carrier,
will perform adjustments on all affected claims. However, if
you do not wish to wait for the adjustments, you may
resubmit the denied services. First Coast apologizes for any
inconvenience this may have caused.
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New Members |
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The FMA would like to welcome the following new members:
Gregory J. Velat, M.D. - Med. School:
University of Florida; Specialty: Neurosurgery Resident;
Practice: Gainesville, FL; Joined the FMA because - "I
think that it is a great way to network within the
neurosurgery community while keeping abreast of the latest
political changes that will affect my career."
Julia Cogburn, M.D. - Med.
School: University of South Florida; Specialty:
Hematology/Oncology; Practice: Fellow at Moffitt Cancer
Center; Joined the FMA - "To join with other Florida
physicians to create a strong presence in Tallahassee and
our communities."
Sanjay Dave, M.D. -
Med. School: University of Iowa; Specialty:
Radiology; Practice: University of Florida;Joined the
FMA - "To keep up to date with medical/legal issues
affecting the practice of medicine in Florida."
Maria Pimentel, M.D. -
Med. School: St. George's
University of Medicine/North Shore University Hospital;
Specialty: Ob-Gyn; Practice: Countryside Obgyn (an affiliate
of Tampa Bay Women's Care) - Clearwater, FL;Joined
the FMA - "Because it is a great resource for MD's
especially for me since I'll be new to Florida."
More New
Members
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address to
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