For Payers, Brokers and Employers

News

Online Claims
Date Published:
Midlands Choice recently added an online tool to increase convenience, reduce turnaround time and help providers submit complete claims to Midlands Choice.

Nebraska Healthcare Reform Study
Date Published:
A Nebraska legislative committee has been appointed to study the impact of the federal Patient Protection and Affordable Care Act on healthcare coverage for Nebraskans.

Iowa Retrospective Payment Rule
Date Published:
Effective July 1, 2010, an Iowa Insurance Division rule that requires retrospective in-network payment to physicians will expand to include advanced nurse practitioners and physician assistants.

New Medical Facilities
Date Published:
Methodist Women’s Hospital, the Omaha, NE, area’s first hospital of its kind, will begin accepting patients this month. Also recently opened, The Bellevue Medical Center is a full-service hospital that houses 266,000 square feet of comprehensive patient services.

CTS Now Includes Access to Claim Attachments
Date Published:
Reports generated within the "Claim Detail" view in the Claim Tracking System (CTS) tool on our website now include links to attachments associated with the claim.

5010 Preparation Under Way
Date Published:
Midlands Choice is completing its analysis to identify business and technical impacts resulting from this mandate and has begun communications with providers regarding their 5010 awareness and readiness. We will also forward additional information regarding 5010 to you directly and in this newsletter as it becomes available.

Network Statistics
Date Published:
Network Statistics for November 2009-January 2010

NPIs Required For All Providers Listed on Claims
Date Published:
Effective Jan. 15, 2010, claims that currently pend for missing or invalid NPI information, including claims submitted by payers to Midlands Choice for "rush" repricing, will be rejected.

2009 Surveys of Payers and Providers Yield Positive Ratings
Date Published:
Responses to payer and provider surveys.

Accurate Information at Year-End Helps Us Serve You Better
Date Published:
December and January traditionally are busy months for groups who are changing administrators. To help us continue to reprice claims accurately and promptly, we need correct information.

Accessing Encrypted E-Mail
Date Published:
To remain compliant with regulations protecting patient privacy, we encrypt any e-mail that contains Patient Health Information (PHI) before sending it to payers.

NCCI Edits
Date Published:
Effective October 1, 2009, Midlands Choice will implement National Correct Coding Initiative (NCCI) edits when repricing physician claims.

Modifiers 50 and 51. Don’t Apply Them a Second Time
Date Published:
During repricing, Midlands choice applies reductions for multiple and bilateral procedures, whether or not modifiers 50 and 51 are present on the claim.

Claim Questions? Go Directly to the Source
Date Published:
The Claims Tracking System (CTS) allows registered users to monitor and track claims submitted during the past 24 months that have been repriced or rejected as "non-par", and when repriced claims were forwarded to payers. You can also view and print the original claim and its face sheet.

2009 Provider Survey
Date Published:
Results of the Midlands Choice biannual survey of network physicians and hospitals are being tallied.

Network Providers Listed as Best Places to Work
Date Published:
Two Midlands Choice providers in Iowa are listed among the nation's top 100 best places to work in healthcare.

Renewal Season Updates
Date Published:
Information about access fees, provider directories and assistance with sales and renewal for 2009.

Provider Relations Changes Focus for Fall Meetings
Date Published:
About 60 network providers are receiving on-site, customized presentations from Midlands Choice provider relations staff this fall.

2009 Iowa and Nebraska Legislation Affects Insured Groups
Date Published:
Actions of state legislatures in Iowa and Nebraska during 2009 sessions apply to fully-insured coverage.

Group Enrollment and Termination Forms Simplify Tasks
Date Published:
If you are submitting group or division enrollments or terminations via mail or fax, your life could be easier.

Getting Your Messages to Midlands Choice Providers
Date Published:
Midlands Choice publishes online and printed communications for providers that your organization can use to communicate easily and quickly with this audience.

Questions About Our Website?
Date Published:
We have posted a web guide to assist payers with navigating this site.

New Website Launch Scheduled for Spring ‘09
Date Published:
Redesigned online forms for submitting group enrollment and termination information will be included in the “Payers, Brokers and Employers” section of a newly designed Midlands Choice website that will be launched in April.