NYSPA's Insurance Committee's Avenues for Seerking Help with Insurance Issues guide
NYSPA provides insurance resources as part of our commitment to allow members access to the most up-to-date information possible to support their practices. We hope this section will prove to be an invaluable tool and daily resource.
This site also allows members to learn more about NYSPA's Insurance Committee and how they are helping shape the future and protect your interests as a psychologist.
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NGS Medicare Link - For all your Medicare questions and answers, please use the following link:
To access by phone please refer to the following contact information:
- 800 numbers for Update NY (area 99)
- automated information (IVR) 877-869-6504
- live operator 866-837-0241
- electronic data interchange 877-273-4334
Updated Form CMS-1500 Information
Effective Date: October 1, 2010
Related CR Transmittal #: R1970CP
Implementation Date: October 4, 2010
Provider Types Affected
This is an informational article for physicians, providers and suppliers who use the Centers for Medicare & Medicaid Services (CMS) CMS-1500 claim form to submit claims to Medicare contractors (carriers, Part A/B Medicare administrative contractors [A/B MACs], and durable medical equipment [DME MACs] for services provided to Medicare beneficiaries.
What You Need to Know
This article, based on Change Request (CR) 6929, updates the CMS-1500 claim form information in the CMS Internet-Only Manual (IOM) Publication 100-04, Medicare Claims Processing Manual by removing language allowing the use of legacy identifiers and making other technical corrections as a result of that change. As part of this update, providers are reminded that they are responsible for purchasing their own CMS-1500 claim forms. Forms can be obtained from printers or printed in-house as long as the forms follow the specifications approved by the CMS as developed by the American Medical Association. Photocopies of the CMS-1500 claim form are not acceptable. Medicare will accept any type (i.e., single sheet, snap-out, continuous feed, etc.) of the CMS-1500 claim form for processing. You may purchase forms from the U.S. Government Printing Office by calling 202-512-1800.
The official instruction issued to your Medicare carrier and/or MAC regarding this change may be viewed at http://www.cms.gov/Transmittals/downloads/R1970CP.pdf (200 KB) on the CMS Web site.
CPT Codes/Health and Behavior Codes
CPT (Current Procedural Terminology) codes are numbers assigned to every task and service a clinician may provide a patient including medical, surgical and diagnostic services. These codes are then used by insurers to determine amount of reimbursement that a practitioner will receive for services rendered.
On January 1, 2013 new psychotherapy CPT Code have replaced codes that most psychologists have heavily utilized in the past. Please familiarize yourself with what the old code was and what the new code is that replaces it. Click here to view the code changes. Please stay tuned to how managed care companies will be executing these new codes.
- Fair Health
- Health Care Reform
This resource provides you with documents and articles related to HIPAA. The acronym stands for Health Insurance Portability and Accountability Act. This Act provides regulations for use/ disclosure of an individual’s health information. The Rule defines how covered entities use individually identifiable health information, how it can be disseminated and what steps must be taken to protect the consumer.
Insurance Committee Minutes
Minutes of NYSPA's Insurance Committee.
**You must be logged in as a NYSPA member to view these documents**
Just Ask Me Insurance Solutions
Former Director of Professional Services, Deanna Stephenson, published a series of articles in the NYSPA Friday Flash entitled "Just Ask Me." The source of these articles were questions from members forwarded to Central Office. An archive of articles separated by topic can be accessed from the menu to the left or in the Insurance Resources / Subcategories section. **you must be logged in as a member to access these files.**
- New York Health Care
- New York Regulations
The interim rule was put in place but a final rule has not been set to date. Please note that where ever state rules are weaker the federal rule will apply and visa versa. New York does have strong parity rules named after 13 year old Timothy O’Claire (Timothy’s Law).
Information regarding Worker's Compensation.
Avenues for Seeking Help with Insurance Issues guide
This guide, developed by NYSPA's Insurance Committee in April 2013, will help you most efficiently work through any insurance issues.