Academy Efforts Help Smooth Payer Relationships, Provide Member Resources payment rates for the TC codes for their geographic Working with public and private payers can be jurisdiction. perceived as an ominous experience by any physician. But the AAN has neurologists’ backs thanks to the The AAN’s payer relations team contacted several AAN Coding and Payment Policy Subcommittee, public and private payers to raise awareness of chaired by Board Member Elaine C. Jones, MD, FAAN, the new code set and request information on when and a dedicated payer relations staff. In numerous medical policy updates can be expected and when ways, their efforts help support members as well as claims will be accepted with the new codes. The Jones payer organizations. Their work includes reviewing Academy received several positive responses from draft medical policies and providing feedback from commercial payers willing to engage with the AAN. AAN subject matter experts to help payer organizations create Many payers indicated they would not update their policies on and/or modify medical policies and fully understand how a long-term EEG monitoring until early in 2020, and the Academy given service is used by neurologists. Academy staff assists continues to monitor payers’ medical policies for changes. members in understanding why coverage might have been The AAN also is increasing engagement with creation of a denied and helps them navigate the next steps. quarterly newsletter to payers. Our first edition was distributed “The way we practice medicine continues to change in early 2020 to educate payers on coding changes, new and dramatically from coding changes in new and old service lines, emerging therapies, and AAN resources. The electronic to emphasizing quality over quantity, and to a more systemresource includes direct links to AAN guidelines, quality focused care model that increases access and decreases measure sets, and guidelines companion pieces that can be cost,” said Jones. “The AAN is actively engaged in fighting used in creating or modifying medical policies. for processes that work for neurologists, and in educating New resources have been created for AAN members as members on navigating these changes successfully. If you ever well, including an Insurance Verification Checklist and Prior have any questions or concerns the AAN is here to help” Authorization Checklist. Both resources are available online When significant coding changes occur, the AAN reaches out at AAN.com/view/PracticeResources. Check back often as to payers to educate them on the changes. One example is the additional tools will be added as member needs are identified. Long-term EEG monitoring service code changes which were The Academy also has created resources for members to find effective January 1, 2020. The Centers for Medicare & Medicaid their regional MAC and tools for working with them, available at Services assigned contractor pricing to the codes reported AAN.com/view/MedicareNews. for the technical component (TC) of the services, which Members who have any concerns or issues with coverage are added another level of complexity. As a result, each Medicare urged to contact AAN staff at practice@aan.com. Administrative Contractor (MAC) is responsible for establishing
Report MIPS Data by End of March The Centers for Medicare & Medicaid Services (CMS) Quality Payment Program Merit-based Incentive Payment System (MIPS) 2019 Performance Year (PY) submission window will close on March 31, 2020, for most eligible clinicians (ECs). ECs can report via multiple mechanisms including CMS Web Interface, a Qualified Clinical Data Registry (QCDR, such as the AAN’s Axon Registry ®), electronic health records, or other registry. For solo and small practice ECs reporting via Part B Claims data, the window previously closed in February 2020. CMS anticipates performance feedback for the 2019 PY will be available on July 1, 2020. Full details of CMS’s timelines can be found at qpp.cms.gov/about/deadlines. Members are encouraged to identify a reporting mechanism for the 2020 PY now. The AAN’s Axon Registry is a CMS QCDR and a free benefit for US members. Learn more by contacting registry @aan.com.
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