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Sequestration 2% cut from Commercial Payers?

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  • Melinda
    Help! I rec d a recent EOB from an insurance company and on a few of my April 2013 claims (non-Medicare patients) they took the 2% sequestration cut. ?!?!? I
    Message 1 of 2 , May 16, 2013
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      Help!

      I rec'd a recent EOB from an insurance company and on a few of my April
      2013 claims (non-Medicare patients) they took the 2% sequestration cut.
      ?!?!?

      I was under the impression that the 2% sequestration was ONLY applicable
      to Medicare & Advantage Plans.

      I was told by the ins co. provider rep, that since the contract we have
      states that some charges (Drugs: 90715-Tdap, J3301-kenalog,
      J1080-depotestosterone) are based on the Medicare rates (not RVUs) and
      therefore are subject to the 2% cut, even though the patient is NOT a
      Medicare patient.

      I have my provider rep. checking with the contracting dept for
      clarification.

      Is this the same thing everyone has been hearing from other payers?

      Please advise!

      TIA,
      Melinda Brown, CMBS
      Ins Biller
    • JOSETTE SYLVAN
      HELLO, FORUM Any acupuncture billing persons out there. Please respond I have some questions to ask. Thanks in advance. josette thomas sylvanins biller To:
      Message 2 of 2 , Jun 4, 2013
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        HELLO, FORUM
        Any acupuncture billing persons out there. Please respond I have some questions to ask. Thanks in advance.

        josette thomas sylvanins biller

        To: MedicalBillers@yahoogroups.com
        From: melindadocsmith@...
        Date: Fri, 17 May 2013 00:31:42 +0000
        Subject: [MedicalBillers] Sequestration 2% cut from Commercial Payers?




























        Help!



        I rec'd a recent EOB from an insurance company and on a few of my April

        2013 claims (non-Medicare patients) they took the 2% sequestration cut.

        ?!?!?



        I was under the impression that the 2% sequestration was ONLY applicable

        to Medicare & Advantage Plans.



        I was told by the ins co. provider rep, that since the contract we have

        states that some charges (Drugs: 90715-Tdap, J3301-kenalog,

        J1080-depotestosterone) are based on the Medicare rates (not RVUs) and

        therefore are subject to the 2% cut, even though the patient is NOT a

        Medicare patient.



        I have my provider rep. checking with the contracting dept for

        clarification.



        Is this the same thing everyone has been hearing from other payers?



        Please advise!



        TIA,

        Melinda Brown, CMBS

        Ins Biller



















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