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RE: [MedicalBillers] Sequestration 2% cut from Commercial Payers?

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  • 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 1 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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