Medicare/Medicaid - New York State Chiropractic Association

UHC Medicare Advantage: Request for Redacted Denials

by Insurance Committee | Jul 2, 2025 | Insurance Updates, Medicare Advantage, Members Only, UHC

Have you received a UHC Medicare Advantage claim denial indicating ‘precertification/ authorization/ notification absent’ for cases where clinical submission was not required? Did you follow the correct process? If so, we...

Medicare Fraud Scheme Involving Phishing Fax Requests

by Insurance Committee | Jun 25, 2025 | Insurance Updates, Medicare/Medicaid, Public

National Government Services (NGS) wants to share with our providers an urgent issue that has been identified by the Centers for Medicare & Medicaid Services (CMS). CMS has been flooded with incoming complaints regarding illegitimate faxes being sent to providers...

New P.O. Boxes for Medicare Part B Claim Submitters in CT and NY (Upstate Counties and Queens)

by Insurance Committee | May 29, 2025 | Insurance Updates, Medicare/Medicaid, Public

Beginning 5/19/2025, there is a new mailing address for Medicare Part B claim submitters in Connecticut and New York (Upstate Counties and Queens). In May 2025, providers submitting paper claims to Medicare will need to mail claims to the applicable P.O....

Excellus BCBS and Univera Healthcare Medicare Advantage Erroneous Payment

by Insurance Committee | Mar 14, 2025 | Excellus, Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, Univera

Last week Excellus BlueCross BlueShield and Univera Healthcare sent letters to their Medicare Advantage members receiving chiropractic care. In those letters, both organizations identified they have been ‘processing chiropractic claims...

UnitedHealthcare Modifies Manual Review Process for Medicare Advantage members

by Insurance Committee | Jan 13, 2025 | Insurance Updates, Medicare Advantage, Medicare/Medicaid, Members Only, UHC

If you participate with UnitedHealthcare / Optum you may have received notice of the change in the aforementioned prior authorization program. Based upon the volume of calls, texts and emails received by the NYSCA Insurance Committee (NIC), there has been several...

Medicare 2025 Fees Schedule Posted

by Insurance Committee | Dec 4, 2024 | Insurance Updates, Medicare/Medicaid, Public

The 2025 Medicare Fee Schedule has been posted to the NGS Medicare website. The Medicare Part B deductible in 2025 is $257.00 This year while the deductible has increased to $257 and premiums have increased for patients, reimbursement has decreased by...