Claims Xten Optimization
Date: 05/26/23
Dear Provider,
Thank you for your continued partnership with Absolute Total Care. As you know, we continually review and update our payment and utilization policies to ensure that they are designed to comply with industry standards while delivering the best patient experience to our members. We are writing today to inform you of new policies Absolute Total Care will be implementing effective 8/1/2023.
Policy Name | Policy Description | Lines of Business |
|---|---|---|
Claims Xten Optimization – NCD Alignment | Adding prepay reviews for several national coverage determinations (NCDs) to be in accordance with CMS guidelines for correct coding. | Medicare |
Single Chamber and Dual Chamber Permanent Cardiac Pacemakers | Medicare | |
Bone (Mineral) Density Studies | Medicare | |
Percutaneous Image-Guided Breast Biopsy | Medicare | |
Prostate Cancer Screening Tests | Medicare | |
Screening for Sexually Transmitted Infections (STIs) and High-Intensity Behavioral Counseling (HIBC) to Prevent STIs | Medicare | |
Screening for Hepatitis B Virus HBV Infection | Medicare | |
Screening for the Human Immunodeficiency Virus HIV Infection | Medicare | |
Glycated Hemoglobin Glycated Protein | Medicare | |
Implantable Cardiac Defibrillators | Medicare | |
Prostate Screening Cancer | Medicare |
If you have questions about this or any of our other policies, please don’t hesitate to reach out to Provider Services.