Approved 2017 MIPS registry list released

Originally published in the April 19th issue of MGMA’s Washington Connection
Reprinted with permission from MGMA

In response to MGMA advocacy calling for an expedited release of crucial program information, the Centers for Medicare & Medicaid Services (CMS) released the 2017 list of approved qualified registries. Physician practices may utilize these third-party vendors to report individual or group data for the Quality, Advancing Care Information, and Improvement Activities categories of the Merit-Based Incentive Payment System (MIPS) in order to avoid a -4% penalty and potentially earn a small bonus in 2019. Registry is one of several MIPS reporting options. For more information and resources to help your group succeed in MIPS, visit MGMA’s MACRA Resource Center.

NCMGM Annual Conference is in Three Weeks: Become an Alliance Sponsor and Secure your Exhibit Booth


Become a 2017 Alliance Sponsor Today
Only a handful of Annual Conference booths remain!

Alliance Sponsorship PhotoOur NCMGMA Annual Conference is scheduled for May 7-9, 2017 at the Westin Charlotte and we would love to have you join us as an exhibitor. Vendor participation at the Annual Conference is part of our annual Alliance Sponsorship program that provides a wealth of benefits and allows your exposure to healthcare practice leaders and decision-makers to continue on long after the conference is over.

Browse this email to learn how you can start enjoying the benefits of Alliance Sponsorship today, as well as secure your exhibitor booth for Charlotte in May!


Founded in 1971, NCMGMA has grown to 800+ members representing medical groups from all across North Carolina. Our membership includes small and large single- and multi-specialty groups, medical school clinics, management service organizations, independent practice associations, and physician-hospital organizations.

About the Alliance Sponsorship Program

Alliance sponsorship spans from January 1 through December 31, each year. Each level of sponsorship includes core benefits as well as a selection of level-specific benefits. Use the Alliance level-specific benefits table to help select the level of sponsorship that best fits your needs. Note: Alliance sponsors receive exclusive access to, and preferred placement in, certain 2017 events.

Alliance Core Benefits

  • An Affiliate membership in the NCMGMA for a key contact in your firm
  • Exhibit booth at the Annual Conference: May 7-9 at the Westin Charlotte
  • Recognition and link on NCMGM News (e-news) and the NCMGMA website
  • Priority exhibitor registration for the M3 Conference with NCMS: September 2017

Alliance Level-Specific Benefits
Click on the table image below for a larger view


Alliance Sponsorship Registration

To sign up to be a 2017 NCMGMA Alliance sponsor, either click on the online or printable brochure buttons below and complete the forms as instructed. Please note that Alliance sponsorship registration will not be processed without payment in full.

2017 NCMGMA Alliance Sponsors

The NCMGMA would like to say “thank you” to the companies who have already made their commitment to the association for 2017!

Apex Technology
Axia Physician Solutions
BB&T Insurance Services
Biz Technology Solutions
Capstone Health Alliance
Carolinas IT
Datamax/Interstate Credit Collections
First Citizens Bank
Flagship Healthcare Properties, LLC
Gordon Asset Management, LLC
HandCraft Services
HealthSystems/GE Healthcare
IT Practice, Inc.
MagMutual Insurance Company
MedFast Management, LLC
Medical Mutual
MedMal Direct Insurance Company
Medstaff National Medical Staffing
MSOC Health
NC MedAssist
NCHA Strategic Partners
NORCAL Mutual Insurance Company
North Carolina Drug Card
NC Society of Medical Assistants
Ozone Waste Solutions
PCB Medical Collection Specialists
Physicians Wear Medical Linen Service
Poyner Spruill LLP
Prince Parker & Associates
Professional Recovery Consultants
Robard Corporation
SCA Collections, Inc.
Stanley Benefit Services
Statewide Collection Service, Inc. (SCS)
Stern Recovery Services
Summit Credit Union
SunTrust Bank
The Doctors Company
Total Medical Compliance
TriMed Technologies, Corp.
TSI Healthcare
United Healthcare
Virtual Revenue Solutions
Young Moore & Henderson, P.A.

2017 NCMGMA Annual Conference

The 2017 NCMGMA Annual Conference will be held Sunday, May 7th, through Tuesday, May 9th, at the Westin Charlotte. Only 2017 Alliance sponsors are eligible to exhibit. Complete your 2017 Alliance Sponsorship form today and join us in Charlotte in May! Follow this link to view the booths still available in the exhibit hall.

A booth in the NCMGMA Annual Conference exhibit hall includes the following:

  • (1) 8×10 Booth
  • (2) Exhibitor Badges
  • (1) Electrical outlet* (if designated on your exhibitor contract)
  • (2) Chairs
  • (1) 6 ft. table, skirted
  • (1) Waste basket
  • Complimentary Wi-Fi in Exhibitor Hall
  • (1) Conference attendee list (sent to contact approximately 3 weeks prior to event)


For questions about the Alliance Sponsorship structure and benefits, please contact the NCMGMA office at 800-753-6462 or 704-365-0565.

NCMGMA-NCMSF April 18th Webinar: Improving Outcomes for Uninsured and Self-Paying Patients

NCMGMA-NCMS Webinar Series

Improving Outcomes for Uninsured
and Self-Paying Patients

April 18, 2017 | 12:00 PM – 1:00 PM


Across North Carolina, low-income, uninsured patients are struggling to purchase their medication. Those suffering with chronic diseases face the greatest economic burden. The North Carolina Medical Society Foundation, in cooperation with the North Carolina Medical Group Management Association, invites you to join us for a webinar to learn how you can help your patients get the life-saving medication they need with the NC MedAssist Free Pharmacy Program. Nicole Banahene, MHA, NC MedAssist’s Clinic Relations Manager, will explain who qualifies for the program and what you can do to help your patients.


Nicole Banahene, MHA
Clinic Relations Manager, NC MedAssist
Nicole Banahene began her nonprofit career as a volunteer at a low-cost clinic in Charlotte, where she eventually interned while finishing her Masters in Health Administration. Nicole has been with NC MedAssist for over 3 years and works to bring awareness to the mission of the program and foster partnerships with health providers. Her goal is to build relationships in communities across the state where NC MedAssist has little to no footprint.

Nicole also serves as Vice Chair of MedLink of Mecklenburg. MedLink is a collaborative group of service providers that advocates for improved access to care in Mecklenburg County.


This webinar is complimentary but space is limited so make sure to register early! After you register, you will receive an emailed confirmation with webinar and phone-in instructions.

Click here to register

Continuing education credit may be granted through your professional organization (MGMA, PAHCOM, AHIMA, etc.). Please self-submit for these organizations.


For questions or more information please contact the NC Medical Society offices at

Palmetto GBA E-mail Update: Tuesday, April 11, 2017

Provider Enrollment Revalidation – Cycle 2
Section 6401 (a) of the Affordable Care Act established a requirement for all enrolled providers/suppliers to revalidate their Medicare enrollment information under new enrollment screening criteria. In an effort to streamline the revalidation process and reduce provider/supplier burden, CMS has implemented several revalidation processing improvements that are captured within this article. Make sure your staff is aware.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General

Local Coverage Determination (LCD) Update: Part A and Part B
The Minimally Invasive Treatment for Benign Prostatic Hyperplasia Involving Prostatic Urethral Lift (Urolift) L36109 for JM A/B MAC LCDs was revised. Please share with appropriate staff.

Applies to:

  • JM Part A//General
  • JM Part B//General

July 2017 Quarterly Average Sales Price (ASP) Medicare Part B Drug Pricing Files and Revisions to Prior Quarterly Pricing Files
Change Request (CR) 10016 provides the July 2017 ASP drug pricing files and quarterly updates, and if released by the Centers for Medicare & Medicaid Services (CMS), the revised April 2017, January 2017, October 2016, and July 2016 Average Sales Price (ASP) drug pricing files for Medicare Part B drugs. Medicare will use these files to determine the payment limit for claims for separately payable Medicare Part B drugs processed or reprocessed on or after July 3, 2017, with dates of service July 1, 2017, through September 30, 2017. MACs will not search and adjust claims previously processed unless brought to their attention.

Applies to:

  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare
  • JM Home Health and Hospice//General

Local Coverage Determination (LCD) Updates Part B
The Hyaluronate Polymers L33432 LCD for JM Part B LCD, was revised. Please share with appropriate staff.

Applies to:

  • JM Part B//General

Palmetto GBA E-mail Update: Thursday, April 06, 2017

Change to Check Mailing Addresses
Palmetto GBA has reduced the number of addresses used for submitting provider checks to satisfy Medicare debts. Please immediately begin using the addresses in this article to submit payment for any Medicare Debts. All other PO Boxes will be closed. Please share with appropriate staff.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General

Gain Insight Into Your Billing Patterns and Utilization Services: Use Electronic Comparative Billing Reports (eCBRs)
Palmetto GBA uses electronic Comparative Billing Reports (eCBRs) as an educational tool for providers to use in order to provide insight into your billing patterns and utilization of services in comparison to your peers. eCBR will provide you with the ability to view and download your individual CBR online.

Applies to:

  • JM Part B//General
  • JM Part B//Chiropractic
  • JM Part B//Physician
  • JM Part B//Primary Care

eUtilization: See Who Has Been Using Your NPI
Electronic Utilization (eUtilization) reports are now available in the eServices portal. eUtilization reports provide rendering providers and ordering and referring providers access to their personal data. This data can be reviewed to ensure providers are aware of when and by whom their NPI is being used for billing Medicare services and when their NPI is entered on a Medicare claim as the ordering referring physician.

Applies to:

  • JM Part B//General
  • JM Part B//Physician
  • JM Part B//Primary Care

Palmetto GBA E-mail Update: Tuesday, April 04, 2017

eServices Makes Asking a Medicare Question Easier
Palmetto GBA has Secure eChat to make asking Medicare questions easier. This innovative feature allows providers to interact with designated Palmetto GBA staff so they can receive real-time assistance locating information on any topics or specialties they are searching for on the Palmetto GBA website or within the eServices online portal. The Secure eChat feature also allows users to dialogue with an online operator who can assist with patient or provider specific inquires or address questions that require the sharing of PHI information! Using Secure eChat is simple! Please share with appropriate staff.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General

What Can You Expect to Receive from the CERT Contractor?
You can expect to receive the following from the CERT Contractor: Information on the CERT process; Health Insurance Portability Accountability Act (HIPAA) compliance information; What documentation to submit; Timeframe for responding to the request; and Claim information.

Applies to:

  • JM Home Health and Hospice//General
  • JM Part A//General
  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Inquiries for Unprocessable/Rejected Claims
Did you know the top two reasons for Palmetto GBA Provider Contact Center inquiries in February all had to do with claims that were unprocessable or rejected? When a claim is rejected (also referred to as unprocessable) the claim is not afforded appeal rights. You must correct and refile the claim correcting the missing, invalid or incomplete information. Reason code MA-130 will appear on your remittance advice (RA) along with one or more remark codes that outline the error causing a claim to be considered unprocessable. If your clearinghouse is not providing you with associated remarks code to explain why a claim was rejected, speak with your clearinghouse to receive that information. Please share with appropriate staff.

Applies to:

  • JM Part B//General

Unprocessable/Rejected Claims Webcast: April 13
Jurisdiction M will hold a Part B Unprocessable/Rejected Claims Webcast on April 13, 2017, at 10 am, ET. This webcast will include identifying, correcting, and reviewing examples and resources to resolve and prevent rejected claims. Please plan to attend.

Applies to:

  • JM Part B//General

E/M Weekly Tip: History Component – Status of Three Chronic/Inactive Conditions
An extended History of Present Illness (HPI) ma y consist of the status of three chronic/inactive conditions for either set of guidelines (1995 or 1997) for services performed on or after on or after September 10, 2013. Please share with appropriate staff.

Applies to:

  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

New Waived Tests
Change Request (CR) 9956 informs MACs of new Clinical Laboratory Improvement Amendments of 1988 (CLIA) waived tests approved by the Food and Drug Administration (FDA). Since these tests are marketed immediately after approval, the Centers for Medicare & Medicaid Services (CMS) must notify MACs of the new tests so that they can accurately process claims. Make sure that your billing staffs are aware of these CLIA-related changes.

Applies to:

  • JM Part B//General
  • Railroad Medicare (RRB)//General – Railroad Medicare

Welcome New Members

Our membership continues to grow! Take a look at the list of healthcare professionals and students who have recently joined NCMGMA (January 27, 2017 – March 30, 2017):


  • Julia Amin, Pinehurst Medical Clinic, Pinehurst, NC
  • Leigh Bell, Temas Eye Center, Winston-Salem, NC
  • Angie Berry, Mountain View Pediatrics PA, Morganton, NC
  • Daniel Coughlin, Cone Health Medical Group Revenue Cycle & Credentialing Team, Greensboro, NC
  • William Ford, Physicians East, P.A., Green, NC
  • Anthony Granato, Cornerstone HealthCare, Winston-Salem, NC
  • Tanya Hylton, Reidsville Pediatrics, Reidsville, NC
  • Susan Moorefield, Piedmont Ear Nose & Throat Associates, PA, Winston-Salem, NC
  • Cheryl Morrison, Pathologists Diagnostic Laboratory, PA, Winston Salem, NC
  • Janine Rierson, Cornerstone HealthCare, Kernersville, NC
  • Susan Roeser, Eastern Urological Associates PA, Greenville, NC
  • Elizabeth Sousa Lafever, Wake Emergency Physicians, PA, Cary, NC
  • Allison Tilley, Triad Cardiac & Thoracic Surgery |CHMG, Greensboro, NC
  • Adrianna Whitehead, Dermatology Group of the Carolinas, Concord, NC


  • Ben Beck, Axia Physician Solutions, Charlotte, NC
  • Bradley Curelop, SunTrust Bank, Raleigh, NC
  • Greg Lucas, NORCAL Mutual Insurance Company, San Francisco, CA
  • Keith Neff, Neff & Associates, Ocean City, MD
  • Ryan Richard, Carolina Shred, Fort Mill, SC
  • Andrew Scherlacher, Stern Recovery Services, Greensboro, NC
  • Steven Shaber, Poyner Spruill LLP, Raleigh, NC


  • Brandt Bettilyon, UNC – Chapel Hill, Chapel Hill, NC
  • Lakenda Crawford, UNC Charlotte, Charlotte, NC
  • Nicholas Dunshie, Appalachian State University, Boone, NC
  • Amanda Gunter, Appalachian State University, Boone, NC
  • Jordan Harrington, UNC Charlotte, Charlotte, NC
  • Gail Marlowe, Columbia Southern University, Orange Beach, NC
  • Preston Myers, Appalachian State University, Union Grove, NC
  • Kenneth Taylor, Appalachian State University, Durham, NC
  • Sierra Wilson, Appalachian State University, Lenoir, NC