Chair: Jonathan Jantz, MD, FAAP
KAAP Pediatric Council’s purpose is to improve the care of Kansas kids while making certain that the insurers of our state help to cover the care they receive. We will work with these companies to make them more aware of our needs to provide better care for our patients.
Issues from Members: click on the title to get more information on these payment issues that KAAP members are experiencing
- New CPT codes and Modifier 95, effective January 1, 2017. Click here to get the new codes that need to be entered into each claims processing system by January 1, 2017.
- Nasal Suctioning Payments – Response from: Melanie K Hanna, Director, Patient Financial Services, Newton Medical Center
Issues with Nasal Suctioning payments. Click here to learn more about payments for Nasal suctioning in a hospital setting by an RT or other provider beginning Jan. 15, 2017.
November 18, 2016
- Issues with Medishare/Christian Care Ministries which is under Multiplan/PHCS (Private Healthcare System) and meeting payment deadlines. Click here to read more about the difference between insurance companies, medical sharing plans, and repricing agents and the issues they present to providers.
November 15, 2016
- Denial of payment for claims of a well child exam and sick visit on the same day. This is a disturbing occurrence that has begun to be more frequent. Example: a child has a well visit in the morning and returns later that day with a broken arm. Click here to read more about same day claim denial issues, payment denials, and documentation suggestions.
November 10, 2016
KAAP Members: If you have a Pediatric Payment Issue that you would like to report, email firstname.lastname@example.org
The Hassle Factor Form
The Hassle Factor Form is for pediatricians to report problems with payers. It is important that you use this Hassle Factor Form to report items of concern or contact Dr. Jon Jantz directly. Increase involvement by pediatricians will help stress the seriousness of the issues. You can complete the form online, by clicking on the link and logging in to the AAP member web site. Then down the left hand side, click on “Private Payer Advocacy”, then click on Hassle Factor Form, in the 3rd paragraph.