Ambulatory Patients Group (APG) Payment Methodology Webinars

Please click on the headings below to view the webinars.


Please note: As per policy changes subsequent to this Webinar recording, in order for an evaluation and management procedure code to qualify for the Contraceptive Management APG (APG 875), a primary diagnosis from the V25 series must appear in the header of the claim.

Accessing the Enhanced Medicaid Ambulatory Patient Group (APG) Payment for Family Planning Providers

Date:
Wednesday, October 5, 2011

Faculty:
Alan Maughan, New York State Department of Health Office of Health Insurance Programs
Ann Finn, Provider Consulting Solutions, Inc.
Lana MacCormack, Provider Consulting Solutions, Inc.


This is a presentation of the New York State Center of Excellence for Family Planning and Reproductive Health Services for New York State family planning providers.

The transition to the Ambulatory Patient Group (or "APG") payment methodology required considerable investments in time and resources from family planning providers. Fortunately, these upfront investments will be more than outweighed by the long-term benefits of having a Medicaid payment methodology that reflects the real cost of providing quality care. Beginning in July 2011, an enhanced Medicaid payment for federally designated family planning procedures further augmented the potential reimbursements available to providers.

At the end of this presentation, participants were able to better understand APG 875 for Contraceptive Management, including the rationale for its creation and policies for its use, including special circumstances and exceptions; and recognized how the appropriate use of APG 875 will result in increased revenue. The program also provided participants with a handful of concrete examples specific to the family planning setting to which they may refer.

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Introduction to Medicaid Billing Using Ambulatory Patient Groups (APG) for Family Planning Providers

Date:
Tuesday, October 18, 2011

Faculty:
Ann Finn, Provider Consulting Solutions, Inc.
Steve MacCormack, Provider Consulting Solutions, Inc.
Ronald Bass, New York State Department of Health Office of Health Insurance Programs
Alan Maughan, New York State Department of Health Office of Health Insurance Programs


This is a presentation of the New York State Center of Excellence for Family Planning and Reproductive Health Services for New York State family planning providers.

New York State's transition to the Ambulatory Patient Group (or "APG") payment methodology required considerable investments in time and resources from family planning providers. Fortunately, these upfront investments will be more than outweighed by the long-term benefits of having a Medicaid payment methodology that reflects the real cost of providing quality care. The purpose of this Webinar was to provide participants with a foundational knowledge of Medicaid billing using APGs.

Through this presentation, participants learned the general payment and policy rules for the APG payment methodology; became familiar with special payment rules and issues of special interest to family planning providers; and gained an understanding of how family planning providers can maximize revenue by managing their claims to assure appropriate billing and payment. The program also provided participants with a handful of concrete examples specific to the family planning setting to which they may refer.

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Understanding the Submission and Remittance Process for the Ambulatory Patient Group (APG) Payment System for Family Planning Providers

Date:
Tuesday, December 6, 2011

Faculty:
Ann Finn, Provider Consulting Solutions, Inc.
Robert Tompkins, Provider Consulting Solutions, Inc.


Description:

This is a presentation of the New York State Center of Excellence for Family Planning and Reproductive Health Services for New York State family planning providers.

The purpose of the Webinar, "Understanding the Submission and Remittance Process for the Ambulatory Patient Group (APG) Payment System for Family Planning Providers," was to clarify the submission and remittance processes surrounding APG and Ordered Ambulatory Fee claims for fiscal and billing staff and administrators in the family planning setting. As a result of this presentation, participants were able to have a better understanding of how to submit claims to Medicaid using APGs, as well as common nuances in the family planning setting; be familiar with common issues relating to the 835 remittance file; recognize frequent causes for claims denials and understand how to manage denied claims; learn how to validate claim payments and adjust paid claims; and gain answers to questions about validating APG remittances and payments.

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