RT Welter Celebrates its 20 Year Anniversary!

As we celebrate this 20th anniversary we acknowledge the fact that you, our clients and friends, are responsible for our success and longevity. We express our sincere thanks and appreciation to you for your business, your loyalty and your support during the past 20 years. From the very beginning we have understood: Our client’s success…

Registration for the Colorado Prescription Drug Monitoring Program

Legislation passed this year (House Bill 14-1283, now CRS 12-42.5-403) requires all Colorado prescribers who possess a DEA registration and all Colorado licensed pharmacists to register an account with Colorado’s Prescription Drug Monitoring Program (PDMP). Prescribers with a DEA registration and pharmacists must register an account by the corresponding deadlines below: Pharmacists and DEA-registered Advanced…

Rates and Volume, Volume or Rates

The fee-for-service world of professional reimbursement (compensation for services) is, essentially, the following economic transaction between payer and provider: Provider point of view: In exchange for patient volume being directed (Steered) into my practice I will allow for a discount off my billed charges. Payer point of view: we will direct patients into your practice…

Patient Eligibility

“Eligibility” is not what it once was! Commercial health plans have HMO’s and PPO’s and various other plan types, they also have various products within those categories, and just to make it more complicated some plans have plans within the plan specific to a given employer or group’s requirement. The Affordable Care Act has added…

Notice of Material Change

Seems to be the Season for the Notice of Material Change! The health plans are required to send out a NOMC anytime there is a change that may affect provider compensation.  Times, must be a changing, as we are seeing an unprecedented number of NOMC notices. Managed care contracting is, increasingly, more about strategy than…

CMS Begins Restructuring Of Quality Improvement Program

The Centers for Medicare & Medicaid Services (CMS) has taken its first step toward improving its efforts to ensure the effectiveness, efficiency, economy, and quality of care quality for Medicare beneficiaries in through the Quality Improvement Organization (QIO) Program. Last week, the federal agency announced the selection of Livanta LLC and KePRO as Beneficiary and…