Payer Forum Question Form - Second Quarter 2020

WMGMA members are invited to submit their quesitons for the Payer Forum.  PLEASE: NO PHI or other Patient Identifers

Timeline & Due Dates:

DUE DATE ACTION WHO
JUNE 15th Questions due for payers WMGMA Members
June 17th Questions Due to Payers WMGMA Executive Director
July 7th Responses from Payers due to WMGMA Payer Representatives

Please submit a separate form for each question!

Questions about the event?  Email WMGMA Executive Director:  Jean Thomas, CMPE | wmgma@wmgma.org


Question Submitted By
Your Name: *
Your Organization: *
Your Title: *
Best number to reach you in the event that clarification is needed: *
Your Email: *
Question Details
Question for: *
Third Party Payer
Medicaid
Medicare
Medicare Advantage
Other (Describe in next question)
Explain Other:
Question relates to: *
Facility
Professional
BOTH Facility AND Professional
Procedure code in question (if there is more than one, please submit a separate form):
Scenario that code is used in:
Provider types:
Additional Information:
Question:
Is your question prompted by:
New Service
General Policy/Coverage Research
Denials (If Denials please provide detail in next question)
If you answered 'Denials' in the previous question, please provide the denial code(s) being used:




Thank you for submitting your questions for the WMGMA Payer Forum.

Have questions?  Email WMGMA Executive Director:  Jean Thomas, CMPE | wmgma@wmgma.org