Thank you for attending The Forum 2012!

Our thanks to those of you who joined us for The Forum 2012…Essential Perspectives for Safety Net Providers, April 11 – 13. Attendance and participation were excellent this year and we benefited from the substantial expertise of our speakers and panelists. 

Sponsor and exhibitor support are crucial and make The Forum possible. Thank you to:

SPONSORS The Colorado Health Foundation; Kaiser Permanente; Colorado Access; Caring for Colorado; COPIC and Pinnacol.

EXHIBITORS

SE AHEC; CRHC CPR; C& M Medical Services, EHR Docs, Colorado Mesa; CHA Shared Services; Peck Shaffer & Williams LLP, and RT Welter.


All presentations are currently available on the Colorado Rural Health Center website at http://coruralhealth.org/events/forum.htm.

The Colorado Rural Health Center and ClinicNET

Congratulations Doug Miller of Rocky Ford!

Nightingale Doug Miller

Doug Miller, a nurse practitioner and owner of the Rocky Ford Family Health Center, is one of four Southern Colorado finalists to be recognized at the state Nightingale awards ceremony. Mr. Miller will be recognized for his leadership in the “medical home” movement and involvement in the national Improving Performance in Practice movement  To read the full article please click here  Congratulations Doug!!

Don’t miss the opportunity to offer loan repayment to your healthcare providers through National Health Service Corp!

Do you have a healthcare provider at your facility who is interested in loan repayment? National Health Service Corps (NHSC) Loan Repayment Program application cycle is closing soon. The application cycle will close May 15, 2012.

Up to $60,000 for a 2-year commitment is available to your primary care healthcare providers!

NHSC provides loan repayment to fully trained primary care providers in exchange for either a two year service obligation in an underserved community. After completing their initial years of service, loan repayors may apply for additional years of support! Eligible providers include primary care Family Physicians, Internists, OB/GYNs, Pediatricians, Psychiatrists, Dentists, Physician Assistants, Nurse Practitioners, Certified Nurse Midwives, Dental Hygienists and licensed mental health professionals.

Many types of healthcare facilities are NHSC eligible sites including Critical Access Hospitals, Rural Health Clinics, Community Health Centers, and safety-net clinics.

To find out more about the NHSC Loan Repayment Program, please visit www.nhsc.hrsa.gov.

Would you like to speak with someone to find out if your facility is eligible for loan repayment? Contact Colorado Provider Recruitment (CPR) at cpr@coruralhealth.org or (303) 832-7493.

TrailBlazer Medicare Contractor Updates

 Did You Know?

 If you missed one of our Web-Based Trainings (WBTs), you can now access the Encore (recorded) event at any time. Below are the latest additions that are now available on the Calendar of Events Web page:



 CAH Top Billing Errors and Resources.
 Electronic and Paper Claim Submission Requirements.



















  

Holding CAH Method II 85X Claims with Modifier 22

Medicare pays for multiple surgeries by ranking from the highest Medicare Physician Fee Schedule (MPFS) amount to the lowest MPFS amount. When the same physician performs more than one surgical service at the same session, the allowed amount is 100 percent for the surgical code with the highest MPFS amount. The allowed amount for the subsequent surgical codes is based on 50 percent of the MPFS amount. In rare situations these payment rules do not apply and may be bypassed by using modifier 22. Since April 2, 2012, the reduction has been erroneously applied to line items containing modifier 22. Medicare contractors have been instructed to hold 85X Type of Bill (TOB) claims, including adjustments, if a modifier 22 is present. Medicare contractors will release the held claims upon the successful implementation of the system fix, which is scheduled for June 4, 2012. No provider action is required. For more information, click here.

CRHC Regional CAH Workshops

Please join us for one of the Colorado Rural Health Center’s (CRHC) upcoming Annual Regional CAH Workshops. There will be a CAH Quality Improvement Workshop (9:00am-3:00pm) and a CAH Board Workshop (4:00pm-7:30pm) offered at each location . The Quality Improvement Workshop will feature a presentation by Beth Katzenberg from CFMC on “Growing and Sustaining Improvement: A Medley of Tactical Approaches” which will address physician engagement and beyond, the improvement “kata” - a unique focus to help you establish target conditions, work through obstacles, and learn from problems encountered, and other approaches to sustain and grow improvement culture. During the Board Workshop CRHC’s Policy and Advocacy Manager, Alicia Haywood, and Charney and Associates CEO, Bill Charney, will provide background and updates on the Affordable Care Act (ACA) and ACOs and the potential impact on hospitals and their communities and will discuss the role of hospital CEOs and Boards in engaging providers, the community, and local stakeholders in these conversations. There is no charge for CAH staff and boards to attend the workshops, but you must register. For more information and to register, click on the links below.


May 1, 2012 – Location: Kit Carson County Memorial Hospital, Burlington, CO
May 3, 2012 – Location: Rio Grande Hospital, Del Norte, CO
May 10, 2012 – Location: Grand River Hospital and Medical Center, Rifle, CO

Best Practices for Critical Access Hospitals to Ensure Revenue Integrity

Free Webinar May 1st!!  
Title: Best Practices for Critical Access Hospitals to Ensure Revenue Integrity
Date: Tuesday, May 1, 2012
Time: 1:00 pm - 2:00 pm Central Time
Learn how Madison County Memorial Hospital, a rural 25-bed critical access hospital, implemented a successful revenue integrity initiative. Patrick Stitt, Director of IT Systems for Madison County, and Lyn Banks, business solutions consultant for Craneware, will discuss CAHs' unique challenges to revenue integrity--the achievement of operational efficiency, compliance and legitimate reimbursement. Stitt will also outline Madison County's strategic plan for preventing revenue leakage, discussing the new processes and technology they implemented as well as the benefits and lessons learned.
Speakers:
Patrick Stitt, Madison County Memorial Hospital

Patrick Stitt has more than nine years of healthcare experience and 25 years of experience in information technology systems. As the Director of Information Technology Systems for Madison County Memorial Hospital, Stitt takes an active role in a wide range of revenue integrity initiatives, working with admissions, the HIM department, billing department, and pharmacy billing and pricing. Stitt also acts as the Project Manager for the installation and training of the hospital's revenue cycle management solution and EMR system.

Lyn Banks, CPC, CPAT

Lyn Banks has more than 30 years of experience. She began her career as an emergency medical technician, later changing her focus to healthcare finance and operations. She understands the challenges in rural healthcare as she has helped several CAHs improve revenue cycle processes and performance. She has served as an Accounting Supervisor and CDM Manager for several hospital systems as well as the Business Office Manager for a physician multi-specialty group. Banks, who has participated in four major system conversions, served on the design, development and implementation team for the Virginia Department of MHMRSAS agency's state-wide Patient/Resident Automated Information System Reimbursement module. She is a Certified Professional Coder and has been a long standing member of HFMA, AAHAM and the American Academy of Professional Coders.




Space is limited. Reserve your webinar seat now at: https://www2.gotomeeting.com/register/444778210

CCSP Teleconference Invitation

 Dear CCSP Partners,

The Colorado Colorectal Screening Program will be hosting a series of teleconferences to provide updates and to discuss the current and future directions of the Program. We would like to invite our clinic partners to participate in a general teleconference with us next week as an opportunity for you to share your thoughts regarding the direction of the Program for the upcoming fiscal year. Please extend this invitation as you see fit.

The call-in line will be open for all three of the following dates and times:   
Wednesday, April 25th at 7:30 AM
Thursday, April 26th at 4 PM
Friday, April 27th at Noon

 Depending on the amount of discussion, we anticipate these calls lasting from 30 to 60 minutes. You are welcome to call-in during any of the above times; however, we ask that you use the ‘voting button’ or reply to keavy.mcabee@ucdenver.edu with your selected participation time, so that we can assure call-line capacity.

Please use the following conference call information for all of the calls:

Dial In:
877-361-1946 
Conference Code:
303-724-1373

If you have any questions, please contact Keavy McAbee at keavy.mcabee@ucdenver.edu or at 303.724.5905.

Thank you for your participation and continued support.

Holly Wolf and the CCSP Team

Something you may be interested in......

Dr. Theo Alkousakis, MD, FAAD is a board certified dermatologist in the Denver area in the early stages of exploring interest in a combined Teledermatology/Rural Surgery program. The service would provide both store and forward capability for patients and providers to send images of suspicious lesions that need diagnosis or triaging and live consults for more complicated cases. Abnormal moles, skin cancers or complicated cases would then be treated with scheduled visits to the rural locations as needed, with all the patients scheduled on one day. Dermatology teaching to staff at rural clinics can be provided during those visits. I am signed up with most major insurance companies, but also would be happy to provide significant cash pay discounts for the uninsured/under insured/high deductible population, which is possible by avoiding the hassles of billing through insurance. The teledermatology interface is set up, but not operational until enough interest is seen. I am looking for feedback on the interest level and needs of the community. There are more than 50 major rural clinics in the network and if there is the need 1-3 times a week from each clinic for a dermatology consult, this would justify setting up the system as soon as possible. Please contact me at castlerockderm@gmail.com with any comments.

Just Released jointly issued brief on Oral Health Care in Colorado

The oral health of America's children is a top priority. But for Colorado, there hasn't been much improvement in the past decade.

The good news is that Governor John Hickenlooper recently made children’s oral health one of Colorado's 10 winnable battles over the next five years. This is an important goal because oral disease can negatively impact a child’s performance in school, speech development, nutrition, self-esteem and sleep.

To help inform this winnable battle, three foundations – The Colorado Trust, Caring for Colorado Foundation and the Delta Dental of Colorado Foundation – jointly issued a new brief, Improving the Oral Health of Colorado's Children. Written by Diane Brunson, RDH, MPH, Director of Public Health, University of Colorado School of Dental Medicine, the brief details:

the causes of oral disease,
multiple prevention strategies,
significant challenges in access to oral health care, and
strategies for improving the oral health of Colorado children.

In addition to the brief, a two-page Executive Summary provides a high-level overview for policymakers.

We invite you to read this new information and to use these resources to help improve the health of Colorado children.

Why Use Swing Beds? Conversations with Hospital Administrators and Staff

 This Rural Health Research and Policy Center study describes learnings from interviews with hospital administrators and staff about the use of swing beds. Topics include the role of swing beds in patient care, swing bed volume and financial considerations, swing beds in the context of all community post-acute skilled care, and swing beds as a benefit for community residents. To access the study, click here.

CMS 3-Day Payment Window

On the April 24 CMS Rural Health Open Door Forum, CMS representatives addressed the 3-Day Payment Window and its applicability to CAHs. During the call, CMS clarified the rule applies to CAHs that are wholly owned or operated by another single hospital - the rule does not apply to independent CAHs or those CAHs owned and operated by a system or corporation. For more information on the 3-day payment window rule, click here.

CO Selected for Medicare Comprehensive Primary Care Initiative!

Dear CIVHC stakeholders,
Colorado received exciting news last week that our state was selected as one of just seven markets nationwide to participate in the Centers for Medicare and Medicaid Innovation (CMMI) Comprehensive Primary Care Initiative (CPCI). This landmark, four-year, multi-payer project aims to strengthen the primary care system while improving health care outcomes and controlling costs through a patient-centered medical home (PCMH) approach. Click here to read the full press release.

Special thanks to HealthTeamWorks and Colorado Association of Health Plans who partnered with CIVHC to engage seven payers in this effort to enhance and expand current PCMH work occurring across the state.

REGISTRATION OPEN: Level 2 Patient Navigator Course, Emotional and Social Aspects of Disease (online course)

Registration is open: Level 2 Patient Navigator Course, Emotional and Social Aspects of Disease (online course)

Chronic diseases affect our physical bodies, but also have an emotional, social and psychological impact. This 7-week online course helps patient navigators understand their role and how to help patients and their caregivers deal with complex emotional issues related to chronic disease.
In this course you will interact with the instructor and other students to explore how to:

Help patients and families adjust to chronic disease
Increase a patient’s sense of empowerment
Assess patient coping strategies
Identify mental illness and patients in crisis


 COURSE DETAILS:

Dates: Monday, May 14 - Friday, June 29, 2012 (7 weeks)
 Cost: $400


Course Format: This is an online course. It is not self-paced, but lead by an instructor. ALL course activities take place via the internet (there are no face-to-face meetings). Course activities include readings, online tutorials or videos, quizzes and online discussions. This online course requires 6 hours per week for 7 weeks. Because you will be participating in online discussions with other students in the course, the success of the course depends on your participation. By registering for this course, you commit to fully participating in the course and online discussions.


See more course details: http://www.patientnavigatortraining.org/website/schedule.htm

Don’t miss the opportunity - Ends April 27th!

Don’t miss the opportunity to offer loan repayment to your healthcare providers – Ends April 27th!

 

Do you have a healthcare provider at your facility who is interested in loan repayment? Let them know that the Colorado Rural Outreach Program (CROP) Loan Repayment Program Spring 2012 application cycle will closing soon. The application cycle is open April 2nd until April 27th, 2012.

 

CROP is a grant applied to by a healthcare facility on behalf of a healthcare clinician:

 

Eligibility requirements for facilities

 

• Public, non-profit or private healthcare facility.
• Located in a designated rural county.
• Ability to contribute a monetary award: Colorado Rural Health Center (CRHC) will “match” this award amount up to $10,000, making the total amount awarded to the clinician $20,000. Award may be funded through other avenues in the community, e.g., a local business, community college, fundraiser, etc.
• Retention grant - facility may apply for CROP on behalf of a clinician already employed. 
• Award may be used for a different financial incentive to a clinician if they do not have loan debt, e.g., a bonus or other community request.

Eligibility requirements for healthcare providers

 

Any clinician providing medical, dental or mental healthcare. Must be providing direct patient care.

Clinician may be employed at facility or be in the process of being hired

 

Application

 

Facility may re-apply for same clinician for up to three years. Facility may apply for more than one clinician, but preference will be given to only one applicant.

There are two application cycles each year (Fall, Spring) as funding allows.

Awardees will be notified four weeks after application cycle closes.

Please download the application packet and coversheet. Please complete and save the coversheet in Microsoft Word. You may submit your application via e-mail or postal mail. If submitting via e-mail, please make the narrative and all attachments ONE inclusive document. The coversheet may be separate. Please send your CROP application to:

 

Attn: Robyn Purvin

Colorado Rural Health Center

3033 S. Parker Rd., Suite 606

Aurora, CO 80014

rp@coruralhealth.org

Main: 303.407.2031

Fax: 303.832.7496

 

www.coruralhealth.org/programs/loanrepayment/crop.htm

CART-Outpatient Version 1.7 Release

 The CMS Abstraction and Reporting Tool (CART)-Outpatient 1.7 has been released and is available on the QualityNet website, http://www.qualitynet.org/. This release includes the addition of three new measure sets; ED-Throughput, Pain Management, and Stroke to the existing measure sets; Acute Myocardial Infarction, Chest Pain, and Surgery.

Please be aware that CART-Outpatient 1.7 is not backward compatible with CART-Outpatient 1.6.1 or earlier, and may not be installed in the same directory. CART-Outpatient 1.7 is compatible with CART-Inpatient 4.11 and may be installed in the same directory.

It is important that the user refers to the Installation Instructions, Release Notes, Known Issues, Edits, and User Guide documents located on the QualityNet website under Hospitals – Outpatient/ Data Collection (& CART)/CART Downloads & Info. Please note that with this release the CART – Outpatient User Guide has not been revised.

CART-Inpatient Version 4.11 Release

The CMS Abstraction and Reporting Tool (CART)-Inpatient 4.11 has been released and is available on the QualityNet website, http://www.qualitynet.org/. This release includes the addition of one new measure set; IMM-Immunization to the existing measure sets; AMI-Acute Myocardial Infarction, ED-Emergency Department, HF-Heart Failure, PN-Pneumonia, and SCIP-Surgical Care Improvement Project.

Please be aware that CART-Inpatient 4.11 is not backward compatible with CART-Inpatient 4.10.2 or earlier and may not be installed in the same directory. CART Inpatient 4.11 is compatible with CART-Outpatient 1.7 and may be installed in the same directory.

It is important that the user refers to the Installation Instructions, Release Notes, Known Issues, Edits, and User Guide documents located on the QualityNet website under Hospitals – Inpatient/ Data Collection (& CART)/CART Downloads & Info. Please note that with this release the CART – Inpatient User Guide has been revised.

6 DAYS UNTIL THE 2012 FORUM!!!

Have you registrered for our annual event brought to you by the Colorado Rural Health Center and ClinicNET? Join us April 11th - 13th at the Sheraton Denver West in Lakewood, Colorado and participate in the numerous education, training and networking opportunities available to you. The agenda is now posted for this years exciting event - check it out and register today!! To register please visit our website or contact Courtnay Ryan at cr@coruralhealth.org. See you there!

Senators sign bipartisan letter in support of rural health appropriations

A bipartisan group of 24 senators sent a letter to the Appropriations Subcommittee on Health and Human Services last week announcing their support for rural health programs. The letter outlines the vital discretionary programs that help maintain the rural health safety net.
NRHA thanks you for your advocacy efforts, as your calls and emails to Congress led to the success of this bipartisan letter.
Senators Kent Conrad (D-N.D.) and Chuck Grassley (R-Iowa) cosponsored the letter, and NRHA applauds them for leading the effort to provide critical support to rural safety net providers.
There are a number of small but vital discretionary programs that help form the rural health safety net. Especially in hard economic times, these programs play an important role in making sure 62 million rural Americans have access to critical primary, emergency and hospital services.
While this letter shows the depth of support for these vital programs, the efforts to ensure adequate funding are not over. As the committees in the House and Senate debate these programs, it remains critical to continually contact your representatives.
Please make your voice heard by staying connected with your elected leaders. As always, you can read the full post and keep up to date with the developments in extending critical funding at NRHA’s Rural Health Voices blog.

The final letter is available here

TrailBlazer Medicare Education Listserv

TrailBlazer Provider Outreach and Education develops and promotes educational opportunities that enhance the Medicare knowledge of our providers and their staffs. All upcoming educational opportunities are posted on the Calendar of Events Web page.

Part A
Seminars/Workshops:

· Various dates – EDI DDE Training.
Web-Based Trainings (WBTs):

· 04/10/2012 – OPPS Updates and Top Billing Errors.

· 04/17/2012 – CAH Top Billing Errors and Resources.

· 04/24/2012 – ORF/CORF Top Billing Errors and Resources.

Teleconferences:

· 04/04/2012 – Cross-Claim Part A/B Medical Review.

· 04/11/2012 – SNF Ask-the-Contractor Teleconference.

Encore (Recorded) WBTs:

· Encore presentations are recorded versions of live Web-based training presentations that are now available on the Calendar of Events page. These presentations can be accessed 24/7 so you can view them at your convenience.

Job Aids:

· Hospital Wage Index Development Timetable.

· SNF UB-04 Billing Examples.

· Swing Bed UB-04 Billing Examples.

Newsletters:

· TrailBlazer eBulletin – March 2012.

Frequently Asked Questions (FAQs):

· FAQs are displayed with the most recent updates listed first with the posting date displayed under the Last Updated column. All FAQs are updated quarterly or more often if needed.



Part B

WBTs:

· 04/04/2012 – Updates, Changes and Reminders.

· 04/11/2012 – Welcome to Medicare – New Provider Guide.

· 04/18/2012 – Electronic and Paper Claim Submission Requirements.

· 04/25/2012 – Understanding the Medicare Remittance Advice.

Teleconferences:

· 04/04/2012 – Cross-Claim Part A/B Medical Review.

Encore (Recorded) WBTs:

· Encore presentations are recorded versions of live Web-based training presentations that are now available on the Calendar of Events page. These presentations can be accessed 24/7 so you can view them at your convenience.

Job Aids:

· Redetermination Checklist.

· IVR Operating Guide.

Manuals:

· Electronic Prescribing Initiative (eRx) Incentive Program Manual.

· Physician Quality Reporting System Manual.

Newsletters:

· TrailBlazer eBulletin – March 2012.

Questions and Answers:

· J4 ACT Questions and Answers – March 14, 2012.

FAQs:

· FAQs are displayed with the most recent updates listed first with the posting date displayed under the Last Updated column. All FAQs are updated quarterly or more often if needed.


Stay informed - Improve office efficiency and claims reimbursement by staying current on Medicare billing and policy changes by sharing this listserv with others in your organization. To register and subscribe to listservs or to view current listserv subscriptions, click Manage subscriptions under Listserv Notifications on the Medicare home page.

Have You Completed Your 5010 Implementation?

There are steps to ensure that your upgrade is a smooth one: establish a line of credit and check partner readiness.  Recently, the Centers for Medicare & Medicaid Services (CMS) announced it will not initiate enforcement action against any HIPAA covered entity for an additional three (3) months, through June 30, 2012,for the updated HIPAA transaction standards (ASC X12 Version 5010, NCPDP Versions D.0 and 3.0).  Although much progress has been made in the successful receipt and processing of claims in the Version 5010 format, CMS is aware that there are still challenges and issues impeding an industry wide upgrade.  During these additional 90 days in which CMS will not initiate enforcement penalties, you should collaborate more closely with trading partners on appropriate strategies to resolve any remaining problems. Two steps providers can take to ensure a smooth upgrade are:  Establishing a line of credit: To avoid potential cash flow disruptions, providers should consider establishing or increasing a line of credit. By doing so, they can prepare for possible delays and denials in payer claims reimbursements if noncompliant Version 5010 transactions are submitted.  Check partner readiness: Because a provider's Version 5010 upgrade can be dependent upon his or her vendor, it is important for providers to be aware of their vendor's transition status. If your vendor is behind schedule for Version 5010 adoption, get confirmation of their timeline to be compliant, and encourage them to take action so that your system will be prepared to handle your claims.



Other steps to prepare for the Version 5010 upgrade can be found on the Version 5010: Ensuring a Smooth Transition Fact Sheet, which provides an overview of several actions providers can take to maintain continuity of operations for their practices as they prepare to complete Version 5010 testing.

Keep Up to Date on Version 5010 and ICD-10.
Please visit the ICD-10 website for the latest news and resources to help you prepare, and to download and share the implementation widget today!

Register Now for CRHC's Regional CAH Workshops!

Please join CRHC for upcoming regional Quality Improvement and Board Workshops for CAHs. These workshops are FREE for all Colorado CAHs, but registration is required. The dates and locations are:
May 1 – Burlington
May 3 – Del Norte
May 10 – Rifle

The Quality Improvement training portion will take place from 9:00am-3:00pm at each location. The CAH Board training portion will take place from 4:00pm-7:30pm at each location. Click on the dates above for more information or go to CRHC’s CAH Events page here.

CRHC is pleased to offer the Kaiser Permanente Institute for Healthcare Improvement (IHI) Community Benefit Program.

This program, offers eligible rural safety net clinic leaders conference registration scholarships and travel support funding to participate in IHI courses. Funding is limited, apply today!  For more information, please click here

Medical Chart Audit and Review Services: Are You Ready? CRHC Can Help!

Chart Reviews are an essential component of your Medicare Fraud and Abuse compliance plan! As part of a facility’s compliance review process, medical record review ensures the adequacy of coding and billing and the underlying medical record documentation. CRHC’s Medical Chart Audit and Review services include:

• Onsite review of a representative sampling of medical charts held in the EHR.
• Comparison of the chart documentation for this representative sampling against actual Medicare/commercial insurer billing.
• Evaluation of documentation for other relevant benchmarks including Medicare RAC audit compliance.
• Evaluation of deficiencies if you are using an EHR
• A written report of findings listing gaps and recommendations.
  
  For more information and pricing, contact jd@coruralhealth.org.