Webinar
Monday, February 24, 2014. 10:00 a.m. – 11:30 a.m. MST
Join us for a webinar hosted by the Colorado Community Health Network (CCHN) and Capital Link that highlights the fundamentals and best practices for nonprofits considering seeking financing, including information about the resources available to health centers and clinics. This training will help health centers and clinics understand why and how to leverage their resources, as well as discuss developing the necessary business plan and financial forecasts. Cost of attendance is free.
Registration information: https://attendee.gotowebinar.com/register/6795304372242068225
Friday, January 31, 2014
At a Glance January 2014
This monthly publication provides updates on Department of Health Care Policy and Financing initiatives including policy changes and program updates. Please feel free to share it with your colleagues, and contact staff designated in the publication if you need further information.
For Article click here:
For Article click here:
Thursday, January 30, 2014
Elevating the Conversation: Critical Skills Training in Suicide......
A State-of-the-Art skills training in Suicide Risk Assessment, Management and Support. With Dr. Thomas Joiner.
February 21, 2014, 7:30 a.m. to 4:00 p.m.
University of Denver
For more information click here:
or to register go to www.carsonjspencer.org
February 21, 2014, 7:30 a.m. to 4:00 p.m.
University of Denver
For more information click here:
or to register go to www.carsonjspencer.org
Wednesday, January 29, 2014
Colorado Center For Nursing Excellence
Invites all nurse leaders in long-term care, home care, hospice and rehabilitation to the
LTC NURSING LEADERSHIP WORKSHOPS
Loveland/Greeley - Centerra, just off I-25
Leaders - March 3, 4, 26, 27, 28, 2014
Coaches—March 24, 25, 2014
Coaches Register Here:
Leaders Register Here:
Denver - Location to be deteremined
Leaders - May 22, 23, 28, 29, 30, 2014
Coaches—May 20 & 21, 2014
Cost: Program is HRSA funded through June, 2014, excluding food.
Leaders: $100—Coaches: $40
Coaches Register Here:
Leaders Register Here:
Go to www.coloradonursingcenter.org to register or call 303-715-0343 ext. 22 for information
LTC NURSING LEADERSHIP WORKSHOPS
Loveland/Greeley - Centerra, just off I-25
Leaders - March 3, 4, 26, 27, 28, 2014
Coaches—March 24, 25, 2014
Coaches Register Here:
Leaders Register Here:
Denver - Location to be deteremined
Leaders - May 22, 23, 28, 29, 30, 2014
Coaches—May 20 & 21, 2014
Cost: Program is HRSA funded through June, 2014, excluding food.
Leaders: $100—Coaches: $40
Coaches Register Here:
Leaders Register Here:
Go to www.coloradonursingcenter.org to register or call 303-715-0343 ext. 22 for information
Monday, January 27, 2014
MLN Connects National Provider Calls
National Provider Calls
February 26, 2014
National Partnership to Improve Dementia Care in Nursing Homes — Register Now
Need to Learn More About ICD-10? The MLN Connects™ Collection of Resources Can Help
CMS Events
Comparative Billing Report Teleconference
Announcements
Continue Seasonal Flu Vaccination through January and Beyond
Submit Quality Data for 2013 PQRS-Medicare EHR Incentive Pilot by February 28
Claims, Pricers, and Codes
Revised CMS 1500 Paper Claim Form: Version 02/12
MLN Educational Products
“Inpatient Rehabilitation Facility Prospective Payment System” Fact Sheet — Revised
February 26, 2014
National Partnership to Improve Dementia Care in Nursing Homes — Register Now
Need to Learn More About ICD-10? The MLN Connects™ Collection of Resources Can Help
CMS Events
Comparative Billing Report Teleconference
Announcements
Continue Seasonal Flu Vaccination through January and Beyond
Submit Quality Data for 2013 PQRS-Medicare EHR Incentive Pilot by February 28
Claims, Pricers, and Codes
Revised CMS 1500 Paper Claim Form: Version 02/12
MLN Educational Products
“Inpatient Rehabilitation Facility Prospective Payment System” Fact Sheet — Revised
ICD-10 Coding Basics MLN Connects™ Video
Are you ready to transition to ICD-10 on October 1, 2014?
To help make sure you’re prepared, CMS has released a new MLN Connects™ video on ICD-10 Coding Basics. Sue Bowman from the American Health Information Management Association (AHIMA) provides a basic introduction to ICD-10 coding, including:
Similarities to and differences from ICD-9
ICD-10 code structure
Coding process and examples
7th Character
Placeholder "x"
Excludes notes
Unspecified codes
External cause codes
To receive notification of upcoming MLN Connects videos and calls and the latest Medicare program information on ICD-10, subscribe to the weekly MLN Connects™ Provider eNews.
Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, deadline. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
To help make sure you’re prepared, CMS has released a new MLN Connects™ video on ICD-10 Coding Basics. Sue Bowman from the American Health Information Management Association (AHIMA) provides a basic introduction to ICD-10 coding, including:
Similarities to and differences from ICD-9
ICD-10 code structure
Coding process and examples
7th Character
Placeholder "x"
Excludes notes
Unspecified codes
External cause codes
To receive notification of upcoming MLN Connects videos and calls and the latest Medicare program information on ICD-10, subscribe to the weekly MLN Connects™ Provider eNews.
Keep Up to Date on ICD-10
Visit the CMS ICD-10 website for the latest news and resources to help you prepare for the October 1, 2014, deadline. Sign up for CMS ICD-10 Industry Email Updates and follow us on Twitter.
CMS to conduct ICD-10 testing in March
During the testing week, Medicare Administrative Contractors (MAC) will offer real-time help desk support for physicians and other health care professionals who participate. CMS has said the MACs also will handle increased call volume during this week. To Find out more click here.
Friday, January 24, 2014
Novitas Update
Medicare News
JH Part B Webinar Handout: "Evaluation and Management Score Sheet-Part Four Auditing Medical Documentation"- January 28, 2014 (10:00 am - 11:00 am CST)
Join us for Part Four-"Auditing Medical Documentation" of the new series on Evaluation and Management Services. This four part series was developed to increase your understanding of evaluation and management services. The series will highlight coding instructions, documentation requirements, assist you in locating valuable resources and provide our philosophy on scoring and auditing documentation. The complete series will be presented every month with one part each week. It is recommended to take the entire series in order to maximize your understanding. However, if you miss any part of the series, it will be presented again the following month in the same order. You have the opportunity to gain four continuing education units for completing the entire series. If you are new to documenting and/or scoring evaluation and management services, this is for you. It is recommended you complete this four part series before registering for any other Novitas evaluation and management event.
The series will consist of the following:
Week One-Part One- Understanding the Key components of Evaluation and Management.
Week Two-Part Two- Introduction to the Score Sheet,
Week Three- Part Three- Using the Score Sheet
Week Four- Part Four- Scoring Medical Records Using the Score Sheet.
This series was developed to increase your understanding of evaluation and management services. We will review coding instructions, documentation requirements and assist you in locating valuable resources while providing our philosophy of scoring and auditing documentation. If you are new to documenting and/or scoring evaluation and management services, this webinar event is for you. You must attend this event. Don't miss it, register today
CMS MLN Connects Provider e-News
The January 23, 2013 edition of the MLN Connects Provider e-News * is now available.
JH Part B Webinar Handout: "Evaluation and Management Score Sheet-Part Four Auditing Medical Documentation"- January 28, 2014 (10:00 am - 11:00 am CST)
Join us for Part Four-"Auditing Medical Documentation" of the new series on Evaluation and Management Services. This four part series was developed to increase your understanding of evaluation and management services. The series will highlight coding instructions, documentation requirements, assist you in locating valuable resources and provide our philosophy on scoring and auditing documentation. The complete series will be presented every month with one part each week. It is recommended to take the entire series in order to maximize your understanding. However, if you miss any part of the series, it will be presented again the following month in the same order. You have the opportunity to gain four continuing education units for completing the entire series. If you are new to documenting and/or scoring evaluation and management services, this is for you. It is recommended you complete this four part series before registering for any other Novitas evaluation and management event.
The series will consist of the following:
Week One-Part One- Understanding the Key components of Evaluation and Management.
Week Two-Part Two- Introduction to the Score Sheet,
Week Three- Part Three- Using the Score Sheet
Week Four- Part Four- Scoring Medical Records Using the Score Sheet.
This series was developed to increase your understanding of evaluation and management services. We will review coding instructions, documentation requirements and assist you in locating valuable resources while providing our philosophy of scoring and auditing documentation. If you are new to documenting and/or scoring evaluation and management services, this webinar event is for you. You must attend this event. Don't miss it, register today
CMS MLN Connects Provider e-News
The January 23, 2013 edition of the MLN Connects Provider e-News * is now available.
2014 ICD-10 Roadshows
The CHIMA ICD-10 Task Force has been hard at work.......
The ICD-10-Road Shows are set for March & April 2014 in Denver, Pueblo, Greeley and Grand Junction! 1-1/2 days of education focused on ICD-10-CM with hands on coding sessions. Colorado’s own AHIMA Approved ICD-10 Trainers will be leading the education. $250 CHIMA members, $300 non-members and $50 for students. Seminar materials and lunch/breakfast provided for these Friday(full day) and Saturday(morning) sessions.
To view meeting details and to register, click here. Please contact Jacquie Zegan & Michele Benson @ chimai10taskforce@gmail.com if you have questions or would like more information.
The ICD-10-Road Shows are set for March & April 2014 in Denver, Pueblo, Greeley and Grand Junction! 1-1/2 days of education focused on ICD-10-CM with hands on coding sessions. Colorado’s own AHIMA Approved ICD-10 Trainers will be leading the education. $250 CHIMA members, $300 non-members and $50 for students. Seminar materials and lunch/breakfast provided for these Friday(full day) and Saturday(morning) sessions.
To view meeting details and to register, click here. Please contact Jacquie Zegan & Michele Benson @ chimai10taskforce@gmail.com if you have questions or would like more information.
Wednesday, January 22, 2014
How to write a budget narrative that will “wow” application reviewers:
Details. Description. Justification.
These are the major components to consider when completing the narrative section describing your financial need. Submitting your budget with a detailed, descriptive and justified narrative will not only thoroughly explain to the reviewers what the numbers in the spreadsheet represent, it will allow them to fully understand how you arrived at those costs, which is crucial for justifying your need. The funder will know exactly how you intend to spend the funds - item by item - and ensures you did your research and your project costs are reasonable and well thought out.
Next, the details – they can be a road block for many people- but the sooner you start looking at the resources you will need and pricing them out, the faster your project will move from the realm of ideas into reality.
Lastly, it is very important to be descriptive and make sure your expenses relate clearly to the project narrative. The narrative is a means to convey the specifics of your plan to the application reviewers. Remember to explain any unusual expenditures identified in the budget, for example, a fire and safety proposal budget that includes a $50,000 reserve would benefit from a budget narrative that explains: “$50,000 is reserved for the near future purchase of a new fire engine to help our rapidly growing service demands in our community.”
Finally, don’t be afraid to use abbreviations, especially when it is important to conserve space. The guiding rule to follow is clarity throughout to ensure each reviewer fully understands your message and financial need.
These are the major components to consider when completing the narrative section describing your financial need. Submitting your budget with a detailed, descriptive and justified narrative will not only thoroughly explain to the reviewers what the numbers in the spreadsheet represent, it will allow them to fully understand how you arrived at those costs, which is crucial for justifying your need. The funder will know exactly how you intend to spend the funds - item by item - and ensures you did your research and your project costs are reasonable and well thought out.
Next, the details – they can be a road block for many people- but the sooner you start looking at the resources you will need and pricing them out, the faster your project will move from the realm of ideas into reality.
Lastly, it is very important to be descriptive and make sure your expenses relate clearly to the project narrative. The narrative is a means to convey the specifics of your plan to the application reviewers. Remember to explain any unusual expenditures identified in the budget, for example, a fire and safety proposal budget that includes a $50,000 reserve would benefit from a budget narrative that explains: “$50,000 is reserved for the near future purchase of a new fire engine to help our rapidly growing service demands in our community.”
Finally, don’t be afraid to use abbreviations, especially when it is important to conserve space. The guiding rule to follow is clarity throughout to ensure each reviewer fully understands your message and financial need.
Medicare Expands Definition of Rural for Telehealth
Effective January 1st, the Centers for Medicare and Medicaid Services (CMS) expanded the definition of “originating sites” to include Health Professional Shortage Areas (HPSAs) that are located in rural census tracts of Metropolitan Statistical Areas. Also, as part of the update to the Physician Fee Schedule for 2014, Medicare added “Transitional Care Management Services” to the list of codes eligible for payment when provided via telehealth. Medicare defines “originating site” as the location of an eligible Medicare beneficiary at the time the service is provided via telemedicine. To find out if an authorized originating site is eligible for Medicare telehealth payment, check out the new payment eligibility analyzer from the Health Resources and Services Administration. Check out the tool here.
Hospital Outcome Measures of Care
The Centers for Medicare & Medicaid Services (CMS) has contracted with Yale-New Haven Health Services Corporation/Center for Outcomes Research and Evaluation (YNHHSC/CORE) to reevaluate three hospital outcomes measures of care transitions for patients hospitalized with acute myocardial infarction (AMI), heart failure (HF), or pneumonia. These measures (one for each condition) were initially developed by CMS/Brandeis University and are currently NQF-endorsed (NQF #0698, #0699 and #0707), but are not in use in CMS programs.
YNHHSC/CORE is seeking members of a Technical Expert Panel (TEP) to provide expert opinion and input on these measures. Given the expertise and mission of your organization, YNHHSC/CORE would like you to identify individuals who could represent your organization in this process. The goal is to have broad representation on the TEP including experts in cardiovascular care, primary care, care transitions and quality improvement/performance measurement, as well as purchaser and consumer perspectives. YNHHSC/CORE will hold 1-2, two-hour teleconference meetings between March 2014 and September 2014. Attached to this message is the TEP Charter which provides additional details about this work and outlines TEP member responsibilities.
If you or someone you know with relevant expertise would be willing to participate, please visit https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TechnicalExpertPanels.html and download the “Reevaluating Hospital-Level Measures of 30-Day Post-Discharge Care Transitions for Patients with AMI, HF, and Pneumonia” documents at the bottom of the page. Please complete the Nomination/Disclosure/Agreement (NDA) form and submit it along with your curriculum vitae and a statement of interest no later than 5:00pm ET, on February 18, 2014. If you are unable to participate but know of someone with relevant expertise who may be interested, please forward this information to that individual.
Please note that in order for the nomination package to be complete, a signature (electronic or handwritten) is required on the Nomination Form. The documents may be submitted in hard copy to the address below, faxed (203-764-5653), or emailed (cmstransitionsmeasures@yale.edu). Once the nomination process is complete, YNHHSC/CORE will select a TEP composed of 8-15 members based on the areas of expertise and the specific requirements of the measure.
Please contact Faseeha Altaf (at cmstransitionsmeasures@yale.edu or 203-764-5700) should you have any questions.
Thank you,
Leora Horwitz
Leora Horwitz, M.D., M.H.S.
Measure Reevaluation Lead
Yale New Haven Health Services Corporation/ Center for Outcomes Research and Evaluation (YNHHSC/CORE)
1 Church Street, Suite 200
New Haven, CT 06510
(203) 764-5700
(203) 764-5653 Fax
caretransitionsmeasures@yale.edu
YNHHSC/CORE is seeking members of a Technical Expert Panel (TEP) to provide expert opinion and input on these measures. Given the expertise and mission of your organization, YNHHSC/CORE would like you to identify individuals who could represent your organization in this process. The goal is to have broad representation on the TEP including experts in cardiovascular care, primary care, care transitions and quality improvement/performance measurement, as well as purchaser and consumer perspectives. YNHHSC/CORE will hold 1-2, two-hour teleconference meetings between March 2014 and September 2014. Attached to this message is the TEP Charter which provides additional details about this work and outlines TEP member responsibilities.
If you or someone you know with relevant expertise would be willing to participate, please visit https://www.cms.gov/Medicare/Quality-Initiatives-Patient-Assessment-Instruments/MMS/TechnicalExpertPanels.html and download the “Reevaluating Hospital-Level Measures of 30-Day Post-Discharge Care Transitions for Patients with AMI, HF, and Pneumonia” documents at the bottom of the page. Please complete the Nomination/Disclosure/Agreement (NDA) form and submit it along with your curriculum vitae and a statement of interest no later than 5:00pm ET, on February 18, 2014. If you are unable to participate but know of someone with relevant expertise who may be interested, please forward this information to that individual.
Please note that in order for the nomination package to be complete, a signature (electronic or handwritten) is required on the Nomination Form. The documents may be submitted in hard copy to the address below, faxed (203-764-5653), or emailed (cmstransitionsmeasures@yale.edu). Once the nomination process is complete, YNHHSC/CORE will select a TEP composed of 8-15 members based on the areas of expertise and the specific requirements of the measure.
Please contact Faseeha Altaf (at cmstransitionsmeasures@yale.edu or 203-764-5700) should you have any questions.
Thank you,
Leora Horwitz
Leora Horwitz, M.D., M.H.S.
Measure Reevaluation Lead
Yale New Haven Health Services Corporation/ Center for Outcomes Research and Evaluation (YNHHSC/CORE)
1 Church Street, Suite 200
New Haven, CT 06510
(203) 764-5700
(203) 764-5653 Fax
caretransitionsmeasures@yale.edu
FY15 Funding Applications
ONLY 4 WEEKS LEFT TO APPLY:
UPDATED! FY15 Funding Applications Open --
Approximately $6.7 million is available through grants and system improvement funding for organizations involved in providing emergency medical and trauma services in Colorado. Apply for these funds at www.coems.info under the Funding Program tab. Read the full FY15 Funding Guide for details or contact Jeanne-Marie Bakehouse and/or Michael Gerber with questions. Applications will be accepted until Feb. 14 at 5 p.m. -- only four weeks left!
UPDATED! FY15 Funding Applications Open --
Approximately $6.7 million is available through grants and system improvement funding for organizations involved in providing emergency medical and trauma services in Colorado. Apply for these funds at www.coems.info under the Funding Program tab. Read the full FY15 Funding Guide for details or contact Jeanne-Marie Bakehouse and/or Michael Gerber with questions. Applications will be accepted until Feb. 14 at 5 p.m. -- only four weeks left!
Tuesday, January 21, 2014
MLN Matters Article to Clarify SNF, IRF, HH and OPT
"Manual Updates to Clarify Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Home Health (HH), and Outpatient (OPT) Coverage Pursuant to Jimmo vs. Sebelius” MLN Matters® Article — Released
MLN Matters® Article #MM8458, “Manual Updates to Clarify Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Home Health (HH), and Outpatient (OPT) Coverage Pursuant to Jimmo vs. Sebelius” has been released and is now available in downloadable format. The article was prepared and is being distributed as a result of the settlement agreement in the case of Jimmo v. Sebelius. This article is designed to provide education on the updated portions of the “Medicare Benefit Policy Manual” (MBPM). It includes clarification on the coverage requirements of skilled nursing and skilled therapy services to Medicare beneficiaries.
MLN Matters® Article #MM8458, “Manual Updates to Clarify Skilled Nursing Facility (SNF), Inpatient Rehabilitation Facility (IRF), Home Health (HH), and Outpatient (OPT) Coverage Pursuant to Jimmo vs. Sebelius” has been released and is now available in downloadable format. The article was prepared and is being distributed as a result of the settlement agreement in the case of Jimmo v. Sebelius. This article is designed to provide education on the updated portions of the “Medicare Benefit Policy Manual” (MBPM). It includes clarification on the coverage requirements of skilled nursing and skilled therapy services to Medicare beneficiaries.
Coffee Klatches and ICD-10 Coder Academy
Join Us for a Coffee Klatch
2.0 CEU’s Available for Certified Coders!
The compliance date for ICD-10 implementation stands firm at October 1, 2014. ICD-10 will bring monumental changes to all physician practices and hospitals, and they face a significant financial impact; including claims denials, cash flow issues, and decreased productivity, if not adequately prepared for the ICD-10 transition.
RT Welter and Associates is hosting two "Coffee Klatches" on February 11th, 2014. The morning session will take place from 8–10 AM and the afternoon from 2–4 PM. This FREE “Coffee Klatch” is an excellent starting point for physician and hospital coders, and will provide an overview of ICD-10 including:
Discuss ICD-10 –CM-PCS Resources & References
(15 mins)
Discuss ICD-10-CM Coding Conventions
(15 mins)
Introduce ICD-10-CM Chapter Guidelines
(30 mins)
Discuss ICD-10-PCS Guidelines and Code Structure
(15 mins)
Introduce the 31 root operations in the Medical & Surgical Section of ICD-10-PCS
(15 mins)
Discuss Coder Academy Information
(15 mins)
Q&A
(15 mins)
Location:
Spine Education and Research Institute
9005 Grant Street, Suite 100
Thornton, CO 80229
We are offering 2.0 CEUs for this session, so make sure to register early!
CLICK HERE to register for the Coffee Klatch today!
ICD-10 Coder Academy – Sign Up Today for Registration Discounts!
This interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM and ICD-10-PCS codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.
Thornton, CO
February 19-21, 2014 — 8:00am – 5:00pm
Spine Education & Research Institute
9005 Grant Street, Suite 100 — Thornton, CO 80229
Englewood, CO
March 12-14, 2014 — 8:00am – 5:00pm
(On 3/13/14 training will be held from 9:00am – 6:00pm)
Swedish Medical Center – Pine B & C Conference Room
501 E. Hampden Avenue — Englewood, CO 80113
Registration Discounts:
Practices registering 3+ participants will receive $50.00 off each registration fee
Seating is limited, register now
to guarantee your spot today!
CLICK HERE TO READ MORE
2.0 CEU’s Available for Certified Coders!
The compliance date for ICD-10 implementation stands firm at October 1, 2014. ICD-10 will bring monumental changes to all physician practices and hospitals, and they face a significant financial impact; including claims denials, cash flow issues, and decreased productivity, if not adequately prepared for the ICD-10 transition.
RT Welter and Associates is hosting two "Coffee Klatches" on February 11th, 2014. The morning session will take place from 8–10 AM and the afternoon from 2–4 PM. This FREE “Coffee Klatch” is an excellent starting point for physician and hospital coders, and will provide an overview of ICD-10 including:
Discuss ICD-10 –CM-PCS Resources & References
(15 mins)
Discuss ICD-10-CM Coding Conventions
(15 mins)
Introduce ICD-10-CM Chapter Guidelines
(30 mins)
Discuss ICD-10-PCS Guidelines and Code Structure
(15 mins)
Introduce the 31 root operations in the Medical & Surgical Section of ICD-10-PCS
(15 mins)
Discuss Coder Academy Information
(15 mins)
Q&A
(15 mins)
Location:
Spine Education and Research Institute
9005 Grant Street, Suite 100
Thornton, CO 80229
We are offering 2.0 CEUs for this session, so make sure to register early!
CLICK HERE to register for the Coffee Klatch today!
ICD-10 Coder Academy – Sign Up Today for Registration Discounts!
This interactive and hands-on ICD-10 training is designed to prepare coders for the AAPC and AHIMA ICD-10 proficiency examinations. Participants will gain the tools they need to appropriately select ICD-10-CM and ICD-10-PCS codes. These training sessions will be coder centric, and the content will be designed for those staff who will be responsible for applying (or verifying) these codes to documentation. Throughout the academy, participants will be given an assortment of scenarios to code to obtain the proficiency they need for coding in ICD-10.
Thornton, CO
February 19-21, 2014 — 8:00am – 5:00pm
Spine Education & Research Institute
9005 Grant Street, Suite 100 — Thornton, CO 80229
Englewood, CO
March 12-14, 2014 — 8:00am – 5:00pm
(On 3/13/14 training will be held from 9:00am – 6:00pm)
Swedish Medical Center – Pine B & C Conference Room
501 E. Hampden Avenue — Englewood, CO 80113
Registration Discounts:
Practices registering 3+ participants will receive $50.00 off each registration fee
Seating is limited, register now
to guarantee your spot today!
CLICK HERE TO READ MORE
Friday, January 17, 2014
CMS Live Wire Jan. 2014
January 2014
Now available: Online Medicare fee schedule for viewing
Novitas has posted the 2014 downloadable Medicare physician fee schedule on their website. Go to http://tinyurl.com/2014-Novitas to download a text-delimited file of the latest fees.
This text file is formatted for viewing only. It is not formatted for importing into billing systems or other types of computer systems. Novitas will notify physicians and practices on their website and by e-mail when the 2014 physician fee schedules are available in PDF and Microsoft Excel formats appropriate for importing.
Lost on ICD-10? Get help now
The Colorado Medical Society is a key partner in the Colorado ICD-10 Training Coalition, which aims to help physician practices navigate the ICD-10 maze. The coalition held a monthly webinar series in 2013, all of which are available on-demand on the coalition's website.
With just 258 days remaining until the Oct. 1, 2014 ICD-10 implementation deadline, we urge practices to visit www.cms.org/icd-10 to catch up on these webinars, access spreadsheets and timeline templates, and more.
Updated CMS 1500 Claim Form version 02/12 now accepted
In June 2013, the National Uniform Claim Committee (NUCC) announced the approval of an updated 1500 Claim Form, version 02/12, that accommodates ICD-10-CM diagnosis codes and meets requirements in the Accredited Standards Committee X12 (ASC X12) Health Care Claim: Professional (837P) Version 5010 Technical Report Type 3.
Many payers began accepting the updated 1500 Claim Form version 02/12 starting on Jan. 6, 2014. Practices are urged to follow the guidelines set forth by the NUCC for completing the new claim form or else claims may be rejected. For more information about the revised 1500 Claim Form, please visit the National Uniform Claim Committee website, www.nucc.org, which provides helpful resources.
Please note that the NUCC's transition timeline for use of the 1500 Claim Form version 08/05 includes a dual submission period from Jan. 6, 2014 - March 31, 2014. Effective April 1, 2014, paper claims should be submitted using only the revised 1500 Claim Form version 02/12.
Check practice status in exchange provider directory
Connect for Health Colorado now has a provider directory available to the public. Anyone shopping for health insurance on the exchange website can search the directory for plans that include certain physicians and preferred hospitals.
Connect for Health Colorado asks providers to help communicate the availability of the directory to their patients as they shop for a health plan.
Physician practices and health care facilities are also encouraged to go online to confirm in which plans they are listed as members. Insurance carriers update the information in the provider directory every month and send it to the exchange to post on the site, completely replacing the prior month's data. Carriers are the only means of changing or correcting information in the directory. The exchange encourages physicians to work closely with them to correct any errors.
To check your practice's information, follow these steps.
1. From the www.ConnectforHealthCo.com home page, click on the "shop now" button under individual and families
2. At top of page, click on "Find a Plan"
3. Click on the second option on the page - "Browse health plans"
4. Fill in the ZIP code and birth month/year of a typical patient
5. Enter a provider name OR practice/facility name and click "Search"
6. Confirm it's the correct office/practice by clicking on the check mark where names are listed at top
7. Select "go back to plans" at the top of the page and view the plans for which you or your facility are listed
Open enrollment on the marketplace extends through March 31, 2014.
For Medicare claims to be paid, ordering/referring physicians
must be enrolled
Previously, physicians and health care providers who billed Medicare were required to list the name and National Provider Identifier (NPI) of the ordering/referring physician or health care provider on their claims in order to be paid.
Starting Jan. 6, 2014, if the ordering/referring physician or health care provider listed on the claim is not enrolled in Medicare OR does not have a valid opt-out affidavit on file, then the billing physician's claims will be denied. This requirement was originally scheduled to go into effect in 2010, but the American Medical Association and Medical Group Management Association (MGMA) successfully convinced the Centers for Medicare and Medicaid Services (CMS) to delay this several times so that more time could be given for physicians to enroll or opt-out.
Click here to read more in this bulletin from the AMA and MGMA.
Also note that the deadline to designate a provider's Medicare participation is Jan. 31, 2014. Click here to read more from the American Medical Association.
Medicaid preventive and wellness services effective Jan. 1, 2014
Beginning Jan. 1, 2014, Colorado Medicaid covers all recommended preventive and wellness services defined by the U.S. Preventive Services Task Force (USPSTF) with a rating of A or B and the Advisory Committee on Immunization Practices (ACIP) without patient cost sharing (co-payments).
Most USPSTF and ACIP recommended preventive and wellness services were previously covered by Medicaid, but beginning Jan. 1, 2014, new preventive and wellness procedure codes were made available.
Proper coding is critical to receiving accurate payment for the USPSTF and ACIP recommended preventive and wellness services. For more information about the preventive and wellness services procedure codes and their utilization go to Colorado.gov/HCPF/ProviderACAInfo.
In This Issue
Novitas Medicare physician fee schedule
ICD-10 help
CMS 1500 Claim Form version 02/12
Check Connect for Health Colorado listing
Medicare claims change
Medicaid preventive and wellness services
Events
Colorado Medical Group Management Association
Feb 12 - Outsourcing Your Revenue Cycle Management - Profit or Loss?, Bette Warn
March, April, May - Three-part series on LEAN for Private Physician Practices, Kearin Schulte
CMGMA webinars are free for active CMGMA members, $50 for non-members. Click here for more information on the CMGMA website.
Submit your event by e-mailing marilyn_rissmiller@cms.org.
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Colorado Indigent Care Program (CICP)
Colorado Indigent Care Program (CICP)
Health Care Reform Frequently Asked Questions (FAQ) for Providers
Signed into law on March 23, 2010, the Affordable Care Act (health reform law) has broad impact on those with and without insurance.
The CICP provides discounted health care services to low income individuals at participating providers. CICP is not insurance, rather the program seeks to partially compensate participating providers who care for the uninsured and underinsured at or below 250% of the Federal Poverty Level (FPL). Individuals enrolled in CICP cannot be eligible for Medicaid or Child Health Plan Plus (CHP+). Through 2014, participating health care providers will continue to be compensated for care given to those enrolled in CICP.
Individuals currently enrolled in CICP may be newly eligible for Medicaid or discounted health insurance coverage purchased through the Connect for Health Colorado marketplace beginning January 2014.
For a list of questions click here: How will CICP be affected by healthcare reform
Health Care Reform Frequently Asked Questions (FAQ) for Providers
Signed into law on March 23, 2010, the Affordable Care Act (health reform law) has broad impact on those with and without insurance.
The CICP provides discounted health care services to low income individuals at participating providers. CICP is not insurance, rather the program seeks to partially compensate participating providers who care for the uninsured and underinsured at or below 250% of the Federal Poverty Level (FPL). Individuals enrolled in CICP cannot be eligible for Medicaid or Child Health Plan Plus (CHP+). Through 2014, participating health care providers will continue to be compensated for care given to those enrolled in CICP.
Individuals currently enrolled in CICP may be newly eligible for Medicaid or discounted health insurance coverage purchased through the Connect for Health Colorado marketplace beginning January 2014.
For a list of questions click here: How will CICP be affected by healthcare reform
Thursday, January 16, 2014
THE Consortium Stage 1 & 2
THE Consortium: HIT Educational Webinar - January 23, 2014 - Stage 1 and 2 Changes-Use of DIRECT to send patient data and CORHIO
Register for this meeting here:https://cc.readytalk.com/r/8pw9gxhg6xmk&eom
Meeting Description:
Please gather your IT, QI and ICD-10 team and join us for the next in our series of HIT webinars on Thursday, January 23, 2014 from 12:00 pm to 1:15 pm.
Big Changes are in store for Stage 2 and the "Transitions of Care" Core Measure; We will focus on the use of "DIRECT" to send patient data to other providers and how CORHIO will help. Please don't miss this valuable webinar as we discuss the many options with CORHIO -- to ease the pain of Stage 2!
This webinar series is free to CRHC members and hospitals participating in the FY2013 SHIP grant program. All other facilities will be invoiced $49 following the webinar.
Presenter Information: David Ginsberg
David Ginsberg is co-founder and President of PrivaPlan Associates, Inc. and is the Senior Advisor for CRHC’s Technology for Healthcare Excellence (THE) Consortium and the Regional Extension Center program we have delivered over the last two years. He has more than 25 years of experience in the healthcare industry including expertise in managed care operations, IPA development, and physician-hospital strategic planning. Mr. Ginsberg has provided practice management consulting and outsourced services to hundreds of physician and allied health professional practices in his career and has practical real time knowledge about the realities of compliance in the physician/provider sector. Mr. Ginsberg has maintained an active practice in compliance audits and consulting and is nationally considered and expert in electronic medical and health records selection, readiness assessments and implementation.
Obesity and Depression Guidelines
Tuesday, February 25, 2014 12:30 - 1:30 pm (MT)
Register now at: http://goo.gl/IG6nYY
Aimee Trudeau, MPH, of the Colorado Department
of Public Health and Environment will discuss the
importance of co-treatment of obesity and depression.
The presentation is tailored for outpatient providers
and will also include valuable resources.
Register now at: http://goo.gl/IG6nYY
Aimee Trudeau, MPH, of the Colorado Department
of Public Health and Environment will discuss the
importance of co-treatment of obesity and depression.
The presentation is tailored for outpatient providers
and will also include valuable resources.
New Cardiac Guidelines
Tuesday, February 4, 2014 12:30 – 1:30 pm (MT)
Register now at: http://goo.gl/EsrIXz
Robert H. Eckel, MD, FAHA, member of the expert
workgroup responsible for the 2013 AHA/ACC Lifestyle
Management Guidelines will present.
Register now at: http://goo.gl/EsrIXz
Robert H. Eckel, MD, FAHA, member of the expert
workgroup responsible for the 2013 AHA/ACC Lifestyle
Management Guidelines will present.
Colorado’s All Payer Claims Database Update
Tuesday, January 28, 2014 12:30 – 1:30 pm (MT)
Register now at: http://goo.gl/uGcXhJ
CIVHC is working to increase transparency and
accountability in Colorado’s health care system by making
comparative cost, quality and safety data for all providers,
health plans and medical facilities available to consumers
and businesses statewide. As of December 2013, the APCD
includes 2009-2012 historic claims data representing over
2.5 million Coloradans. Having access to this information,
gives Coloradans the ability to choose the best, most
affordable health care for themselves and their families,
and gives providers incentives to contain costs and ensure
consistently high-quality care.
Aggregated price and quality indicators for commonly used
medical services will be available on the public website,
www.cohealthdata.org on a provider-group name basis.
This information will allow providers, health plans and
patients to compare price and quality across physician
groups.
Physicians and physician groups can use the APCD to
identify opportunities to control costs and improve care by
understanding their patient population health utilization
and costs associated with care for their patient population.
Register now at: http://goo.gl/uGcXhJ
CIVHC is working to increase transparency and
accountability in Colorado’s health care system by making
comparative cost, quality and safety data for all providers,
health plans and medical facilities available to consumers
and businesses statewide. As of December 2013, the APCD
includes 2009-2012 historic claims data representing over
2.5 million Coloradans. Having access to this information,
gives Coloradans the ability to choose the best, most
affordable health care for themselves and their families,
and gives providers incentives to contain costs and ensure
consistently high-quality care.
Aggregated price and quality indicators for commonly used
medical services will be available on the public website,
www.cohealthdata.org on a provider-group name basis.
This information will allow providers, health plans and
patients to compare price and quality across physician
groups.
Physicians and physician groups can use the APCD to
identify opportunities to control costs and improve care by
understanding their patient population health utilization
and costs associated with care for their patient population.
Wednesday, January 15, 2014
Swing Bed Part I Webinar
Swing Bed Part 1 Thu, Jan 23, 2014 - 12:00 PM MST
Click here to register
Join the Colorado Rural Health Center (CRHC) for Part I in a 2-part webinar series on Swing Bed usage in Critical Access Hospitals. Utilizing swing beds in Critical Access Hospitals provides a viable option at the local community level for patients in need of skilled care. Additionally, swing bed usage for rehabilitation can strengthen relationships between Critical Access Hospitals and larger tertiary facilities subject to Inpatient Rehab Facility rules that limit treatment for specified conditions.
During the CAH Swing Bed Webinar Part I, experts from the Joffit Group will cover a comprehensive overview of Medicare Swing Bed regulations for CAH Swing Beds including:
Introduction
Overview of Critical Access Hospital Program
Overview of Financial Benefit
Benefit and Eligibility Criteria for Swing Bed
Staff and Physician Information
Patient Transfer Process
Post-Acute Care Transfer Payment Policy
Patient and Family Swing Bed Information
Provisions of Clinical Care and Documentation Requirements
Registration Fees
Registration Fees for the CAH Swing Bed Webinars (you will be invoiced after the webinar):
CRHC Members - FREE
Non-members - $99
To see if you facility is a current CRHC member, click here.
Click here to register
Join the Colorado Rural Health Center (CRHC) for Part I in a 2-part webinar series on Swing Bed usage in Critical Access Hospitals. Utilizing swing beds in Critical Access Hospitals provides a viable option at the local community level for patients in need of skilled care. Additionally, swing bed usage for rehabilitation can strengthen relationships between Critical Access Hospitals and larger tertiary facilities subject to Inpatient Rehab Facility rules that limit treatment for specified conditions.
During the CAH Swing Bed Webinar Part I, experts from the Joffit Group will cover a comprehensive overview of Medicare Swing Bed regulations for CAH Swing Beds including:
Introduction
Overview of Critical Access Hospital Program
Overview of Financial Benefit
Benefit and Eligibility Criteria for Swing Bed
Staff and Physician Information
Patient Transfer Process
Post-Acute Care Transfer Payment Policy
Patient and Family Swing Bed Information
Provisions of Clinical Care and Documentation Requirements
Registration Fees
Registration Fees for the CAH Swing Bed Webinars (you will be invoiced after the webinar):
CRHC Members - FREE
Non-members - $99
To see if you facility is a current CRHC member, click here.
Utilization Management Webinar -
Tue, Jan 21, 2014 - 12:00 PM MST
Click here to register
Join the Colorado Rural Health Center for this webinar on Utilization Management (UM) and Utilization Review (UR) for CAHs. All hospitals, including CAHs, must have a UM/UR Plan that describes the process used to review all services provided by the institution and by the members of the medical staff. In addition to assuring optimal healthcare delivery and positive patient outcomes, sound UM/UR practices are integral to achieving successful results during activities such as RA audits.
Experts from the Joffit Group, will discuss the components involved in setting up an efficient UM/UR process and will review CRHC's Utilization Management Resource for Critical Access Hospitals: a concise, easy-to-use tool for hospital providers and staff that explains the role of UM/UR in various CAH settings including: Inpatient, Outpatient, Observation, and Swing Bed. This resource includes:
New information and additional clarification of old UM regulations
New information regarding the Recovery Audit process
Key UM/UR Concepts and Examples
Regulatory and Audit Impacts (including RAC, MIC, and CERT)
UM Plan Example
Checklists for Developing Comprehensive UM/UR Processes
FAQ's, Quick Reference Guides, and Resource Links
Registration Fees
Registration Fees (you will be invoiced after the webinar):
CRHC Member Colorado CAHs : FREE
Non-member Colorado CAHs: $79
All other registrants: $99
To see if you facility is a current CRHC member, click here.
Click here to register
Join the Colorado Rural Health Center for this webinar on Utilization Management (UM) and Utilization Review (UR) for CAHs. All hospitals, including CAHs, must have a UM/UR Plan that describes the process used to review all services provided by the institution and by the members of the medical staff. In addition to assuring optimal healthcare delivery and positive patient outcomes, sound UM/UR practices are integral to achieving successful results during activities such as RA audits.
Experts from the Joffit Group, will discuss the components involved in setting up an efficient UM/UR process and will review CRHC's Utilization Management Resource for Critical Access Hospitals: a concise, easy-to-use tool for hospital providers and staff that explains the role of UM/UR in various CAH settings including: Inpatient, Outpatient, Observation, and Swing Bed. This resource includes:
New information and additional clarification of old UM regulations
New information regarding the Recovery Audit process
Key UM/UR Concepts and Examples
Regulatory and Audit Impacts (including RAC, MIC, and CERT)
UM Plan Example
Checklists for Developing Comprehensive UM/UR Processes
FAQ's, Quick Reference Guides, and Resource Links
Registration Fees
Registration Fees (you will be invoiced after the webinar):
CRHC Member Colorado CAHs : FREE
Non-member Colorado CAHs: $79
All other registrants: $99
To see if you facility is a current CRHC member, click here.
CAH Method II Overpayments Related to Annual Wellness Visit
In July 2013, Medicare Administrative Contractors (MACs) began to recover overpayments on Annual Wellness Visit (AWV) claims with dates of service on and after January 1, 2011 that were processed by Medicare on and after April 4, 2011 through March 31, 2013 (see MLN Matters® Article # 8153).
It was subsequently determined that both the professional and technical components of Method II critical access hospital (CAH) claims had been identified as overpayments and recouped in error. Method II CAHs are entitled to payment for the professional components of these claims. In September, a system update prevented the problem going forward. Another systems update is planned for February that will allow MACs to refund the professional components of these claims that were recouped in error. Method II CAHs should not resubmit claims unless directed to do so by their MAC. For more information, click here.
Tuesday, January 14, 2014
Health Care Delivery, Information Exchange and the Future of Electronic Quality Measurement
Industry Talks about Health Care Delivery, Information Exchange and the Future of Electronic Quality Measurement
By Robert Tagalicod, Director, Office of E-Health Standards and Services
We were excited to see a full room and hear robust discussions at CMS headquarters in Baltimore during our eHealth Summit on December 6. Four dynamic panels of health care thought leaders shared their insights into successes and challenges they are facing in implementing eHealth initiatives.
For those of you unable to join us in person or online, let me highlight some of the key issues discussed related to innovative health care delivery models, Stage 3, health information exchange, and clinical quality measures.
Health IT Innovation in New Health Care Delivery Models
The first panel discussed how new health care delivery models are improving patient care by using EHRs and exchanging patient information. Panelists explained that the improvements were a result of statewide health information sharing, real-time alerts to doctors when a patient checks in to a hospital, using data warehouses to stratify patients by risk, and using this data to focus care for these patients in a clinical setting.
The panelists also talked about the challenges involved in building and connecting systems that safely store and transmit meaningful patient data across disparate platforms. Suggestions to fix these challenges included common standards that would allow systems to communicate with each other across state lines and making sure programs provide financial benefits to providers who participate.
Trends in Health Information Exchange (HIE) Organizational Staffing
During this panel, AHIMA and HIMSS provided an overview of research they conducted in 2011 on HIE organizations. The majority of the organizations were small and struggled to find staff that could support technology and operational needs, highlighting these important challenges.
The panelists, who represented HIMSS, AHIMA, and an HIE in Oklahoma, concluded that the current goals of HIEs would benefit from additional support, and asked that CMS prioritize the issue of HIE staffing and explore ideal staffing models.
Stage 3 Meaningful Use
Vendors, payers, and providers reflected on Stage 1 and 2 meaningful use requirements and provided recommendations for Stage 3 in our third panel. Lauding the progress industry has made with health IT implementation, the panel also discussed concerns about the lack of time for providers to prepare for each stage. The panelists acknowledged that while Stage 3 will require a significant effort, it will undoubtedly support improved care outcomes.
As you may know, CMS proposed a new meaningful use timeline following the summit. Make sure to read the blog by Dr. Jacob Reider and me on the details, and how we are working to address concerns expressed during the Summit.
eReporting and the Future of Quality Measurement
Our final panel of the day focused on the development of electronic clinical quality measures (eCQMs), which help to streamline quality reporting and provide invaluable data which supports CMS policy decisions and informs best practices for improving the health of patients in our country.
CMS works with industry to establish eCQMs that can be used by different types of providers in their practice routines. Panelists noted challenges with properly testing eCQMs, as timelines are often compressed, and the need for additional patient data for field testing. In addition, panelists highlighted the importance of focusing on de novo electronic measure development – that is creating new measures specifically designed for an electronic platform – in order to maximize the potential return from quality measurement programs.
What’s Next?
As I said at the Summit, CMS appreciates and carefully reviews the feedback and insights from the panelists who contribute their time to present their findings and tell us about their experiences. These discussions provide helpful information as we continue with health IT implementation and the eHealth programs. We look forward to our next Summit on February 14, and continuing this ongoing collaboration with the health care industry.
Make sure to watch the morning and afternoon video sessions from our Summit, and review this blog on our eHealth website.
February 11, 2014 Part A/B "IHS Ask the Contractor Teleconference"
Upcoming Events
JH Part A/B Teleconference Handout: "Indian Health Services (IHS) Ask-the-Contractor Teleconference" - February 11, 2014 (1:00pm-2:30pm CT)
Join us for our "Indian Health Services (IHS) Ask-the-Contractor Teleconference" on February 11, 2014 (1:00pm-2:30pm CT). During this teleconference, we will discuss the most current Medicare changes and allow you to interact directly with representatives from various departments within Novitas Solutions. Register for this informative teleconference today.
Novitas Updates
Customer Contact Center - No Training January 24, 2014
The Customer Service Units will not close for training on January 24, 2014. The lines will remain open until 5:00 PM CT. 1-855-252-8782
Holding claims with 2014 dates of service
Medicare administrative contractors will be holding some claims containing 2014 service dates for up to the first 10 business days of January 2014 (i.e., Thursday, January 2 through Wednesday, January 15).
Functional Therapy Reporting Requirements
Are you finding that you have questions on Functional Therapy G-codes? Here are some helpful links with valuable information on this topic.
Introduction to Functional Therapy Reporting Requirements
MLN Matters Article MM8005: Implementation of the Claims-Based Data Collection Requirement for Outpatient Therapy Services
Quick Reference Chart for G-Codes
Physical Therapy, Occupational Therapy, and Speech Langauge Pathology FAQs
Our Outreach and Education department will be offering webinars on Functional Therapy Reporting Requirements in the near future. Make sure to check our Outreach and Education Center from time to time for a listing of dates and times for this upcoming event.
The Customer Service Units will not close for training on January 24, 2014. The lines will remain open until 5:00 PM CT. 1-855-252-8782
Holding claims with 2014 dates of service
Medicare administrative contractors will be holding some claims containing 2014 service dates for up to the first 10 business days of January 2014 (i.e., Thursday, January 2 through Wednesday, January 15).
Functional Therapy Reporting Requirements
Are you finding that you have questions on Functional Therapy G-codes? Here are some helpful links with valuable information on this topic.
Introduction to Functional Therapy Reporting Requirements
MLN Matters Article MM8005: Implementation of the Claims-Based Data Collection Requirement for Outpatient Therapy Services
Quick Reference Chart for G-Codes
Physical Therapy, Occupational Therapy, and Speech Langauge Pathology FAQs
Our Outreach and Education department will be offering webinars on Functional Therapy Reporting Requirements in the near future. Make sure to check our Outreach and Education Center from time to time for a listing of dates and times for this upcoming event.
Part A Tie-in Process Explained
Medicare News
Part A Tie-in Process Explained
Novitas has published a refresher article on the Part A Tie In/Tie Out Process! In this article we provide additional information, resources and tips on who to contact with your questions. You can read the whole article by clicking here
MLN Connects Provider e-News
MLN Connects Provider e-News
The January 9, 2014 edition of the MLN Connects Provider e-News * is now available.
The January 9, 2014 edition of the MLN Connects Provider e-News * is now available.
Evaluation an Management Score Sheet Part Two:
Upcoming Events
"Evaluation and Management Score Sheet Part Two: Introduction to the Score Sheet"- January 14, 2014 10:00am -11:00am CT
Join us as for Part Two-"Introduction to the Score Sheet "of the new series on Evaluation and Management Services. This four part series was developed to increase your understanding of evaluation and management services. The series will highlight coding instructions, documentation requirements, assist you in locating valuable resources and provide our philosophy on scoring and auditing documentation. The complete series will be presented every month with one part each week. It is recommended to take the entire series in order to maximize your understanding. However, if you miss any part of the series, it will be presented again the following month in the same order. You have the opportunity to gain four continuing education units for completing the entire series. If you are new to documenting and/or scoring evaluation and management services, this is for you. It is recommended you complete this four part series before registering for any other Novitas evaluation and management event.
The series will consist of the following:
•Week One-Part One- Understanding the Key components of Evaluation and Management.
•Week Two-Part Two- Introduction to the Score Sheet,
•Week Three- Part Three- Using the Score Sheet
•Week Four- Part Four- Scoring Medical Records Using the Score Sheet.
This series was developed to increase your understanding of evaluation and management services. We will review coding instructions, documentation requirements and assist you in locating valuable resources while providing our philosophy of scoring and auditing documentation. If you are new to documenting and/or scoring evaluation and management services, this webinar event is for you. You must attend this event. Don't miss it, register today!
"Evaluation and Management Score Sheet Part Two: Introduction to the Score Sheet"- January 14, 2014 10:00am -11:00am CT
Join us as for Part Two-"Introduction to the Score Sheet "of the new series on Evaluation and Management Services. This four part series was developed to increase your understanding of evaluation and management services. The series will highlight coding instructions, documentation requirements, assist you in locating valuable resources and provide our philosophy on scoring and auditing documentation. The complete series will be presented every month with one part each week. It is recommended to take the entire series in order to maximize your understanding. However, if you miss any part of the series, it will be presented again the following month in the same order. You have the opportunity to gain four continuing education units for completing the entire series. If you are new to documenting and/or scoring evaluation and management services, this is for you. It is recommended you complete this four part series before registering for any other Novitas evaluation and management event.
The series will consist of the following:
•Week One-Part One- Understanding the Key components of Evaluation and Management.
•Week Two-Part Two- Introduction to the Score Sheet,
•Week Three- Part Three- Using the Score Sheet
•Week Four- Part Four- Scoring Medical Records Using the Score Sheet.
This series was developed to increase your understanding of evaluation and management services. We will review coding instructions, documentation requirements and assist you in locating valuable resources while providing our philosophy of scoring and auditing documentation. If you are new to documenting and/or scoring evaluation and management services, this webinar event is for you. You must attend this event. Don't miss it, register today!
CMS Medicare Learning Network Matters Articles
Medicare Learning Network Matters Articles from CMS
New:
SE1344 – Further Information on Mandatory Reporting of an 8-Digit Clinical Trial Number on Claims
SE1343 – Medicare System Project for Electronic Submission of Medical Documentation (esMD)
Revised:
MM8553 – Expansion of Medicare Telehealth Services for CY 2014
Part B Compounded Drugs Used in an Implantable Infusion Pump
Effective December 1, 2013, Novitas Solutions will reimburse compounded drugs used in an implantable infusion pump based on the acquisition cost reported on the claim.
The JH Part B Inquiries Frequently Asked Questions (FAQs) have been updated. Please visit our FAQs for the answers to your questions.
New:
SE1344 – Further Information on Mandatory Reporting of an 8-Digit Clinical Trial Number on Claims
SE1343 – Medicare System Project for Electronic Submission of Medical Documentation (esMD)
Revised:
MM8553 – Expansion of Medicare Telehealth Services for CY 2014
Part B Compounded Drugs Used in an Implantable Infusion Pump
Effective December 1, 2013, Novitas Solutions will reimburse compounded drugs used in an implantable infusion pump based on the acquisition cost reported on the claim.
The JH Part B Inquiries Frequently Asked Questions (FAQs) have been updated. Please visit our FAQs for the answers to your questions.
Electronic Prescribing (eRx)
Electronic Prescribing (eRx)
HCPCS G8553 that was used for eRx claims is no longer valid for claims billed dates of service
01/01/2014 and after.
HCPCS G8553 that was used for eRx claims is no longer valid for claims billed dates of service
01/01/2014 and after.
2014 Physician Fee Schedule
Medicare News
2014 Physician Fee Schedule - Downloads Available!
The 2014 Physician Fee Schedules have been added in several formats. You can download these files in Microsoft Excel, Adobe PDF, or in a text-delimited file. These codes have also been loaded into our Fee Schedule Lookup Tool
Note:
These files include the 0.5 percent payment update that was signed into law with the Pathway for SGR Reform Act of 2013 on December 26, 2013 by President Obama, and are effective January 1, 2014 through March 31, 2014.
Retooling after Rejection
Retooling after Rejection
No one likes criticism or rejection, but it happens to everyone. Critiques aren’t personal and can serve
as a guide for reframing and refocusing work. The combination of learning from critiques and
collaborating with your RETAC Coordinator, Colorado Rural Health Center CREATE Staff and your
internal leadership on a new application can prove crucial to your success. If your application review
points out flaws in the first submission, take them seriously in preparing a resubmission. Sometimes
small revisions and clarifications might satisfy the reviewers the second time around. Other times,
you may need to completely rethink the idea or your methods. The comments will help you decide
the next step appropriately. Take the time during the retooling process review the CREATE scoring
tool found on the website and compare to your CREATE review score to easily identify what area’s
needed improvement. When in doubt on how to proceed next, contact Lakesha Jones, CREATE
Grants Manager for assistance by email at lj@coruralhealth.org or by phone at (720) 248-2742.
Thursday, January 9, 2014
CMS will begin reinforcement of supervision requirements at CAHs
CMS will begin reinforcement of supervision requirements at CAHs
Hospitals are required to ensure that a physician or qualified non-physician provider provides direct supervision of outpatient therapeutic services, including chemotherapy administration and radiation therapy.
Although Critical Access Hospitals (CAHs) were encouraged to comply with the regulation, for the past several years CMS indicated that it would not enforce the requirements for small rural hospitals. In 2014, CAHs will be expected to be in compliance with all supervision requirements in order to be eligible for Medicare reimbursement.
Complying with the supervision requirement is resource intensive. Prior to 2010, most hospitals assumed that simply locating their outpatient departments on the hospital's campus, where physicians were working at all hours, was sufficient to meet CMS’s supervision requirements.
Following the "clarification" CMS issued in 2010, many hospitals had to hire additional physicians or advanced practice providers to ensure that a qualified clinician was available to supervise care in infusion and radiation therapy centers.
CAHs are now concerned that the enforcement of the supervision requirements will force them to close outpatient departments, including infusion centers, thus making it more difficult for their patients to access care.
CMS Final Rule Release
CMS Final Rule Release
Since March 2010, CMS has instructed all Medicare contractors not to enforce supervision requirements for outpatient therapeutic services provided in critical access hospitals (CAHs). In CY 2011, this policy was expanded to small rural hospitals having 100 beds or fewer.
CMS is not extending this non-enforcement policy for CY 2014, and it will expire on December 31, 2013. This means that CAHs and small rural hospitals will have to comply with the same supervision requirements as other outpatient hospitals.
In the Final Rule, CMS stated that it would allow the non-enforcement of the supervision requirement for therapeutic services for CAHs and small rural hospitals to expire on December 31, 2013. Therefore, beginning January 1, 2014, CAHs and small rural hospitals will be required to abide by the supervision requirements for therapeutic services.
The Final Rule amends the Medicare conditions of payment for therapeutic outpatient hospital or CAH services and supplies furnished “incident to” a physician’s or non-physician practitioner’s service to require individuals furnishing such services be qualified to furnish those services under the scope of practice laws of the state in which the services are provided. Previously, CMS generally deferred to hospitals to ensure that practitioners were following state scope of practice and other rules related to delivery of health care services.
This change makes clear that Medicare contractors could deny or recoup payment for outpatient therapeutic services performed “incident to” a physician’s or non-physician practitioner’s service if such services are not furnished in accordance with state law. CMS did state that this does not impose any new requirements on providers since they are already required to comply with state law.
For More information on the Final Rule click here.
PiHQ: January 30th, 2014 QHi Back to Basics Webinar
PiHQ: Partners in Healthcare Quality:
Event: QHi Back to Basics 1/30/14
Location: Webinar/Conference Call
Starts At: 1/30/14, 2:00 p.m.
Ends At: 1/30/14, 3:00 p.m.
All QHi participants are invited to join our next QHi Back to Basics Session scheduled for Thursday, January 30 from 2:00 to 3:00 PM Central Time. During this session, we will walk through the live site demonstrating the basics of selecting measures, adding users, entering data and running reports. New enhancements and measure updates will be presented as well.
We will leave time at the end for an open forum so please bring questions for your peers.
All QHi webinars are free and open to all users.
Please click here or enter https://cc.readytalk.com/r/p7db4g7p7i25&eom into your web browser to register for the session.
Event: QHi Back to Basics 1/30/14
Location: Webinar/Conference Call
Starts At: 1/30/14, 2:00 p.m.
Ends At: 1/30/14, 3:00 p.m.
All QHi participants are invited to join our next QHi Back to Basics Session scheduled for Thursday, January 30 from 2:00 to 3:00 PM Central Time. During this session, we will walk through the live site demonstrating the basics of selecting measures, adding users, entering data and running reports. New enhancements and measure updates will be presented as well.
We will leave time at the end for an open forum so please bring questions for your peers.
All QHi webinars are free and open to all users.
Please click here or enter https://cc.readytalk.com/r/p7db4g7p7i25&eom into your web browser to register for the session.
FY15 Funding Applications Open
FY15 Funding Applications Open --
Approximately $6.7 million is available through grants and system improvement funding for organizations involved in providing emergency medical and trauma services in Colorado.
Apply for these funds at www.coems.info under the Funding Program tab. Read the full FY15 Funding Guide for details or contact Jeanne-Marie Bakehouse and/or Michael Gerber with questions. Applications will be accepted until Feb. 14 at 5 p.m.
Approximately $6.7 million is available through grants and system improvement funding for organizations involved in providing emergency medical and trauma services in Colorado.
Apply for these funds at www.coems.info under the Funding Program tab. Read the full FY15 Funding Guide for details or contact Jeanne-Marie Bakehouse and/or Michael Gerber with questions. Applications will be accepted until Feb. 14 at 5 p.m.
Wednesday, January 8, 2014
Writing An Effective Budget Narrative
Writing An Effective Budget Narrative
The budget narrative is essential in justifying project costs to the grant reviewers. An effective budget narrative explains how the funds would be spent, why the course is important, and why it is cost effective. The narrative must tell the reader more then why the costs are needed but give a mental picture of the impact that can be made with the grant funds being requested. Addressing unorthodox purchases or large expenditures will help the reviewers understand the budgeting practices of the entity and help justify the need. Write each justification with “cost effectiveness” in mind. Show evidence to convince the reviewer that the course would make an impact worth the price and is a necessity. Identify the specific goals and objectives of the proposal that correspond with each budget category, equally, state why the course is important to the mission of the organization. Identifying prices of expected costs when writing your budget narrative are always important as well, do not require the reader to look back at the budget and “assume” what things will cost. If costs are based on projections only, give details on how the costs were estimated, and attach copies of estimates to the proposal.
****If you happen to be in the Durango area on Wednesday, January 15th, join us for a Grant Writing Workshop at the Durango Fire Department from 1pm – 4pm. Contact Lakesha for more information*********
The budget narrative is essential in justifying project costs to the grant reviewers. An effective budget narrative explains how the funds would be spent, why the course is important, and why it is cost effective. The narrative must tell the reader more then why the costs are needed but give a mental picture of the impact that can be made with the grant funds being requested. Addressing unorthodox purchases or large expenditures will help the reviewers understand the budgeting practices of the entity and help justify the need. Write each justification with “cost effectiveness” in mind. Show evidence to convince the reviewer that the course would make an impact worth the price and is a necessity. Identify the specific goals and objectives of the proposal that correspond with each budget category, equally, state why the course is important to the mission of the organization. Identifying prices of expected costs when writing your budget narrative are always important as well, do not require the reader to look back at the budget and “assume” what things will cost. If costs are based on projections only, give details on how the costs were estimated, and attach copies of estimates to the proposal.
****If you happen to be in the Durango area on Wednesday, January 15th, join us for a Grant Writing Workshop at the Durango Fire Department from 1pm – 4pm. Contact Lakesha for more information*********
CCHN Loan Repayment Opportunity
CCHN Announces Loan Repayment Opportunity for Safety Net Clinical Support Staff
The Colorado Community Health Network (CCHN) is excited to announce that the Kaiser Permanente Educational Loan Repayment for Safety Net Clinical Support Staff program is officially open. The application cycle is open from January 6-31, 2014.
CCHN was funded by the Kaiser Permanente Community Health Fund to administer a loan repayment program for clinical support staff working at Community Health Centers (CHCs), ClinicNET Safety Net Clinics, and Rural Health Clinics in Colorado. Loan repayment will help ease the burden of prior educational debt for clinical support staff in exchange for a one year service commitment to the safety net clinic. The Kaiser Permanente Educational Loan Repayment for Safety Net Clinical Support Staff program will help modernize and expand the safety net workforce by supporting recruitment and retention of high performing clinical support staff committed to serving in underserved areas.
There are two ways to complete applications:
The Colorado Community Health Network (CCHN) is excited to announce that the Kaiser Permanente Educational Loan Repayment for Safety Net Clinical Support Staff program is officially open. The application cycle is open from January 6-31, 2014.
CCHN was funded by the Kaiser Permanente Community Health Fund to administer a loan repayment program for clinical support staff working at Community Health Centers (CHCs), ClinicNET Safety Net Clinics, and Rural Health Clinics in Colorado. Loan repayment will help ease the burden of prior educational debt for clinical support staff in exchange for a one year service commitment to the safety net clinic. The Kaiser Permanente Educational Loan Repayment for Safety Net Clinical Support Staff program will help modernize and expand the safety net workforce by supporting recruitment and retention of high performing clinical support staff committed to serving in underserved areas.
There are two ways to complete applications:
Online - Access the online application here, or
Hard Copy - Access the hard copy application here.
Listed below is more information regarding eligibility, requirements and terms, and application materials. For more information, please review the entire application document here.
Eligibility: Clinical support staff who have worked for at least six (6) months at CHCs, ClinicNET Safety Net Clinics, and Rural Health Clinics in Colorado are eligible to apply.
Clinical support staff may include professions such as:
Dental assistant, dental hygienist, expanded duties dental assistant, lab technician, licensed practical nurse, medical assistant, nursing aide, pharmacy technician, phlebotomist, licensed practical nurse, registered nurse, ultrasound technician, and x-ray technician. (Please note that this is not an exhaustive list; however, CCHN cannot issue loan repayment for positions higher than a registered nurse or requiring more than a bachelor’s degree).
Applicants are eligible for up to $10,000 in loan repayment, dependent on their completed years of service at their place of employment. Awardees are not eligible to reapply for additional loan repayment in future repayment cycles.
Requirements and Terms: Applicants who submit all required paperwork by January 31, 2014, will be considered for loan repayment. Applicants will be notified within one month of the application due date. Loan repayments will be made directly to the loan servicing companies in one lump sum approximately in April 2014.
Applicant must be employed at their current safety net clinic for at least six months and be in good standing with their employer.
Applicant must have successfully completed a certificate or degree at an accredited health professional training institution.
Applicant is required to complete an employment commitment to the safety net clinic of one year, upon receipt of the award and as specified in a contract.
Loan repayment requests must be for education expenses related to the health professions training and the applicant’s current position.
Debt must be in good standing. CCHN will make loan repayments directly to the lending institution or loan servicing organization. Payments will not be made to private parties or debt collectors.
Awardees are required to attend one CCHN financial learning webinar and 4 of 6 leadership and skill development webinars during the one year service commitment. These webinars will be recorded and available online for viewing at the awardee’s convenience.
Awardees who do not complete a year of service to their safety net clinic after their award for any reason other than death, disability or the written permission of CCHN, will be required to pay full loan award plus a 10% administrative fee back to CCHN.
Application Materials: Along with the application, applicants are required to submit the following information.
- Applicant Information & Employment Information
- Loan Repayment Information & Proof of Educational Debt
- One Supervisor Letter of Recommendation
- Personal Statement, Signed and Dated
- Documentation of Successful Completion of Education/Training Program
- Signed and dated Executive Leadership Sponsorship
- Signed and Dated Applicant Obligation Statement
If you have any questions, feel free to contact Angela Rose at 303-867-9511 or at Angela@cchn.org, or you can contact Stephanie Auxier at 303-867-9514 or at SAuxier@cchn.org.
The Arizona Telemedicine Program Blog
The Arizona Telemedicine Program Blog
Bringing you stories about telemedicine, telehealth & technology in health care
Vida! Engaging Citizens in Their Own Health
By Ana Maria Lopez on Dec 31, 2013 08:00 am
¡Vida! emerged from work with breast cancer survivors who, despite five years or more since the breast cancer diagnosis, clearly articulated their goal not only to live, but to live well.
Named from the Spanish word meaning “life,” ¡Vida! is a monthly partner educational series for patients and their professional health care teams. Guided by a broad-based Community Partnership Group, ¡Vida! has been proactively addressing the identified needs of patients and their families across the state of Arizona.
While ¡Vida! originally began with a focus on breast cancer survivorship, the series has evolved to include topics related to lifestyle medicine, wellness, and advocacy with the overarching goal of engaging Arizona’s citizens in their own health!
Read more »
Bringing you stories about telemedicine, telehealth & technology in health care
Vida! Engaging Citizens in Their Own Health
By Ana Maria Lopez on Dec 31, 2013 08:00 am
¡Vida! emerged from work with breast cancer survivors who, despite five years or more since the breast cancer diagnosis, clearly articulated their goal not only to live, but to live well.
Named from the Spanish word meaning “life,” ¡Vida! is a monthly partner educational series for patients and their professional health care teams. Guided by a broad-based Community Partnership Group, ¡Vida! has been proactively addressing the identified needs of patients and their families across the state of Arizona.
While ¡Vida! originally began with a focus on breast cancer survivorship, the series has evolved to include topics related to lifestyle medicine, wellness, and advocacy with the overarching goal of engaging Arizona’s citizens in their own health!
Read more »
TWO MIDNIGHT RULE CMS WEBINAR!!!!
TWO MIDNIGHT RULE CMS WEBINAR!!!!
Description:
This MLN Connects™ National Provider Call provides an overview of the inpatient hospital admission and medical review criteria (also known as the 2-Midnight Rule) that was released on August 2, 2013 in the FY 2014 Inpatient Prospective Payment System/Long-Term Care Hospital final rule (CMS-1599-F). CMS presents case scenarios on the application of the rule to sample medical records. Following the presentation, CMS will address frequently asked questions received from providers.
When: Tuesday, January 14, 2014
Time: 1:30 PM - 3:00 PM Eastern Time
Target Audience:
Hospitals, physicians and non-physician practitioners, case managers, medical and specialty societies, and other healthcare professionals.
Agenda:
· Summary of the 2-Midnight Rule
· Case example presentation
· Question and answer session
Call Materials:
A link to the slide presentation will be posted to this page prior to the call. A link to the audio recording and written transcript of this call will be posted to this web page in approximately 2 weeks following the call.
Registration:
To register for an MLN Connects National Provider Call, please visit the CMS MLN Connects Upcoming Calls registration website.
· Review the frequently asked questions on the HELP page.
· If you need additional assistance with registration, please email us at cms-mlnconnectsnpc@blhtech.com.
· If you require services for the hearing impaired, please email your request to npc-mlnconnectsttt@blhtech.com no later than 3 business days before the event.
For More Information:
More information is available on the Inpatient Hospital Review web page at go.cms.gov/InpatientHospitalReview
Description:
This MLN Connects™ National Provider Call provides an overview of the inpatient hospital admission and medical review criteria (also known as the 2-Midnight Rule) that was released on August 2, 2013 in the FY 2014 Inpatient Prospective Payment System/Long-Term Care Hospital final rule (CMS-1599-F). CMS presents case scenarios on the application of the rule to sample medical records. Following the presentation, CMS will address frequently asked questions received from providers.
When: Tuesday, January 14, 2014
Time: 1:30 PM - 3:00 PM Eastern Time
Target Audience:
Hospitals, physicians and non-physician practitioners, case managers, medical and specialty societies, and other healthcare professionals.
Agenda:
· Summary of the 2-Midnight Rule
· Case example presentation
· Question and answer session
Call Materials:
A link to the slide presentation will be posted to this page prior to the call. A link to the audio recording and written transcript of this call will be posted to this web page in approximately 2 weeks following the call.
Registration:
To register for an MLN Connects National Provider Call, please visit the CMS MLN Connects Upcoming Calls registration website.
· Review the frequently asked questions on the HELP page.
· If you need additional assistance with registration, please email us at cms-mlnconnectsnpc@blhtech.com.
· If you require services for the hearing impaired, please email your request to npc-mlnconnectsttt@blhtech.com no later than 3 business days before the event.
For More Information:
More information is available on the Inpatient Hospital Review web page at go.cms.gov/InpatientHospitalReview
New Allied Health Job Board with Colorado Provider Recruitment!
New
Allied Health Job Board with Colorado Provider Recruitment!
Colorado
Provider Recruitment (CPR) will be incorporating an Allied Health Specific Job
Board to better serve your recruitment needs! We welcome you to post any
clinical or non-clinical opening you have that CPR does not already recruit
for. From there, interested candidates will contact you directly. The best
part? This service is free to you, as a member of the Colorado Rural Health Center!**
For a full listing of positions CPR is actively recruiting for, please click here.
Tuesday, January 7, 2014
CAHs This is a huge billing change in 2014!
This code does not apply to CAHs (for now).
This is a huge billing change in 2014! CMS has implemented a policy to combine outpatient clinic evaluation and management visit codes into one APC. CMS finalized a policy that eliminated the existing five levels of hospital outpatient clinic visit codes for both new and established patients and replaced them with a new HCPCS code (G0463) that will represent a single level of payment for all hospital outpatient clinic visits. The new HCPCS code will apply to all outpatient clinic visits (except emergency room visits) paid under the OPPS regardless of the level of effort and regardless of whether the patient is a new or established patient. Effective January 1, 2014, CMS will no longer recognize CPT codes 99201 through 99205 (new patient clinic visits) and 99211 through 99215 (established patient clinic visits) under the OPPS.
CMS stated that this new system will reduce the hospital’s administrative burden and will be easy to adopt and comply with. For example, this new policy will eliminate the need for hospitals to develop and apply their own internal guidelines to differentiate between levels of clinic visits. It is also in line with CMS’s goal of using large payment bundles to incentivize hospitals to provide care in more efficient manners. CMS did not finalize its proposal to replace the current five levels of codes for emergency department visits but is considering options to improve codes for these services in future rulemaking.
Since OPPS (Outpatient Prospective Payment System) does not apply to Critical Access Hospitals, this new rule does not affect them.
Here is a link to the CMS regulation, http://www.cms.gov/Regulations-and-Guidance/Guidance/Transmittals/Downloads/R2845CP.pdf
Readmissions and the CO APCD Webinar: January 22nd, 12:00-1:00 MT
Readmissions and the CO APCD: New Data Available to Support Care Transitions
Webinar: January 22nd, 12:00-1:00 MT
Hosted by the Center for Improving Value in Health Care
Measuring success in reducing readmissions can be challenging. Time after time, it boils down to data: How many patients were admitted to the hospital? Where did they go after discharge? How many came back? Data on these basic numbers can be surprisingly hard to come by. Data available to providers and communities often comes from various sources and can be incomplete or focused on a specific population. In December, the Colorado All Payer Claims Database (CO APCD) released new reports on all cause 30-day readmissions that make access to clear and consistent readmissions information a lot easier.
During this webinar you'll learn how the data available on the CO APCD can support your work in care transitions and how looking at readmissions from different perspectives can provide new insights and help identify ways to reduce unnecessary hospitalizations. Join us to learn more about the publicly available CO APCD readmissions data and what they can do for you!
Click Here for Free Registration
Speaker Bios:
Jonathan Mathieu, Director of Data and Research, CIVHC
Dr. Mathieu provides quantitative and analytical support for CIVHC and the APCD. Prior to joining CIVHC, Jonathan was employed as an economist at The Nature Conservancy, as well as the U.S. Food and Drug Administration where he provided support for policy initiatives affecting prescription drug, biological product and medical device manufacturers. He also served as an Assistant Professor of Public Policy at Georgetown University in Washington, D.C. He holds master of arts and doctor of philosophy degrees in economics from the University of Colorado, Boulder, and a bachelor of science degree in applied mathematical economics from Oswego State University.
Alicia Goroski, Director of Performance Measurement, CIVHC
Ms. Goroski oversees the analysis, use and release of data related to the CO APCD. Dedicated to improving the delivery of health care services, she has worked in public health and quality improvement for 16 years. Prior to joining CIVHC, Alicia was Associate Director of National Programs at CFMC, the Medicare Quality Improvement Organization (QIO) for Colorado. At CFMC she directed several national programs funded by the Centers for Medicare & Medicaid Services (CMS), including the Integrating Care for Populations and Communities National Coordinating Center, where she led 41 QIOs in identifying target communities and implementing improvement plans to coordinate hospital and community-based systems of care. Ms. Goroski also directed the Learning and Action Network National Coordinating Center which provides technical assistance and tools for QIOs, health care providers and other organizations to implement improvement initiatives around an evidence-based agenda to achieve rapid, wide-scale improvement. Before joining CFMC in 2005, Ms. Goroski worked for the Centers for Disease Control and Prevention, the Louisiana State Health Department, the University of Alabama, and the Alabama Department of Public Health. Ms. Goroski received her Master's degree in Public Health from Rollins School of Public Health at Emory University in 1997.
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