Thursday, August 28, 2014

ICD-10 Webinars for September

The following is a list of ICD-10 webinars for the month of September hosted by the Colorado Rural Health Center. Click the links below to find more information and to register:

September 11: ICD-10 Starts With Physicians
https://cc.readytalk.com/r/ts7bbj2d31fe&eom

September 16th: ICD-10 Coding Review – End of Webinar Series, Training #10
https://cc.readytalk.com/r/ocpl1vhf9u2o&eom

September 17th: ICD-10 Implementation and Post-Implementation: Where Clinical Documentation Meets Data Collection
https://cc.readytalk.com/r/oyr4mj3ty04o&eom

September 23rd: Principals of ICD-10 Clinical Documentation for Providers – Sept 23
https://cc.readytalk.com/r/tfk273jnc3mf&eom

Wipfli Webinar: Revenue Improvement for RHCs

Please join the Colorado Rural Health Center and Wipfli for "Revenue Improvement for Rural Health Clinics" on Thursday, September 4th at 11:00 am.

This session will address key revenue cycle functions within a rural health clinic, focusing on front-end and back-end data collection and processing as well as ensuring the RHC chargemaster is appropriate.  We will identify typical problems, offer solutions, and point out challenges and barriers to improving revenue in a RHC.

The Wipfli webinar series is free for members of the Colorado Rural Health Center and for clinics that are participating in the Kaiser grant program. For all other facilities, the cost is $49.00 per webinar. You will be invoiced following the webinar.

To register, click here.

Kaiser Webinar Rescheduled

Due to technical difficulties, "Improving Your Ability to Improve" has been postponed to Tuesday, September 2nd at 11:00 am.

"When things are not working the way we want or we are not getting the desired results, we often decide to make changes. But sometimes we find these changes do not make things better, and in some cases, make things worse. Using a systematic approach improves the likelihood of attaining our goals and targeted state. In this webinar, we will discuss how to use systematic methods to improve our ability to improve."

The new registration link is here.

The next webinar in the series, "How do we get buy-in from our providers and staff?" will still take place as planned on Wednesday, September 3rd at 11:00 am.

"A frequent question raised when implementing improvement systems is “How do we get people to buy-in to and engage with what we are doing?” People are critical to the success of our improvement efforts. Different issues may affect whether and how much people commit to this work. Join us for this webinar in which we will discuss issues affecting buy-in and ways we can cultivate and grow people’s engagement in our endeavor to attain our goals."

The registration link is here.

**This webinar series is free to members of the Colorado Rural Health Center and facilities participating in the Kaiser grant. For non-members, the cost is $49 per webinar. Participants will be invoiced following the presentation.

MBQIP Deadline is Today!

The inpatient MBQIP deadline is TODAY! If you have not submitted your MBQIP data please do so. If you have any questions or are not sure how to submit your data please contact Marcy Cameron with Telligen. She can help you with your QualityNet Secure Portal as well as your CART tool. Her contact information can be found below.

August 28, 2014
□ Q1 2014 Hospital Inpatient Clinical Data
□ Q1 2014 Hospital Inpatient Population & Sampling - Enter zeros if you have on data to submit


Please contact Marcy Cameron, Telligen, if you need help with CART or submitting data to the QualityNet Secure Portal.
Marcy can be reached by phone: 303-784-5748 or email:

Thursday, August 21, 2014

Webinar: Principals of ICD-10 Clinical Documentation for Providers

Tuesday, September 23rd at 12:00pm

Physicians, this one is for you!! Would you like to find out how ICD-10 can help you reduce claims denials and increase revenue?

Invite your staff to attend also -- you'll want to start regular discussions about this, after you attend this webinar.

Clinical documentation is an important aspect of the ICD-10 transition due to the increased specificity and granularity in the ICD-10 code set. This webinar emphasizes the significance of the physician’s role in providing adequate detail within the clinical encounter for precise translation into ICD-10 codes. Capturing the necessary documentation elements to satisfy common ICD-10 conventions will be discussed. A comparison of your organization’s top 20 ICD-9 to ICD-10 code conversions is used to demonstrate the similarities and differences in documentation elements so that providers can begin making necessary modifications to their documentation practices right away. An emphasis will also be placed upon the unique coding circumstances of rural health facilities.

To register, click here.

Webinar: ICD-10 Starts with Physicians

Thursday, September 11th at 12 pm

Physicians -- you asked for ICD-10 training -- just for you... Let's get started together... (let your staff know it would be good if they participate too!!)

This one-hour webinar is designed to engage physicians and staff in tackling the ICD-10 transition by educating them on the realities of ICD-10, both positive and negative, and the importance of proper documentation. In a brief, upbeat, and to-the-point presentation we deliver the message that ICD-10 can be an opportunity depending on how physicians and staff prepare. Participants learn how to simplify starting the transition and the importance of engaging and motivating physicians at the cornerstone for ICD-10 success.

To register, click here.

Webinar: Improving Your Ability to Improve

"Improving Your Ability to Improve"
Wednesday, August 28th, 11:00am- 12:00pm

When things are not working the way we want or we are not getting the desired results, we often decide to make changes. But sometimes we find these changes do not make things better, and in some cases, make things worse. Using a systematic approach improves the likelihood of attaining our goals and targeted state. In this webinar, we will discuss how to use systematic methods to improve our ability to improve.

This webinar series is free to members of the Colorado Rural Health Center and facilities participating in the Kaiser grant. For non-members, the cost is $49 per webinar. Participants will be invoiced following the presentation.

To register, click here. For additional questions, contact Liz Kelman at lk@coruralhealth.org.


Medicare Part A and B News/Updates

The following information is provided by Novitas Solutions.

2014 Novitas Medicare Symposium Registration
Registration is now available for upcoming symposium events in September, October, and November! Please visit our website to review upcoming locations and to register today for an event near you!

Novitas Medicare Learning Center References Updated
The Novitas Medicare Learning Center Quick Reference Guide and Frequently Asked Questions (FAQs) have been updated! Please take a moment to review.

Medicare Part B News-Jurisdiction H for August 18th, 2014

The following information is provided by Novitas Solutions

Medicare News

Medical Review Fax Process for Paperwork (PWK) Segment

Our Medical Review (MR) area recently found that the PWK Fax Cover Sheet is not being used properly. As a result, we provide guidance on the use of the PWK segment.


Medicare Learning Network (MLN) Articles from CMS
Revised:



Medicare Part A News- Jurisdiction H for August 18th, 2014

The following information is provided by Novitas Solutions.

System Alert
Issued 08/15/2014 at 1:06 PM


REMINDER - Dial-up Customers Using the 717 Area Code Modem Telephone Number – Less Than Two Weeks Left

EDI trading partners still connecting to Novitas via the former 717 area code modem telephone number will no longer be able to connect for claim submission and report retrieval as of 12:01 AM Eastern Time (ET) on Friday, August 29, 2014 – that’s less than two weeks away!

Effective August 29, 2014 at 12:01 AM ET, dial-up trading partners must transition to the new number, 904-371-9510. We have found that customers who have made the switch to the new dial-up number may need to down speed their modem if they are having difficulties connecting.

The majority of our trading partners have already made these changes, and we appreciate your assistance with this effort. Currently, customers still connecting through the 717 area code mode telephone number may already be experiencing:
  • Inability to connect for claim submission, remittance and/or report retrieval. 
  • Decreased connection quality. 
  • Frequent connection time-outs. 
If your modem is more than four years old, you may need to purchase a new dial-up modem in order to connect. Customers who have not changed to the new connections should speak to their software vendor immediately to resolve any connection issues you are experiencing. Additionally, trading partners who are located in the 717 area code will need long distance phone service in order to connect.

If you have questions regarding this change, please contact an EDI Analyst at the numbers listed below.

EDI Services:
1-877-235-8073, Option 3 (JL)
1-855-252-8782, Option 3 (JH)

Medicare News
Update to the CWF Qualifying Stay Edit C7123 for Inpatient SNF and SB Claims

CMS recently resolved an issue concerning the Common Working File (CWF) qualifying stay edit C7123 to allow Skilled Nursing Facility (SNF) and Swing Bed (SB) claims that contain a valid qualifying hospital stay to bypass edit C7123. SNF and SB providers that have received this edit in error may adjust their affected claims or contact their Medicare Administrative Contractor (MAC) in order to have their claims adjusted. CMS is currently working on a permanent coding fix for CWF edit C7123 that will address all possible bypass scenarios for the edit. SNF and SB providers should contact their MAC with any questions or concerns.

Medicare Learning Network (MLN) Articles from CMS

New:
Revised:

Medicare Part A and B News-Jurisdiction H for August 15th, 2014

The following information is provided by Novitas Solutions.

Medicare News

JH Part A September & October Calendar of Events
The JH/JL Part A September and October Calendar of Events are now loaded for your viewing pleasure!

CMS MLN Connects™ Provider eNews for August 14, 2014
Please take time to review the articles in the MLN Connects Provider eNews for August 14, 2014.

Medical Policy Local Coverage Determination (LCD) and Article Updates
Medical Policy Updates
The following JH LCDs have been revised:
Biomarkers for Oncology (L34796)
Biomarkers Overview (L33638)
Thrombolytic Agents (L34743)
Vestibular and Audiologic Function Studies (L32767)

Local Coverage Article Updates
The following JH Article has been added effective August 14, 2014:
Isolated Ultrafiltration for Management of Fluid Overload in Cardiac Disease (A51037)
The following JH Article has been revised:
Self-Administered Drug Exclusion List (A51866)

The following JH Local Coverage Article was retired and replaced with Local Coverage Article NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A47551) to create a uniform Local Coverage Article across MAC Jurisdictions.
NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Non-Oncologic Conditions (A52202)

The following JH Local Coverage Article was retired and replaced with Local Coverage Article NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A49325) to create a uniform Local Coverage Article across MAC Jurisdictions.
NCD Coding Article for Positron Emission Tomography (PET) Scans Used for Oncologic Conditions (A52203)

Understanding Healthcare Fraud Symposium

Protect Yourself by Understanding Healthcare Fraud

The Centers for Medicare & Medicaid Services, in collaboration with the Colorado Medical Society, will host the Protect Yourself by Understanding Healthcare Fraud Symposium on September 11, 2014. The purpose of this event is to educate physicians, other healthcare providers, and administrators on how to safeguard and protect their
professional identity, andtheir most valuable assets-their medical practice andtheir patients-from fraud.

Topics Include:
• Real-life examples of issues faced by healthcare professionals in Colorado with cybersecurity, HIPAA compliance, risks of data breeches and medical ID theft;
• Understanding the different audits conducted by MACs, RACs, ZPICs, MEDIC; and more!

To register, visit: http://protectyourself-denversymposium.eventbrite.com
Date: September 11, 2014
Time: 8:15am-4:45pm
Location: Colorado Medical Society, 7351 E. Lowry Boulevard, Denver, CO 80230

Telehealth Webinar: State innovations to assure a health workforce to provide high value, quality care in rural areas

Southwest Telehealth Resource Center Presents...

Telehealth Webinar: “State innovations to assure a health workforce to provide high value, quality care in rural areas”
Wednesday, September 10, 2014 ~ 11:00am PDT
(11am PDT; 11am Arizona; 12pm MDT; 1pm CDT; 2pm EDT)

Learning Objectives:
1. Understand how state pacesetters are addressing health workforce shortages to assure high value, quality health care in rural and underserved areas.
2. Review state innovations to assure a well-trained and placed health workforce through legislation, regulation and state agency implementation.

For more information and registration instructions go to
http://telemedicine.arizona.edu/distant-education/upcoming-workshops

Reach Out and Read

Here is a link to the slides our speaker, Dr. Amy Shriver, MD, will be using for the August 26th (2:00pm EASTERN) call on the Reach Out and Read initiative: Reach Out & Read

Reach Out and Read is an effective, efficient, and evidence-based model of exam-room based early literacy promotion which strengthens children’s early language and literacy skills development by promoting “shared reading” practices in the home.

Here are links to handouts our speaker will be referencing as well as contact information for the Reach Out and Read program:  Mission, Evidence, Milestones, Contacts

Finally, you are encouraged to view this brief (2 ½ minute) video showing a physician talking with the parent of a small child about this initiative: https://www.youtube.com/watch?v=QElKz8Yctwk

The Reach Out and Read model provides a special opportunity to use books as a developmental surveillance tool, a relational assessment tool, and a way for families to promote cognitive, social, and emotional health of children beginning at a very young age.

Toll-free Call-in Number:                  888-603-9640
Participant passcode:                          9854323


There is no charge to participate and you do not need to register ahead of time.  I hope you will join us for this important call and share this information with others who might benefit from learning more about this exciting initiative.

Medicare News and Updates

The following information is provided by Novitas Solutions.

REMINDER - Dial-up Customers Using the 717 Area Code Modem Telephone Number – Less Than Two Weeks Left

EDI trading partners still connecting to Novitas via the former 717 area code modem telephone number will no longer be able to connect for claim submission and report retrieval as of 12:01 AM Eastern Time (ET) on Friday, August 29, 2014 – that’s less than two weeks away!

Effective August 29, 2014 at 12:01 AM ET, dial-up trading partners must transition to the new number, 904-371-9510.  We have found that customers who have made the switch to the new dial-up number may need to down speed their modem if they are having difficulties connecting.

The majority of our trading partners have already made these changes, and we appreciate your assistance with this effort.  Currently, customers still connecting through the 717 area code mode telephone number may already be experiencing:

Inability to connect for claim submission, remittance and/or report retrieval.Decreased connection quality.Frequent connection time-outs.

If your modem is more than four years old, you may need to purchase a new dial-up modem in order to connect.  Customers who have not changed to the new connections should speak to their software vendor immediately to resolve any connection issues you are experiencing.   Additionally, trading partners who are located in the 717 area code will need long distance phone service in order to connect.

If you have questions regarding this change, please contact an EDI Analyst at the numbers listed below.
EDI Services:
1-877-235-8073, Option 3 (JL)
1-855-252-8782, Option 3 (JH)

CMS ICD-10 News

News Updates | August 14, 2014

CMS Launches Road to 10 Webcast Series
The Centers for Medicare & Medicaid Services (CMS) has released a new webcast introducing the “Road to 10” tool. Accessible through the “Road to 10” link on the CMS website, the webcast covers the history of the International Classification of Diseases (ICD) and the benefits of ICD-10. This is the first in the new “Road to 10” webcast series. Five more webcasts will follow—all aimed at helping small practices get ready for ICD-10 by the October 1, 2015, compliance date.

Also available now is a brief video introduction to the “Road to 10” tool. Developed in collaboration with physicians, the “Road to 10” tool offers:
Clinical documentation tips
Coding concepts
Clinical scenarios
Training calendar

Go to the CMS ICD-10 website to get started on the “Road to 10” today.


University of Colorado School of Medicine- Research Project

Are you a parent of a child with a developmental disability and willing to contribute to a research project to increase awareness and understanding?

If so, please consider joining us at the University of Colorado School of Medicine!


  • The purpose of this study is to gain knowledge on the topic of everyday stressors that affect the lives of children with developmental disabilities, as well as their parents/caregivers 
  • Participants will be asked to fill out a survey as well as take part in an optional focus group with other parents
  • Focus group participants will be compensated for their time


If you are interested in contributing to the research of this very important subject, please contact Brenna Benson at (303) 520-7346 or Brenna.Benson@ucdenver.edu

Road to 10: ICD-10 Training

Designed for physicians and practice managers, this educational session will offer background and strategies on ICD-10 implementation so that small physician practices will understand the business imperative around implementing ICD-10. The presentation will cover the following topics:

  • An in depth ICD-10 Overview: Where do I begin?
  • Business Impacts of ICD-10
  • Tips and Resources for Creating a ICD-10 Training Program for the entire practice
  • Clinical Documentation Primers and Strategies
  • Creating a Customizable Action Plan

This event was created in collaboration with The American Health Information Management Association (AHIMA) and The Professional Association of Health Care Office Management (PAHCOM).

Thursday, August 28, 2014 from 12:00 PM to 1:00 PM (MDT)

For more information and registration, click here!

Register Now: Using Health IT to Reduce Medication Errors and Improve Patient Safety

The Agency for Healthcare Research and Quality (AHRQ) invites you to join a free Web conference August 26 from 2:30-4 p.m. Eastern Time:  "Using Health IT to Reduce Medication Errors and Improve Patient Safety".  There are 1.5 continuing education (CE) credits available to participants who attend the entire Web conference and complete the online evaluation.

This web conference will review research to improve medication management strategies to reduce errors and improve outcomes through (1) implementation of the “Medication Metronome” project to support between-visit medication safety monitoring and dose adjustment for patients with chronic conditions, (2) evaluation of the potential severity of specific Look-Alike, Sound-Alike (LASA) drug name substitution errors in pediatric ambulatory practice to flag potential errors, and (3) implementation of a medication reconciliation program that seeks to understand how electronic facilitation of medication reconciliation alters the incidence of medication errors in ambulatory care.

To register go to https://ahrqnrc-conferences.webex.com/ahrqnrc-conferences/onstage/g.php?t=a&d=999198624

Thursday, August 14, 2014

340B Recertification

Eligibility in the 340B Drug Pricing program is reviewed annually by the Office of Pharmacy Affairs (OPA) and Covered Entities are required to recertify as a part of this process. Hospitals and safety net providers are currently up for recertification, and they must complete the process by September 10. OPA recently sent email notifications about the recertification process to the Primary Contact and Authorizing Official for each Covered Entity. If providers require more assistance with the recertification process, please refer them to the OPA web page on recertification, http://www.hrsa.gov/opa/programrequirements/recertification/index.html, which includes some key information about the process and a step-by-step guide to recertification. 

Medicare Part A and B News-Jurisdiction H for August 13th, 2014

The following information is provided by Novitas Solutions.

Medicare News

Providers Enrolled as a ‘Sole Practitioner’, or ‘Private Practice’– Claim Submission Requirements for the Billing and Rendering Information
If you are enrolled as a ‘Sole Practitioner’, or ‘Private Practice’ Provider, only the Billing NPI assigned should be submitted on the claim. It is not required to also report an NPI as the Rendering Provider. Incorrectly reporting a Rendering Provider NPI that is not required, the system will automatically reject the claim based on the system editing for the Billing and Rendering information. To learn more, click here.


One to One Education for Providers With Zero Claims Reviewed During Two Midnight
Due to a variety of circumstances, The Centers for Medicare and Medicaid Services (CMS) has limited Medicare Administrative Contractor claim review samples during the first Probe & Educate process. While we anticipate most facilities will be subject to medical review, if a provider has not submitted any claims for billing or has not been selected for medical review during the last several months, they may still receive generalized education on the final rule. Please contact your Medicare Administrative Contractor if you would like to receive educational information related to CMS Final Rule 1599, as it relates to the appropriateness of inpatient admissions.


Part A Top Inquiries
The Part A Top Inquiries Frequently Asked Questions (FAQs) have been updated. Please take time to review these FAQs for answers to your questions.


Adjustment of Some Hospital Claims for Therapy Services
Certain hospital claims for therapy services processed between April 7 and July 28, 2014 may have been paid in error because Medicare claims processing systems did not apply the services to the therapy cap appropriately. The claims affected had one or more lines with revenue code 042x, 043x, or 044x with modifier GN, GO, or GP. The system problem was corrected on July 28 and the affected claims will be adjusted. No provider action is needed.

Medicare Part A and B News- Jurisdiction H for August 14th, 2014

The following information is provided by Novitas Solutions.

Medicare News

Medicare Learning Network (MLN) Articles from CMS

New: 

Novitas Solutions Mailing Addresses - August 26 deadline is fast approaching!
The time for forwarding mail to the Mechanicsburg address is fast approaching. Effective August 26, mail received at the Camp Hill address will be returned to you. Begin using the correct address now and avoid processing delays. To locate the appropriate mailing address, please visit the Contact Us page of our website.

Part B Top Inquiries
The monthly Part B FAQs have been updated. Please take some time to review these FAQs for answers to your questions.

Medicare Part A and B News-Jurisdiction H for August 12th

The following information is provided by Novitas Solutions.

Medicare News

FY 2016 Wage Index Timetable

For FY 2016, the Centers for Medicare & Medicaid Services (CMS) have changed the Wage Index Development Timetable. CMS finalized changes to the FY 2016 Wage Index timetable in the FY 2015 IPPS final rule, issued by CMS on August 2, 2014.

The FY 2016 Wage Index Development process started in May 2014, with the posting of the preliminary worksheet S-3 PUF on May 23, 2014 (previously posted in September/October and known as the October PUF). Consequently, certain subsequent dates in the FY 2016 Wage Index Development process are also earlier than in previous years. Please pay careful attention to the new posting dates, due dates, and deadlines. Please visit our wage index page for more details.

Customer Contact Center Survey
Your feedback is important to us. Please take a moment to complete the Customer Contact Center Survey so we can better assist you.


Novitas Medicare Learning Center Handouts
The following webinar handouts are now available in the Novitas Medicare Learning Center:
  • 8/21 Part A to Part B Rebilling of Denied Hospital Inpatient Claims 
  • 8/22 Part A How To Avoid Top Claim Errors - Third Quarter 

Medicare Insights Weekly Enrollment Podcasts Continue


The Medicare Insights Weekly Podcast series on enrollment forms continues this week. Don't miss these informative podcasts that will help you complete your Medicare enrollment forms.


Part A Top Claim Submission Errors
The Top Claim Submission Errors and resolutions for July 2014 are now available. Please take time to review these errors and avoid them on future claims.


Novitas Educational Tips and Tools (NETTs) Addition
The new Forms Decision Tree has been add to the Novitas Educational Tips and Tools (NETTs) page. Check back often as we continue to update and add information related to Medicare.

MLN Connects Provider eNews: August 14th, 2014

The Medicare Learning Network's Provider eNewsletter for August 14th, 2014 is now available online. To read this edition, click here.

Using Health IT to Reduce Medication Errors and Improve Patient Safety

The Agency for Healthcare Research and Quality (AHRQ) invites you to join a free Web conference August 26 from 2:30-4 p.m. Eastern Time: Using Health IT to Reduce Medication Errors and Improve Patient Safety. There are 1.5 continuing education (CE) credits available to participants who attend the entire Web conference and complete the online evaluation.

This web conference will review research to improve medication management strategies to reduce errors and improve outcomes through (1) implementation of the “Medication Metronome” project to support between-visit medication safety monitoring and dose adjustment for patients with chronic conditions, (2) evaluation of the potential severity of specific Look-Alike, Sound-Alike (LASA) drug name substitution errors in pediatric ambulatory practice to flag potential errors, and (3) implementation of a medication reconciliation program that seeks to understand how electronic facilitation of medication reconciliation alters the incidence of medication errors in ambulatory care.

To register go to https://ahrqnrc-conferences.webex.com/ahrqnrc-conferences/onstage/g.php?t=a&d=999198624.

Telehealth Webinar: September 10th

The University of Arizona Center for Rural Health & the Southwest Telehealth Resource Center invite you to a free webinar on the implementation and practice of telemedicine.

Telehealth Webinar
Wednesday, September 10, 2014 ~ 11:00am PDT
(11am PDT; 11am Arizona; 12pm MDT; 1pm CDT; 2pm EDT)

“State innovations to assure a health workforce to provide high value, quality care in rural areas”

Learning Objectives:
1. Understand how state pacesetters are addressing health workforce shortages to assure high value, quality health care in rural and underserved areas.
2. Review state innovations to assure a well-trained and placed health workforce through legislation, regulation and state agency implementation.

For more information and registration instructions go to: http://telemedicine.arizona.edu/distant-education/upcoming-workshops

AMA Foundation and AmeriCares: Funding Opportunity

The AMA Foundation and AmeriCares have both released Requests for Proposals for two separate grant programs supporting free and charitable clinics. Both grant programs will provide two-year grants of $10,000 to clinics to implement the CDC's Diabetes Prevention Program.

Pre-diabetes is a preventable health condition that increases the risk of developing type 2 diabetes, heart disease and stroke. Estimates show that 79 million people in the United States have prediabetes, but less than ten percent are aware of their condition. The goal of these programs is to increase the identification of prediabetes among free clinic patients and improve their health-related outcomes.

Please note that while these programs are similar, they have separate application processes, implementation requirements and eligibility guidelines:
Interested clinics should carefully review both organizations' programs to determine which opportunity is the best fit for them. Clinics will only be accepted into one of these two programs. The deadline for submitting your application to both programs is September 22, 2014.

CREATE Tip of the Week

What is Realistic When Asking for Grant Funds?

It is not realistic to ask for grant funds without being able to demonstrate your organization's strict attention to developing and maintaining meticulous financial strategy, adherence to operational budgets and successful results. So take time to show your financial plan and implementation strategy. Communicate how you will measure your success as a result of grant funding. Devise a plan for how you will report on your implementation and what you will continue to do to sustain your success. It is truly about being prepared to post a powerful presence for your EMS organization. You have to ask yourselves if the grant application reviewers will see your brand of EMS as distinctive and special. The equipment looks the same, and the protocols and requirements to provide service are highly regulated. Your organization's people are the real distinguishers. Who is caring for others through the leadership, culture and values set by your operation? While you want everyone you serve to trust all care providers in your organizations equally during emergency response, you also want your people to stand out when you are vying for grant funding.

Maybe your medical director animates your organization's mission with aggressive medical protocols and unrelenting standards of care. Or perhaps your organization's community involvement touches many more people than those who would actually receive ambulance transport. At the very least, be ready to supply information and commitment of those you want trained. With these tips, you'll be a step ahead in readying your organization for the next round of grant funds you seek.

For more information and grant writing assistance contact Lakesha Jones, CREATE Grant Manger at the Colorado Rural Health Center 720.248.2742 or by email at lj@coruralhealth.org.

Thursday, August 7, 2014

Webinar: Treating Diabetes in the Hospital

Please join us on August 12th at 1:00pm for "Treating Diabetes in the Hospital," a presentation by Dr. Dan Bessesen, the Chief of Endocrinology at Denver Health Medical Center, Professor of Medicine at the University of Colorado, School of Medicine and Director of Fellowship Training in Endocrinology, Metabolism and Diabetes at the University of Colorado.  

Webinar Objective: At the end of this presentation attendees will be able to make informed decisions about glucose monitoring, the use of glucose lowering medications, dietary choices and hypoglycemia treatment in hospitalized patients with  diabetes.

This webinar is free for members of the Colorado Rural Health Center and $99 for non-members. Attendees will be invoiced following the presentation.

Register here!

MBQIP Data Submission Deadlines

With the recent migration of My QualityNet to the QualityNet Secure Portal, technical issues have been reported to CMS and we are addressing these issues as quickly as possible. We have also received calls that could be addressed through use of our educational resources. You will find links below to a list of User Guides and Training Videos available on the QualityNet Training page and QualityNet Secure Portal Resources page.

If you continue to experience any issues, please contact the QualityNet Helpdesk directly so that they can be thoroughly triaged and escalated to the appropriate party. In an effort to resolve reported issues as quickly as possible, we request that the QualityNet Helpdesk be the first line of contact Logging a request with the QualityNet Helpdesk allows CMS to determine emergent issues, prioritize critical fixes, and assess the need to extend submission deadlines for our Quality Reporting Programs.

We appreciate your patience as we continue to resolve reported issues and have extended the following data submission deadlines accordingly:


Hospital Outpatient Quality Reporting Program –

o Clinical Process of Care Data and Population and Sampling data for Quarter 1 2014, formerly due on August 1, will now be due on August 21, 2014.


Hospital Inpatient Quality Reporting Program –

o Clinical Process of Care Data formerly due on August 15, and Population and Sampling data formerly due on August 1, for Quarter 1 2014, will now be due on August 28, 2014.

o CLABSI/CAUTI or MRSA/CDI templates for hospitals selected for validation, formerly due on August 1, will now be due on August 28, 2014.

o Healthcare-Associated Infection data due on August 15 to CDC’s National Healthcare Safety Network (NHSN) will not change.


QualityNet Educational Resources:

A summary of the issues and resolutions is available on QualityNet from the following link:
http://qualitynet.org/dcs/ContentServer?c=Page&pagename=QnetPublic%2FPage%2FQnetHomepage&cid=1120143435363

Final Rule for RHC Contractors

Last October a Notice of Proposed Rulemaking was posted by CMS. It was recently finalized and will be in effect October 1st. It will allow for greater flexibility for RHCs contracting with NPs, PAs, CPs and CSWs.

Revise § 405.2468(b)(1) by removing the parenthetical “RHCs are not paid for services furnished by contracted individuals other than physicians, ” and revising § 491.8(a)(3) to allow non-physician practitioners to furnish services under contract in RHCs, when at least one NP or PA is employed.
So the rule still stands – one NP or PA must be employed by the RHC (Section 1861(aa)(2)(iii) of the Act) – employed is interpreted to mean that the employer issues a W-2 form to the employee, but beginning Oct. 1st, RHCs can be paid for services furnished by contracted individuals other than physicians, (as long as the one NP or PA is employed).



Medicare Part B News-Jurisdiction H for August 7th, 2014

The following information is provided by Novitas Solutions.

Medicare Part A News-Jurisdiction H for August 7th, 2014

The following information is provided by Novitas Solutions.

Medicare Learning Network (MLN) Articles from CMS

New:


Revalidation for Jurisdiction H (JH) Providers and Suppliers
Novitas has updated the Revalidation Request Mailing Schedule on our website. As outlined in the Schedule, mailings began on July 30, 2014 and will continue through September 3, 2014. These mailings comprise approximately 10,300 providers/suppliers. The Centers for Medicare and Medicaid Services (CMS) will publish the listing of providers/suppliers included in these mailings on their website approximately 3-4 weeks after all contractors have provided their mailing information for the months of July - September.

If you have questions related to the revalidation initiative, please visit our Enrollment Center for more information.


Novitas Solutions Mailing Addresses – Extended deadline looming!
Don’t forget to change our mailing address in your records before August 26. Mail received at the Camp Hill address will be returned to you and not forwarded to our Mechanicsburg address on and after August 26. Sending claims and other correspondence to the wrong address will delay processing of your request and may impact timeliness. Our mailing addresses are located on the Contact Us page of our website.

Wednesday, August 6, 2014

Medicare Part A and B News-Jurisdiction H for August 6th, 2014

The following information is provided by Novitas Solutions. 

CMS MLN Connects Provider e-News Special Edition - August 5, 2014
The August 5, 2014 Special Edition of the CMS MLN Connects Provider e-News is now available. Please take time to review this important information.
  • CMS Issues Hospital Inpatient Payment Regulation 

Important edit changes for Institutional claims effective October 5, 2014

CMS issued Change Request (CR) 8700 edit spreadsheet changes for Institutional electronic claims. These Institutional edit changes will be implemented the evening of October 5, 2014.


Medicare Learning Network (MLN) Articles from CMS
Revised:

Medicare Part B News-Jurisdiction H for August 5th, 2014

The following information is provided by Novitas Soluations.

JH and JL Part B Coordination of Benefits Crossover Issue

UPDATE: After further review of this issue and the remittance advice codes that were applied, it has been determined that adjustments are not necessary to generate new remittances for COBC or quality measurement reporting as the message does not affect the quality based reporting process. No further provider action is required.

UPDATE: Novitas has completed additional analysis on this issue. The Part B claims that contained certain non-payable measurement codes which also contained other payable services did actually cross over to the COBC. The claims with the payable services were received and accepted by the COBC and sent to the appropriate supplemental insurers for processing.

The non-payable measurement services which contained the dash (-) in the standard message field and where the ERA showed OA 121 were also accepted by the COBC but did not contain sufficient information for the supplemental insurers to make a determination on responsibility/liability for the non-payable measurement code service. Although there should not be a change in payment, Novitas will be performing adjustments on these claims to correct the system outputs. No action is required by providers at this time.

ISSUED 07/11/2014 @ 3:58PM: Due to a system error, Part B claims containing certain non-payable measurement codes were not being crossed over to the Coordination of Benefits Contractor (COBC). Although the measurement codes are non-payable, if the claim contained a non-payable measurement code and another payable service, the system error prevented the entire claim from being crossed over to the COBC. In these situations, the provider remittance shows a message that the claim was crossed over to the COBC, however, the system error prevented the claim from being accepted by the COBC. In addition, the system error may have caused the paper remittance to show a dash (-) in the standard message field, and the ERA may show qualifier OA and message 121 for the impacted services. The system error impacted claims finalizing between July 1 and July 10. Novitas is currently identifying all claims that were impacted by this error, and will perform adjustments on the claims to correct the system error and the corrected claims will be sent to the COBC for further processing. We will update this notice as we work through the adjustment process. We apologize for any inconvenience this has caused. No action is necessary at this time by providers.

Medicare Enrollment Podcasts Now Available
In this week's Medicare Insights Weekly podcast, we review incomplete or missing items from the enrollment form. Listen to this podcast to avoid common errors that delay your enrollment processing. This is the first in a series. Keep listening every week for more helpful tips!

Participating Provider versus Non-Participating Provider

A new resource has been added to the Novitas Educational Tips and Tools (NETTs) page. Please take a moment to review the newest addition to the NETTs documents.

Medicare Part B News-Jurisdiction H for August 4th, 2014

The following information is provided by Novitas Solutions.

New Message Codes to be Used for Quality Reporting Purposes

Per CMS direction, Medicare Administrative Contractors (MACs) shall use the following CARC/RARC combination to communicate quality measure programs that use claims-based reporting. The quality incentives are based on provider reporting, not the messages received on the remittance. This message change does not affect the quality based reporting process. No provider action is necessary on claims that have already processed with a different message.
  • CARC 246: “This non-payable code is for required reporting only” and, 
  • RARC N620: “Alert: This procedure code is for quality reporting/informational purposes only.” 


CMS MLN Connects Provider eNews - Special Edition August 1, 2014

The August 1, 2014 Special Edition of the CMS MLN Connects Provider e-News is now available.
  • Deadline for ICD-10 Allows Health Care Industry Ample Time to Prepare for Change 
  • ICD-10 Testing Opportunities for Medicare FFS Providers

Medicare Enrollment Podcast

Medicare Enrollment Podcasts Now Available

In this week's Medicare Insights Weekly podcast, we review incomplete or missing items from the enrollment form. Listen to this podcast to avoid common errors that delay your enrollment processing. This is the first in a series. Keep listening every week for more helpful tips!

Medicare Part B News-Jurisdiction H for August 1st, 2014

The following information is provided by Novitas Solutions.

Other Part B Frequently Asked Question (FAQ) Topics

The Other Part B FAQs have been updated. Please take time to review these FAQs for answers to your questions.


The following webinar handouts are now available in the Novitas Medicare Learning Center:

8/5 Part B Chriopractic Services
8/6 New & Small Provider Education - Part 2 Part B Claim Overview
8/7 JL Part B Update - New Novitas Website
8/8 JH Part B Update - New Novitas Website
8/12 Part B Initial Inpatient Services

Medicare Part A News-Jurisdiction H for August 1st, 2014

The following information is provided by Novitas Solutions.

Website Maintenance - Sunday Morning
We will be performing website maintenance on Sunday, August 3rd, from 9:00 AM CST - 12:00 PM CST. Some features (Appeals Status, Enrollment Status, MEDPAR Directory Search, and SOAR/PPTN) may be unresponsive or completely unavailable during this time frame. We apologize for any inconvenience.

2015 ESRD PPS Low Volume Attestations are due by November 1, 2014
ESRD Providers that are currently receiving the Low Volume Adjustment are required to submit an annual Attestation prior to November 1st preceding the next payment year. Attestations will not be accepted after the November 1st deadline. Click here for more details.


Medicare Learning Network (MLN) Articles from CMS
Revised:

Novitas Medicare Learning Center Frequently Asked Questions (FAQs) have been revised
Please take time to review the newest Novitas Medicare Learning Center FAQs.

Other Part A Frequently Asked Question (FAQ) TopicsThe Other Part A FAQs have been updated. A new FAQ has been added to the Skilled Nursing Facility (SNF), General category, regarding the 3-day qualifying stay requirement. Please take time to review all FAQs for answers to your questions.

Frequently Asked Questions: Using the Novitas Solutions Web Site
The Frequently Asked Questions About Our Web Site have been updated. Please take time to review these FAQs for answers to your questions.

The following webinar handouts are now available in the Novitas Medicare Learning Center:

8/6 New & Small Provider Education - Part 2 Part A Claim Overview
8/8 CMS Final Rule 1599-F: Understanding Inpatient Admissions and Reviews
8/15 JH Part A Update - New Novitas Webiste
8/19 JL Part A Update - New Novitas Website



Health Equity Learning Series August 21st

Community Health Partnership, LiveWell Colorado Springs, The UCCS Health Promotion Program and The Independence Center invite you to attend the next event in the Health Equity Learning Series with a presentation by Laura Frank and Llewellyn Smith. Two options for viewing will be available: the regularly scheduled live stream with lunch on August 21 or an after-work viewing of the recorded event with dinner on September 2

Laura Frank is President and General Manager of News for Rocky Mountain PBS. Ms. Frank is a Denver native who spent 20 years at newspapers, radio and public television around the country, focusing on in-depth reporting. She oversaw creation of the 2013 I-News report Losing Ground, which shed light on racial and ethnic disparities in Colorado.

Llewellyn Smith is Director of Media for Production at BlueSpark Collaborative, a film and research company. In 2004, Mr. Smith founded Vital Pictures, an independent, Boston-based documentary company. Additionally, he co-executive produced the PBS series Unnatural Causes: Is Inequality Making Us Sick?, looking at the impact social and economic conditions have on health and longevity. Ms. Frank and Mr. Smith will discuss how they have told the story of health disparities through video, print and photos, as well as the importance of sharing compelling health equity stories.

WHEN:
Thursday, August 21, 2014
11:30 a.m. - 1:00 p.m.
Lunch provided. Arrive by 11:15 to get seated.
Tuesday, September 2, 2014*
5:00 p.m. - 6:30 p.m.
Dinner provided. Arrive by 4:45 to get seated.
WHERE:
Kaiser Permanente of S. Colorado
Wayback Conference Room
1975 Research Pkwy, Ste 250
Lane Center at UCCS
Rm. 120, first floor
4863 N. Nevada Ave.
RSVP:
RSVP to Julia at Julia@ppchp.org or 632-5094 by August 18. Please communicate any dietary restrictions.
Register at www.the-ic.org/HELS 
by August 27. Please include any dietary restrictions or needs.
* Contact The Independence Center at 471-8181 x 222 for needed accommodations. Complimentary parking in Lot 170 provided by UCCS Parking Services. Please do not park in the Peak Vista or Health Circle spots. If you are unable to attend either event, please note that The Colorado Trust will be live-streaming the presentation on Aug. 21, 2014, at 11:30 a.m. Click here to register for the live stream.

Deadline for ICD-10 and FFS Testing Opportunities

Deadline for ICD-10 Allows Health Care Industry Ample Time to Prepare for Change
Deadline set for October 1, 2015

On July 31, HHS issued a rule finalizing October 1, 2015 as the new compliance date for health care providers, health plans, and health care clearinghouses to transition to ICD-10. This deadline allows providers, insurance companies, and others in the health care industry time to ramp up their operations to ensure their systems and business processes are ready to go on October 1, 2015.

The ICD-10 codes on a claim are used to classify diagnoses and procedures on claims submitted to Medicare and private insurance payers. By enabling more detailed patient history coding, ICD-10 can help to better coordinate a patient’s care across providers and over time. ICD-10 improves quality measurement and reporting, facilitates the detection and prevention of fraud, waste, and abuse, and leads to greater accuracy of reimbursement for medical services. The code set’s granularity will improve data capture and analytics of public health surveillance and reporting, national quality reporting, research and data analysis, and provide detailed data to enhance health care delivery. Health care providers and specialty groups in the United States provided extensive input into the development of ICD-10, which includes more detailed codes for the conditions they treat and reflects advances in medicine and medical technology.

"ICD-10 codes will provide better support for patient care, and improve disease management, quality measurement, and analytics,” said Marilyn Tavenner, Administrator of CMS. “For patients under the care of multiple providers, ICD-10 can help promote care coordination.”

Using ICD-10, doctors can capture much more information, meaning they can better understand important details about the patient’s health than with ICD-9-CM. Moreover, the level of detail that is provided for by ICD-10 means researchers and public health officials can better track diseases and health outcomes. ICD-10 reflects improved diagnosis of chronic illness and identifies underlying causes, complications of disease, and conditions that contribute to the complexity of a disease. Additionally, ICD-10 captures the severity and stage of diseases such as chronic kidney disease, diabetes, and asthma.

The previous revision, ICD-9-CM, contains outdated, obsolete terms that are inconsistent with current medical practice, new technology, and preventive services.

ICD-10 represents a significant change that impacts the entire health care community. As such, much of the industry has already invested resources toward the implementation of ICD-10. CMS has implemented a comprehensive testing approach, including end-to-end testing in 2015, to help ensure providers are ready. While many providers, including physicians, hospitals, and health plans, have completed the necessary system changes to transition to ICD-10, the time offered by Congress and this rule ensure all providers are ready.

For additional information about ICD-10, please visit the ICD-10 website.

ICD-10 Testing Opportunities for Medicare FFS Providers

On July 31, HHS issued a rule (CMS-0043-F) finalizing October 1, 2015 as the new compliance date for health care providers and health plans to transition to ICD-10. ICD-10 represents a significant code set change that impacts the entire health care community.

CMS is taking a comprehensive four-pronged approach to preparedness and testing for ICD-10 to ensure that CMS, as well as the Medicare Fee-For-Service (FFS) provider community, is ready:
  • CMS internal testing of its claims processing systems 
  • CMS Beta testing tools available for download 
  • Acknowledgement testing 
  • End-to-end testing 
For more information, see MLN Matters® Special Edition Article #SE1409, “Medicare FFS ICD-10 Testing Approach.”

Acknowledgement Testing

This past March, CMS conducted a successful ICD-10 acknowledgement testing week. Providers, suppliers, billing companies, and clearinghouses are welcome to submit acknowledgement test claims anytime up to the October 1, 2015 implementation date. In addition, special acknowledgement testing weeks in November, March, and June of 2015 will give submitters access to real-time help desk support and allows CMS to analyze testing data. Registration is not required for these virtual events. Contact your Medicare Administrative Contractor (MAC) for more information about acknowledgment testing.

End-to-End Testing

CMS plans to offer providers and other Medicare submitters the opportunity to participate in end-to-end testing with MACs and the Common Electronic Data Interchange (CEDI) contractor in January, April, and July of 2015. As planned, approximately 2,550 volunteer submitters will have the opportunity to participate over the course of three testing periods. The goals of this testing are to demonstrate that:
  • Providers and submitters are able to successfully submit claims containing ICD-10 codes to the Medicare FFS claims systems 
  • CMS software changes made to support ICD-10 result in appropriately adjudicated claims 
  • Accurate Remittance Advices are produced 

Additional details about end-to-end testing will be available soon.

Check the ICD-10 Medicare FFS Provider Resources web page for the latest information and educational resources to implement and transition to ICD-10 medical coding.

Free Webinar: Integrated Primary Care and Behavioral Health Resources for HRSA Grantees

Health Resources and Services Administration Region VIII
Presents a Live Webinar:

Integrated Primary Care and Behavioral Health Resources for HRSA Grantees

Region VIII: Colorado, Montana, North Dakota, 
South Dakota, Utah, and Wyoming

Please Join Us for a Free Webinar:
August 20th 12:00 pm-1:00 pm Mountain Time

Adobe Connect Link: https://hrsa.connectsolutions.com/r43gm7dqg8e/

Conference Number: (866) 916-3919 Participant Code: 488652

This webinar will provide information on integrated primary and behavioral healthcare, with a focus on resources and information available through the HRSA/SAMHSA Center for Integrated Health Solutions. The webinar will discuss HRSA programs and integrated care, and provide information on planning for, implementing, and delivering integrated healthcare services. Some of the topics covered include models of integrated care, workforce, clinical practice, screening tools, operations and administration, and the business case for behavioral health integration. In addition, a HRSA grantee providing integrated care will be featured. The webinar is targeted to HRSA grantees providing healthcare services.


Speakers: 
Kim Patton, PsyD, 
Public Health Analyst 
HRSA, Region VIII

Laura M. Galbreath, MPP
Director, SAMHSA-HRSA Center for Integrated Health Solutions
National Council for Behavioral Health

For additional information, please contact Kim Patton at 303-844-7865 or KPatton@hrsa.gov.

CMS Tips to Streamline Your Open Payments System Registration

Tips to Streamline Your Open Payments System Registration

The Open Payments system registration is a voluntary process for physicians and teaching hospitals. However, it becomes a requirement if you want to review, and possibly dispute data submitted about you by applicable manufacturers and applicable group purchasing organizations (GPOs).

If you plan to review the information that has been submitted, we encourage you to first review the helpful tips below to ensure that your registration experience is as efficient as possible.
  • Use Internet Explorer versions 8-10, Chrome or Firefox browsers. Currently the Open Payments system is not optimized for the Safari browser; 
  • Understand that registration for physicians and teaching hospitals for this first reporting year requires registering in the CMS Enterprise Portal and then in the Open Payments system; and, 
  • Consider answering “optional” questions during the registration process (skipping these questions can slow your registration). 
To learn more about Open Payments system registration and the nomination process, visit the Program Registration, Physicians and Teaching Hospitals web pages on the Open Payments website. Instructional resources are also available.

To understand the review and dispute process, visit the Dispute and Resolution web page on the Open Payments website.

Colorado Crisis and Support Line

Colorado Crisis and Support Line: 844-493-8255 (TALK)

The first STATEWIDE Crisis & Support Line in Colorado!
www.metrocrisisservices.org

1. Crisis Line
  • 100% free, every call, every time.
  • 24/7 access to a trained mental health professional.
  • Crisis support, intervention, and consultation.
  • No wrong door to access services, regardless of your insurance or location.
  • Immediate help when you need it.
  • Referrals to resources in your area that meet your exact needs.
  • Friends and family members are able to access professional guidance for a loved one they are concerned about.

Common calls: Suicidal thoughts, depression, stress, anxiety, grief of loss, abuse, self-harm, substance use, worries for a friend or family member.

2. Support Line
  • 100% free, every call, every time.
  • 24/7 access to a certified Peer Specialist or Recovery Coach.
  • Opportunity to talk to an individual with lived experience—living in recovery with mental health or substance use challenges.
  • Opportunity to talk to someone who is able to offer first-hand support.
  • Trained in long-term recovery.
  • Support for family and friends.
Common calls: Recovery struggles, loneliness, stress, homelessness, joblessness, relationship and family issues, financial issues 

3. Resource Directory
  • Resources available 24/7 by calling the crisis line, support line, or accessing online at www.metrocrisisservices.org
  • More than 4,200 resources, throughout the state of Colorado.
  • Knowledge of the services available in your geographic area.
  • Updated on an ongoing basis by a team of resource specialists.
Common resources: Counselors and therapists, behavioral health and substance use treatment facilities, faith-based organizations, peer-to-peer support, self-help groups