Connect Archives

October 2010

Friday, October 15, 2010

REVISED CODING REFERENCE SHEET NOW AVAILABLE ONLINE

Precise, accurate coding to the highest level of specificity for each patient’s condition is more important than ever before. For those offices without certified coders, Health First Network has maintained a Reference Guide for Coding on the website. This list was recently updated, and the revised sheet is now available.

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FLU VACCINATION INFORMATION FOR MEDICARE MEMBERS

Health First Network has received guidelines, benefit and coverage information on seasonal flu vaccine from both WellCare and HealthSpring. The reimbursement amount for the seasonal flu vaccine has been set at $30.00.

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IMPORTANT CHANGES TO BACKGROUND SCREENING REQUIREMENTS FOR HEALTHCARE PROVIDERS

The Florida legislature recently made significant changes to background check requirements. The changes to the law require all employees that are expected to provide direct patient care or services, or have access to client property, funds or living areas, to have a Level 2 screening. Most applicants seeking licensed medical employment after August 1, 2010 must have a Level 2 screening unless they were screened and qualified by a Level 2 screening in the previous 5 years and have not been unemployed for more than 90 days. If already screened, the employee must complete and sign an Affidavit of Compliance with Background Screening Requirements, AHCA Form 3100-0008. Some of the key elements that impact how hospitals, physician offices and other Health Care facilities will do business after the law goes into effect on August 1st include the following:

* July 31, 2015 is the deadline to conduct Level 2 re-screening on current employees hired prior to August 1, 2010.

* Employees must be rescreened every 5 years.

* All Level 2 screening requests must be submitted electronically through a LiveScan vendor approved to submit fingerprint requests through the Florida Department of Law Enforcement (FDLE).

* Providers may access the screening results through the Agency for Health Care Administration's (AHCA) secure website.

* A health care provider may not hire a new employee until a final screening determination of "Eligible" has been made or the individual is "Not Eligible" but has been granted an Exemption from Disqualification from the Agency or the Department of Health.

* Requires associates to attest upon hiring that they meet the requirements for employment and agree to inform the employer immediately if arrested for any disqualifying offense. This is accomplished using AHCA Form 3100-0008.

The cost for screenings is $43.50. Since this eligibility requirement is portable, it is recommended that the screening be paid for by the applicant. Soon, most licensed medical applicants should already have an eligibility determination available on the AHCA website. In that case, simply verify it using the website discussed above and have the applicant complete the attestation form also discussed above.

You can also access needed forms and information at the Agency for Health Care Administration website.

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WELLCARE MODEL OF CARE ONLINE TRAINING

WellCare Health Plans has notified Health First Network that Providers can now participate in free online training for the WellCare Model of Care Program. The link to the training may be accessed using either of the links provided below.

WellCare is requesting that WellCare Providers participate in this initiative for WellCare Access and Select members by performing the following steps:

1.) Reviewing the member care plans faxed to you by a MED3000 Case Manager
2.) Updating the Care Plan with any required changes, and, if necessary, faxing back the revised care plan to the member’s MED3000 Case Manager.
3.) If you have questions or wish to discuss the care plan, you can call the case manager directly at the phone number listed on the fax cover sheet.
4.) Retain a copy of the updated care plan in the patient’s record, and review with the member during their next office visit.
5.) If you wish to participate in the Interdisciplinary Care Team for all SNP members and give feedback as appropriate, please contact the MED3000 Case Manager or Health First Network for the dates and times of such Meetings.

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DR. TAN RECEIVES SERVICE AWARD FOR HIS MANY YEARS OF SERVICE ON THE HFNI, BOARD OF DIRECTORS

Tom Tan, M.D. and Charles Brewer, CEO, HFNI After many years of service on the HFNI Board of Directors, Dr. Tom Tan decided his commitments in other areas no longer allowed him to devote the necessary time to participate as a member of the Board. Dr. Tan has been a key member of the Board serving on both the Finance Committee and the Executive Committee. His leadership and thoughtfulness have been instrumental in the development of Health First Network. We wish Tom well in his practice and with his new venture at The Woodlands.