Connect Archives

October 2013

Tuesday, October 15, 2013

MEDICAID MANAGED CARE CONTRACT AWARD

On September 23, 2013 AHCA announced the winners of Medicaid Medical Assistance Program (MMA) contracts. For Region I (Escambia, Santa Rosa, Okaloosa and Walton Counties) the winners for General Plans are Humana and Better Health. The winners in Specialty Plans are Simply Healthcare Plans’ Clear Health HIV/Aids Specialty Plan and Sunshine State’s Child Welfare Specialty Plan.

Three of the plans that were not awarded contracts have filed legal challenges. These plans are: Integral Quality Care, Coventry, and Molina. If any of the challenges are successful, the state may add them to the list of contracted plans or may replace one of the contracted plans with a challenger. It is not clear what the state will do.
HFNI is contracted with all of the plans that were awarded contracts and all of the plans that are challenging the awards.

Region I has a current (as of October 1) enrollment base of 108,848. Of these, 7,894 are in Walton County where HFNI currently has a limited network.

AHCA will begin implementing the MMA contracts on May 1, 2014 and expects to be fully implemented by July 31, 2014.

We will be contacting you regarding your decision to participate in these arrangements when the state settles the legal challenges.

REMINDER FOR PROVIDERS OFFICES

Please remember to notify the Health First Network Credentialing Dept. at 850-434-6715 or Provider Relations Dept. at 850-438-4487 when you have a Provider who is joining or leaving the Practice, changing office locations, moving out of the area, or taking an extended leave of absence, such as military deployment, or maternity leave. This allows us to keep our Credentialing and Provider Network database current for credentialing letters and re-cred. applications and keeps our health plans updated with the most current information on Physicians in our Network.

HEALTHSPRING MEDICARE ADVANTAGE HMO TRANSITION FOR CLAIM PROCESSING

Effective 1/1/14 Health First Network, Inc. (HFNI) / MED3000 will no longer be responsible for processing claims for Healthspring Medicare Advantage HMO.

Health First Network, Inc. will continue to work with Healthspring; giving support to our providers for that product.

It is very important that all claims with dates of service December 31, 2013 back are filed to HFNI / MED3000 no later than June 30, 2014 at the address below.

HealthSpring Medicare HMO
P. O. Box 11547
Pensacola, FL 32524

All claims received after June 30, 2014 will be denied timely, NO EXCEPTIONS will be made.

All claims for dates of service 1/1/14 forward should be filed to:

Healthspring Medicare Advantage HMO
P.O. Box 981804
El Paso, TX 79998

Please contact Jenny Caillouet at 850-438-4487 if you have any questions.

PHYSICIAN INSERVICE

Health First Network will be presenting a CME-Approved Program on Tuesday evening, October 29, 2013 at 5:45 P.M. in the Baptist Medical Meeting Room, located at 1717 N. E St., Pensacola, FL. The two-part program will feature a presentation by Dr. William Whibbs on “Documenting In A Risk Adjusted World”, and a second topic covering “ACO Updates”.

Baptist Hospital has approved this educational activity for a maximum of 1.5 hours AMA PRA Category 1 creditTM. A Buffet Dinner will be served. Doors will open at 5:30 PM. The program will begin promptly at 5:45 PM.

Please RSVP no later than Wednesday, October 23rd to Jenny Caillouet at 438-4487.


HFNI SHAREHOLDER MEETING RESULTS

The Annual HFNI Shareholder’s meeting was held on Monday, September 30, 2013 at 5:30 p.m. at Health First Network located at 2929 Langley Avenue, Ste. 103, Pensacola, FL.

The Shareholders have elected to:
1) Retain Warren Averett O’Sullivan Creel as HFNI’s external auditors.

2) Approve all proposed changes to the Stock Restriction Agreement and By-Laws

3) Elected to the Board were:

PCP's:
William Zimmern, M.D.
Randall Reese, M.D.
William Whibbs, M.D.

RCP’s
Sid Clements, M.D.
Warren Herron, M.D.

NEW HFNI SHAREHOLDER PAGE AVAILABLE ONLINE

As part of our continuous commitment to provide access to important information, Health First Network has added a new “HFNI Shareholder’s page” to the website. From this page you can access such things as, HFNI By-Laws, Stock Restriction Agreement, and Audited Financials.



FLU VACCINE UPDATE

The Center for Medicare and Medicaid Services (CMS) has released their Annual Update for the 2013 – 2014 Flu season with the updated Influenza Vaccine Payment Allowances for the Fall and Winter Season. The effective date is August 1, 2013 with an implementation date no later than October 25, 2013.

Related Links


NEW JOB POSTINGS PAGE COMING SOON

HFNI is in the process of creating a new “Job Postings page” in an effort to help our physician offices fill job vacancies.

If you would like to advertise open employment opportunities on the HFNI website, please contact Jenny Caillouet at 850-438-4487.

NEW PHYSICIANS JOINING THE NETWORK

Health First Network would like to welcome the most recent physicians to join the Network:

Ronald Johnston, M.D. Dermatology
Matthew Pearson, M.D. Pediatric Neurology
Renee Bonetti, M.D. Radiology
Jerome Enad, M.D. Orthopaedic Surgery
Andrew Schulman, M.D. Pediatric Surgery
Daniel Murawski, M.D. Orthopaedic Surgery
Stephen Sawrie, M.D. Radiation Oncology
Norma Jones, M.D. Therapeutic Radiology

** To determine which health plans each physician is participating in check the “Find A Doctor” section on the HFNI website.