Connect Archives

July 2015

Wednesday, July 15, 2015

CIGNA HEALTHSPRING TERMINATION NOTICE

Cigna HealthSpring has notified Health First Network, Inc. that they are terminating their agreement with us effective midnight 12/31/2015.

Cigna HealthSpring will be contacting your office to contract directly with them. If you have any questions regarding the termination, please contact Jackie Murph, HFNI Director, Network Development/ Provider Relations/Credentialing at (850) 438-4487.

CHRONIC CARE MANAGEMENT (CCM) BETA PROGRAM

The HFNI CCM beta program is moving forward; the team has run into a couple of snags that have slowed data loading down by 2 weeks, but we are set to load preliminary data this week, and should be up and running after that. We will keep you posted on early successes! If you have questions, please contact Dr. William Whibbs at 850-438-0818.

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SHARES FOR SALE

Recently, Health First Network, Inc. ("Health First") received notice from several of our shareholders that they would like to sell their shares. Pursuant to Health First’s Shareholders Agreement, the selling shareholders are authorized to sell their shares to "Permitted Transferees" – which includes existing shareholders and network physicians.

If you are interested in purchasing Health First shares from a current shareholder, and you are an existing shareholder or network physician, please contact E.L. Roche, Chief Financial Officer, at 850-438-0818. Your response will be an indication of your interest in purchasing shares, but it does not obligate you to purchase, nor obligate any shareholder to sell to you, any shares. After we determine the number of shareholders and network physicians interested in purchasing shares, we will follow up with relevant information for the potential buyers and sellers. Interested shareholders and network physicians will be listed on a first-come, first-serve basis.

BECKER’S HOSPITAL REVIEW™ ARTICLE: CMS ANNOUNCES CHANGES TO ICD-10 TO HELP EASE TRANSITION: 4 POINTS TO KNOW

CMS has released additional guidance for ICD-10 that will allow for greater flexibility in claims auditing and quality reporting to help providers transition to the new coding and billing sets.

There are four key changes to know.

1. Providers will have a one-year transition period. During the first year of ICD-10, providers' Medicare claims will not be denied or audited solely based on the specificity of diagnoses codes as long as they still come from the appropriate family of ICD-10 codes.

2. Similarly, physicians will not face penalties for the Physician Quality Reporting System based on the specificity of diagnoses codes as long as the code is from the correct ICD-10 family of codes.

3. CMS will authorize advance payments to physicians if Medicare contractors are unable to process claims due to ICD-10-related issues.

4. CMS plans to establish a communication center to monitor and resolve issues, including an appointed official to investigate physician complaints.

It is important to note that Medicare claims processing systems will not be able to accept ICD-9 codes for services after Sept. 30, 2015. This includes dual ICD-9 and ICD-10 coding.

CMS has also released "Road to 10," a guidance geared toward smaller physician practices to help them continue their transition.

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MODERN HEALTHCARE™ ARTICLE: CMS WILL MODIFY—NOT SCRAP—'TWO-MIDNIGHT' RULE

The CMS plans to soften but keep the controversial "two-midnight" rule governing short hospital stays in spite of aggressive calls from providers and policy experts to abandon the policy.

In a proposed payment rule posted, the Obama administration said it plans to allow physicians to exercise judgment to admit patients for short hospital stays on a case-by-case basis. The CMS also said it would remove oversight of those decisions from its administrative contractors and instead ask quality improvement organizations to enforce the policy. Recovery audit contractors, meanwhile, would be directed to focus only on hospitals with unusually high rates of denied claims.

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IS YOUR MEDICAL PRACTICE LOSING IMPORTANT SPACE TO IN-HOUSE STORAGE?

Space is at a premium in every busy medical office. Every examining room represents another patient that can be seen, and another seat open in the waiting room. At the same time, relocating to a larger office space can be costly and inconvenient. Often, a smart practice manager will be looking for every opportunity to economize space and make the most of the room they have.

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ANOTHER REASON TO VISIT WWW.HFNI.COM

As part of our commitment to provide value added benefits to our physician network, we have added several new services (financial services, document storage and destruction, office supplies, medical waste disposal, etc.) and will continue to add additional services as we negotiate group pricing. We invite you to explore the benefits available to you through your membership in Health First Network, Inc.

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NEW PHYSICIANS JOINING THE NETWORK

Health First Network would like to welcome the most recent physicians to join the Network:
Drew Horlbeck , M.D. - Otolaryngology
Tommye Crosby, M.D. - Family Practice
Joseph Fountain, D.O. - Family Practice
Jennifer Heegard, M.D. - Pediatrics
Xin Wei, M.D. - Hospitalist
Rebecca Martin, M.D. - Hospitalist
Lucy Rice, M.D. - OB/GYN
Juan Ronderos, M.D. - Neurological Surgery
Angeli Saith, M.D. - Family Practice
Eric Shoemaker, D.O. - Sports Medicine
Andy Somesan, M.D. - Internal Medicine
Jennifer Stinson, M.D. - Pediatrics
Glennal Verbois, M.D. - Physical Medicine & Rehab.
David Wartenberg, M.D. - Family Practice

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

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