UCare's County News Briefs - Spring 2015 AWS
County Hotline: 1-866-457-7146 toll free
Did you know?
Spring 2015
UCare’s Mobile Dental Clinic is visiting these Greater Minnesota counties this year:
What’s up with ICD-10 at UCare?
• Winona County – Winona, May 18-22
• Olmsted County – Rochester, June 8-12 • Carlton County – Cloquet, July 13-17
• Nobles County – Worthington, Aug. 3-7
• St. Louis County – Duluth, Sept. 14-18 and Sept. 19, 8 a.m.-12 p.m. Visit the Dental Care for U page on our website for more dates and details. Behavorial health updates and overview bulletin View the March 30, 2015, Provider Bulletin for a summary of 2015 changes and UCare Behavioral Health overview.
UCare is continuing preparations for the ICD-10 go-live date of Oct. 1, 2015. All HIPAA-covered entities must begin using the new code set on that date. ICD-10 will be larger, more complex, and much more comprehensive than ICD-9. It will touch most health care businesses, including providers, payers, vendors, and clearinghouses. ICD-10 will have an impact on technology systems, clinical documentation practices and behaviors, business rules and reporting, training and education programs, and more. Electronic claims testing with UCare partners continues UCare will begin testing electronic claims submissions with several groups of providers using the ICD-10 code set. In the meantime, we’re refining data analysis techniques to streamline how we will analyze the test results.
Pillboxes are available for MSHO members AM/PM-style pillboxes are one of UCare’s supplemental MSHO benefits in 2015. Members can order the pillboxes through their UCare care coordinator.
Our current ICD-10 testing process is to use the most commonly received ICD-9 codes to create ICD-10 claims. We will run the ICD-10 coded claims through the test claims system to validate that the codes process as expected. Other external testing involves ensuring that ICD-10 codes move smoothly between our provider partners and UCare.
To find a member’s care coordinator, please call UCare’s Case Management Central Intake Line at 612-676-6622 or 1-866-242-2497 toll free.
To ensure your UCare-specific testing concerns and questions are addressed, we encourage you to contact Angela Amendolare at [email protected]. We will continue to report on our testing initiatives up until the Oct. 1 cutover date.
Visit UCare’s Counties web page
ICD-10 resources ICD-10 compliance on Oct. 1, 2015, is mandatory for all HIPAA-covered entities. While the clock is definitely ticking, we offer many resources to help providers meet the deadline. Although we don’t endorse any organization in (cont. on page 2)
County News Briefs (cont. from page 1)
particular, this short list of resources may be useful as you work toward the date: Centers for Medicare & Medicaid Services (CMS)
Spring 2015 partner in ICD-10 preparations, send inquiries to [email protected]. We welcome your input.
Jim Eppel selected as next UCare President and CEO
CMS Provider Resources Page
CMS Road to 10: The Small Physician Practice’s Route to ICD-10 Workgroup for Electronic Data Interchange (WEDI) American Medical Association
American Health Information Management Association (AHIMA) American Academy of Professional Coders (AAPC) HIMSS ICD-10 Playbook
Industry involvement aids process UCare ICD-10 employees are active members of the Workgroup for Electronic Data Interchange (WEDI) and the Minnesota ICD-10 Collaborative. They meet regularly with other payers, providers, vendors, and government agencies to discuss ICD-10 implementation strategies. We encourage you to visit the WEDI website for more information and ICD10 preparation resources. Tips for ICD-10 success Here are some tips to help providers through the ICD-10 transition:
• Begin training physicians, nurses, coders, and staff now for ICD-10. • Have a Clinical Documentation Improvement (CDI) program in place. • Talk with vendors about ICD-10 planning.
• Collaborate with trading partners and get involved with testing.
• Submit claims containing ICD-9 codes (service date prior to Sept. 30, 2015); the sooner the better. If you have questions about this activity or have suggestions to help UCare be a better provider
2
Jim Eppel
Jim Eppel will succeed Nancy Feldman as President and Chief Executive Officer when she retires this summer. Eppel comes to UCare from OptumInsight, a division of UnitedHealth Group.
A search committee of the UCare Board of Directors, working with an executive recruitment firm, conducted a national search to identify and interview candidates to succeed Feldman, who is retiring after leading UCare since 1995. Eppel will assume CEO duties on June 22 following Feldman’s retirement on June 19. “Jim has a wealth of experience with both health plans and providers, and is extremely well regarded throughout the community,” said Macaran Baird, M.D., chair of UCare’s Board of Directors. “What’s more, he is deeply committed to UCare’s mission and values and will be an exceptionally good cultural fit for the organization.” Prior to his work at Optum, Eppel served in executive leadership roles for Blue Cross Blue Shield of Minnesota, Allina Health, UnitedHealth Group, Medica, and MedCenters Healthcare. He began his career with KPMG Peat Marwick and is a graduate of the University of St. Thomas. “I have long admired and respected UCare, and I look forward to joining an organization with such a demonstrated commitment to the health of the populations it serves,” Eppel said.
County News Briefs
Free summer camps for kids with asthma or diabetes If you work with a child who has asthma or diabetes and is a UCare member, he or she may be eligible to attend a summer camp that helps kids learn to manage their conditions while having fun. UCare will cover the cost of one of the following camps:
• Camps for kids with asthma, ages 7 to 16, offered through the American Lung Association. • Camps for kids with diabetes (Type 1 or 2), ages 5 to 16, offered through the American Diabetes Association. • Family camp for kids with Type 2 diabetes, ages 7 and up, offered through One Heartland.
To find out more about these camps, call the Customer Services number on the back of the child’s UCare ID card or visit ucare.org. Camps fill up quickly, so call soon!
UCare can support your community events Many counties and groups are busy planning a variety of community and social events for the spring, summer, and fall. Please let us know if it would be helpful to have UCare involved or supporting your efforts in some way. For example, we can provide health and wellness items you can distribute at your heath events or county fair exhibit. Contact your UCare County Team Liaison or the County Hotline at 1-866-457-7146 to tell us about your community calendar plans and needs this year.
Spring 2015
3
County Partners Innovations Corner
Saluting county-based achievements in health and wellness
Making the healthy choice the easy choice Crow Wing Energized wants to make the healthy choice be the easy choice for local residents. That’s why Essentia Health is partnering with Crow Wing County officials to lead the new grassroots effort to improve the health and wellness of county residents. “Essentia Health is committed to improving the health of the communities in which we live and serve,” says Adam Rees, Essentia Health’s regional president in Brainerd. “Crow Wing Energized is the name of this movement in our region.” This grassroots effort is bringing together community leaders and interested volunteers to identify ways to help people live healthier lives. Some initiatives are as easy as connecting people to existing programs or resources, such as promoting local farmers markets or events that help families exercise together. Others will take more time and study, such as reducing obesity or falls among senior citizens Efforts are underway to address needs identified in a community health survey. Last fall’s survey asked county residents about their access to health care as well as their nutrition, physical activity, tobacco use, and other social, physical, and mental health-related issues. The data helped assess residents’ current health as well as identify health perceptions and barriers to healthy living. The community health survey was sponsored by Crow Wing Energized and the (cont. on page 4)
County News Briefs (cont. from page 3)
Minnesota Department of Health’s Statewide Health Improvement Program (SHIP). The Minnesota Center for Health Statistics and the Essentia Institute of Rural Health also played a role. Four groups are working on these goals:
• Healthy Choices: Develop sustainable strategies and encourage healthy choices by increasing access to healthy foods, increasing active living opportunities, and helping to promote and support healthy environments.
• Mental Fitness: Encourage and equip citizens to achieve and maintain mental fitness by building networks throughout the county for achieving resilience, increasing the practice of intentional choices to help reduce stress and anxiety, and educating communities to increase the knowledge of mental fitness to make positive choices in overall health.
• Workplace Wellness: Help create a healthy and energized workforce by increasing employee satisfaction, maximizing productivity, minimizing absenteeism, and helping to reduce healthcare costs. • Community Connections: Connect Crow Wing County citizens to services, events, organizations, and resources that promote healthy living.
Crow Wing Energized also is awarding Healthy Community Grants to support efforts that move its community to a place where the healthy choice is the easy choice with lasting impacts on the county. Grants awarded to date are for: • Northland Arboretum Outdoor Wellness Fitness Trail
• Earth Diggers Project at Forestview Middle School (student-led garden)
• Assertive Community Treatment (ACT) team of Northern Pines Mental Health Center • Brainerd Public Library (seed library)
• The Center in Brainerd (The Center Energized, a wellness program) • City of Brainerd (trail way-finding signage)
Spring 2015
4
To learn more about Crow Wing Energized, contact Coordinator Cassie Carey at 218-821-6975 or Cassie.Carey@ CrowWingEnergized.org. We are always looking for county innovations to highlight in this newsletter. Please send your suggestions to our County Team’s Sharon Crawford at [email protected].
Cassie Carey, Crow Wing Energized Coordinator
Change made to Special Transportation Services (STS) and Certificate of Need (CON) process The Certificate of Need (CON) process for Special Transportation Services (STS) providers changed April 22, 2015. As of that date, UCare directly manages the CON process for STS. Rides continue to be arranged by medical providers, STS providers, UCare members, and other helpful parties; however, UCare processes the CON form (located on the UCare provider website) submitted to UCare, signed by the attending health care professional. As a reminder, STS are intended for members who are unable to use common carrier transportation (e.g., private auto, taxi, or bus) because of physical or mental impairment or disability and require a driver to provide direct assistance to the recipient (door through door assistance). Minnesota Statutes, section 256B.0625, subds.17, 17a & 18. Additionally, UCare requires an approved CON form, signed by the attending physician, mental health professional, nurse practitioner, clinical nurse specialist, or physician assistant working under the delegation of the attending physician, to be on file with UCare.
County News Briefs
Spring 2015
UCare Phone List Behavioral Health Services Authorization and Notification, Claims, Billing, and Benefits 612-676-3300 or 1-888-531-1493 toll free 1-855-307-6981 fax Clinical Care Coordination Liaisons Jessica Assefa and Nancy Launderville 612-294-5045 1-866-613-1395 [email protected] Clinical Services Authorization and Intake 612-676-6705 1-877-447-4384 toll free Customer Services/ Enrollment 612-676-3200 1-800-203-7225 toll free (State Public Programs) 612-676-6868 1-866-280-7202 toll free (SNP: UCare’s MSHO)
Eligibility Verification 612-676-6824 1-800-203-7225 toll free 24/7 Nurse Line 1-800-942-7858 toll free TTY: 1-855-307-6976 toll free Health Promotion 612-676-3351 1-866-243-5157 toll free Health Ride Transportation 612-676-6830 1-800-864-2157 toll free Provider Assistance Center (PAC) 612-676-3300 1-888-531-1493 toll free
UCare Dental Connection Members should call 651-768-1415 1-855-648-1415 toll free County staff should call Delta Dental Government Programs Access Unit 651-994-5198 1-866-303-8138 toll free County Team Liaisons Carol Berg, RN, MPH Public Health and County Manager 612-676-3635 [email protected] Sharon Crawford County Relations Coordinator 612-294-5201 [email protected] Laurie Ann Moore, MSW, LGSW County Relations Supervisor 612-294-5364 [email protected]
612-676-3395 1-877-903-0061 toll free (SNBC: UCare Connect) Do you have a question not answered through your regular contacts? Need help untangling an issue? Can’t remember who to call? Then use our toll-free County Hotline! We welcome your calls and questions to help you work with our UCare members.
County Hotline: 1-866-457-7146 toll free
5
Did you know?
Spring 2015
UCare’s Mobile Dental Clinic is visiting these Greater Minnesota counties this year:
What’s up with ICD-10 at UCare?
• Winona County – Winona, May 18-22
• Olmsted County – Rochester, June 8-12 • Carlton County – Cloquet, July 13-17
• Nobles County – Worthington, Aug. 3-7
• St. Louis County – Duluth, Sept. 14-18 and Sept. 19, 8 a.m.-12 p.m. Visit the Dental Care for U page on our website for more dates and details. Behavorial health updates and overview bulletin View the March 30, 2015, Provider Bulletin for a summary of 2015 changes and UCare Behavioral Health overview.
UCare is continuing preparations for the ICD-10 go-live date of Oct. 1, 2015. All HIPAA-covered entities must begin using the new code set on that date. ICD-10 will be larger, more complex, and much more comprehensive than ICD-9. It will touch most health care businesses, including providers, payers, vendors, and clearinghouses. ICD-10 will have an impact on technology systems, clinical documentation practices and behaviors, business rules and reporting, training and education programs, and more. Electronic claims testing with UCare partners continues UCare will begin testing electronic claims submissions with several groups of providers using the ICD-10 code set. In the meantime, we’re refining data analysis techniques to streamline how we will analyze the test results.
Pillboxes are available for MSHO members AM/PM-style pillboxes are one of UCare’s supplemental MSHO benefits in 2015. Members can order the pillboxes through their UCare care coordinator.
Our current ICD-10 testing process is to use the most commonly received ICD-9 codes to create ICD-10 claims. We will run the ICD-10 coded claims through the test claims system to validate that the codes process as expected. Other external testing involves ensuring that ICD-10 codes move smoothly between our provider partners and UCare.
To find a member’s care coordinator, please call UCare’s Case Management Central Intake Line at 612-676-6622 or 1-866-242-2497 toll free.
To ensure your UCare-specific testing concerns and questions are addressed, we encourage you to contact Angela Amendolare at [email protected]. We will continue to report on our testing initiatives up until the Oct. 1 cutover date.
Visit UCare’s Counties web page
ICD-10 resources ICD-10 compliance on Oct. 1, 2015, is mandatory for all HIPAA-covered entities. While the clock is definitely ticking, we offer many resources to help providers meet the deadline. Although we don’t endorse any organization in (cont. on page 2)
County News Briefs (cont. from page 1)
particular, this short list of resources may be useful as you work toward the date: Centers for Medicare & Medicaid Services (CMS)
Spring 2015 partner in ICD-10 preparations, send inquiries to [email protected]. We welcome your input.
Jim Eppel selected as next UCare President and CEO
CMS Provider Resources Page
CMS Road to 10: The Small Physician Practice’s Route to ICD-10 Workgroup for Electronic Data Interchange (WEDI) American Medical Association
American Health Information Management Association (AHIMA) American Academy of Professional Coders (AAPC) HIMSS ICD-10 Playbook
Industry involvement aids process UCare ICD-10 employees are active members of the Workgroup for Electronic Data Interchange (WEDI) and the Minnesota ICD-10 Collaborative. They meet regularly with other payers, providers, vendors, and government agencies to discuss ICD-10 implementation strategies. We encourage you to visit the WEDI website for more information and ICD10 preparation resources. Tips for ICD-10 success Here are some tips to help providers through the ICD-10 transition:
• Begin training physicians, nurses, coders, and staff now for ICD-10. • Have a Clinical Documentation Improvement (CDI) program in place. • Talk with vendors about ICD-10 planning.
• Collaborate with trading partners and get involved with testing.
• Submit claims containing ICD-9 codes (service date prior to Sept. 30, 2015); the sooner the better. If you have questions about this activity or have suggestions to help UCare be a better provider
2
Jim Eppel
Jim Eppel will succeed Nancy Feldman as President and Chief Executive Officer when she retires this summer. Eppel comes to UCare from OptumInsight, a division of UnitedHealth Group.
A search committee of the UCare Board of Directors, working with an executive recruitment firm, conducted a national search to identify and interview candidates to succeed Feldman, who is retiring after leading UCare since 1995. Eppel will assume CEO duties on June 22 following Feldman’s retirement on June 19. “Jim has a wealth of experience with both health plans and providers, and is extremely well regarded throughout the community,” said Macaran Baird, M.D., chair of UCare’s Board of Directors. “What’s more, he is deeply committed to UCare’s mission and values and will be an exceptionally good cultural fit for the organization.” Prior to his work at Optum, Eppel served in executive leadership roles for Blue Cross Blue Shield of Minnesota, Allina Health, UnitedHealth Group, Medica, and MedCenters Healthcare. He began his career with KPMG Peat Marwick and is a graduate of the University of St. Thomas. “I have long admired and respected UCare, and I look forward to joining an organization with such a demonstrated commitment to the health of the populations it serves,” Eppel said.
County News Briefs
Free summer camps for kids with asthma or diabetes If you work with a child who has asthma or diabetes and is a UCare member, he or she may be eligible to attend a summer camp that helps kids learn to manage their conditions while having fun. UCare will cover the cost of one of the following camps:
• Camps for kids with asthma, ages 7 to 16, offered through the American Lung Association. • Camps for kids with diabetes (Type 1 or 2), ages 5 to 16, offered through the American Diabetes Association. • Family camp for kids with Type 2 diabetes, ages 7 and up, offered through One Heartland.
To find out more about these camps, call the Customer Services number on the back of the child’s UCare ID card or visit ucare.org. Camps fill up quickly, so call soon!
UCare can support your community events Many counties and groups are busy planning a variety of community and social events for the spring, summer, and fall. Please let us know if it would be helpful to have UCare involved or supporting your efforts in some way. For example, we can provide health and wellness items you can distribute at your heath events or county fair exhibit. Contact your UCare County Team Liaison or the County Hotline at 1-866-457-7146 to tell us about your community calendar plans and needs this year.
Spring 2015
3
County Partners Innovations Corner
Saluting county-based achievements in health and wellness
Making the healthy choice the easy choice Crow Wing Energized wants to make the healthy choice be the easy choice for local residents. That’s why Essentia Health is partnering with Crow Wing County officials to lead the new grassroots effort to improve the health and wellness of county residents. “Essentia Health is committed to improving the health of the communities in which we live and serve,” says Adam Rees, Essentia Health’s regional president in Brainerd. “Crow Wing Energized is the name of this movement in our region.” This grassroots effort is bringing together community leaders and interested volunteers to identify ways to help people live healthier lives. Some initiatives are as easy as connecting people to existing programs or resources, such as promoting local farmers markets or events that help families exercise together. Others will take more time and study, such as reducing obesity or falls among senior citizens Efforts are underway to address needs identified in a community health survey. Last fall’s survey asked county residents about their access to health care as well as their nutrition, physical activity, tobacco use, and other social, physical, and mental health-related issues. The data helped assess residents’ current health as well as identify health perceptions and barriers to healthy living. The community health survey was sponsored by Crow Wing Energized and the (cont. on page 4)
County News Briefs (cont. from page 3)
Minnesota Department of Health’s Statewide Health Improvement Program (SHIP). The Minnesota Center for Health Statistics and the Essentia Institute of Rural Health also played a role. Four groups are working on these goals:
• Healthy Choices: Develop sustainable strategies and encourage healthy choices by increasing access to healthy foods, increasing active living opportunities, and helping to promote and support healthy environments.
• Mental Fitness: Encourage and equip citizens to achieve and maintain mental fitness by building networks throughout the county for achieving resilience, increasing the practice of intentional choices to help reduce stress and anxiety, and educating communities to increase the knowledge of mental fitness to make positive choices in overall health.
• Workplace Wellness: Help create a healthy and energized workforce by increasing employee satisfaction, maximizing productivity, minimizing absenteeism, and helping to reduce healthcare costs. • Community Connections: Connect Crow Wing County citizens to services, events, organizations, and resources that promote healthy living.
Crow Wing Energized also is awarding Healthy Community Grants to support efforts that move its community to a place where the healthy choice is the easy choice with lasting impacts on the county. Grants awarded to date are for: • Northland Arboretum Outdoor Wellness Fitness Trail
• Earth Diggers Project at Forestview Middle School (student-led garden)
• Assertive Community Treatment (ACT) team of Northern Pines Mental Health Center • Brainerd Public Library (seed library)
• The Center in Brainerd (The Center Energized, a wellness program) • City of Brainerd (trail way-finding signage)
Spring 2015
4
To learn more about Crow Wing Energized, contact Coordinator Cassie Carey at 218-821-6975 or Cassie.Carey@ CrowWingEnergized.org. We are always looking for county innovations to highlight in this newsletter. Please send your suggestions to our County Team’s Sharon Crawford at [email protected].
Cassie Carey, Crow Wing Energized Coordinator
Change made to Special Transportation Services (STS) and Certificate of Need (CON) process The Certificate of Need (CON) process for Special Transportation Services (STS) providers changed April 22, 2015. As of that date, UCare directly manages the CON process for STS. Rides continue to be arranged by medical providers, STS providers, UCare members, and other helpful parties; however, UCare processes the CON form (located on the UCare provider website) submitted to UCare, signed by the attending health care professional. As a reminder, STS are intended for members who are unable to use common carrier transportation (e.g., private auto, taxi, or bus) because of physical or mental impairment or disability and require a driver to provide direct assistance to the recipient (door through door assistance). Minnesota Statutes, section 256B.0625, subds.17, 17a & 18. Additionally, UCare requires an approved CON form, signed by the attending physician, mental health professional, nurse practitioner, clinical nurse specialist, or physician assistant working under the delegation of the attending physician, to be on file with UCare.
County News Briefs
Spring 2015
UCare Phone List Behavioral Health Services Authorization and Notification, Claims, Billing, and Benefits 612-676-3300 or 1-888-531-1493 toll free 1-855-307-6981 fax Clinical Care Coordination Liaisons Jessica Assefa and Nancy Launderville 612-294-5045 1-866-613-1395 [email protected] Clinical Services Authorization and Intake 612-676-6705 1-877-447-4384 toll free Customer Services/ Enrollment 612-676-3200 1-800-203-7225 toll free (State Public Programs) 612-676-6868 1-866-280-7202 toll free (SNP: UCare’s MSHO)
Eligibility Verification 612-676-6824 1-800-203-7225 toll free 24/7 Nurse Line 1-800-942-7858 toll free TTY: 1-855-307-6976 toll free Health Promotion 612-676-3351 1-866-243-5157 toll free Health Ride Transportation 612-676-6830 1-800-864-2157 toll free Provider Assistance Center (PAC) 612-676-3300 1-888-531-1493 toll free
UCare Dental Connection Members should call 651-768-1415 1-855-648-1415 toll free County staff should call Delta Dental Government Programs Access Unit 651-994-5198 1-866-303-8138 toll free County Team Liaisons Carol Berg, RN, MPH Public Health and County Manager 612-676-3635 [email protected] Sharon Crawford County Relations Coordinator 612-294-5201 [email protected] Laurie Ann Moore, MSW, LGSW County Relations Supervisor 612-294-5364 [email protected]
612-676-3395 1-877-903-0061 toll free (SNBC: UCare Connect) Do you have a question not answered through your regular contacts? Need help untangling an issue? Can’t remember who to call? Then use our toll-free County Hotline! We welcome your calls and questions to help you work with our UCare members.
County Hotline: 1-866-457-7146 toll free
5
