In This Issue:
State of Emergency Notice
Welcome New Members!
Northwestern Announces New President
CMS Policy Change: Requirements for Collecting Overpayments from Providers
NIH Task Force Reports on Chronic Low Back Pain
U.S. Ranks First in Health Spending, Last in Outcomes
- July 1: Deadline for EHR Incentive Program Hardship Exception Applications (For Medicare providers who were unable to successfully demonstrate meaningful use for 2013: CMS is accepting applications for hardship exceptions to avoid the upcoming Medicare payment adjustment that will begin January 1, 2015.)
- July 7: Requirements for collecting provider overpayments take effect (see below)
- August 1: Deadline to apply for the University of St. Thomas Chiropractic Leadership Institute
- September 6: Coding Seminar with Dr. Anthony Hamm at Northwestern Health Sciences University
- SAVE THE DATE: Active Care Certification at Northwestern Health Sciences University. All sessions are from 8 a.m.-noon (Registration information will be posted soon.)
- September 20: Program 2
- October 4: Program 4
- November 1: Program 2
- November 22: Program 4
Special Focus: When the Governor Declares a State of EmergencyLast week, Governor Mark Dayton issued a five-day state of emergency in 35 Minnesota Counties. He extended the state of emergency to 30 days on June 24. If your practice is affected by the related flooding, please note the following:
- For a brief period of time, patients affected by a state of emergency may be treated by non-contracted providers and services rendered will be eligible for payment (regardless of out-of-network benefit coverage). If you are not able to continue treating your ChiroCare patients as a result of the flooding and feel it is in their best interest, you may redirect them to a non-participating provider without financial impact to the patient. If you choose to notify your patients of this option, please ensure they understand this option is available only during the defined state of emergency period.
- If the flooding is deterring you from being submitting your claims in a timely manner, please contact our Provider Services Department at 877-886-4941 for assistance.
- A state of emergency offers a reminder of the importance of having a disaster recovery plan in place that is tested at least once every 12 months.
If you have any questions, or if we can be of assistance, please call our corporate office at (651) 389-2006, or (866) 714-0524.
Welcome New Members!Jenny Bachmeier, DC
Christopher Bargmann, DC
Tucker Bauman, DC
Nathan Cornelius, DC
Tawnee Croteau, DC
Trenton Hinton, DC
Erin Hovey, DC
Krystine Kaiser, DC
Aimee Marz, DC
Lucas Marz, DC
Sean Neubauer, DC
Jessica Weninger, DC
Northwestern Announces New PresidentDr. Chris Cassirer has been named the new President of Northwestern Health Sciences University. “Dr. Cassirer brings excellent academic credentials and a wealth of experience in higher education and healthcare that will help drive growth and success for Northwestern.”
CMS Policy Change: Requirements for Collecting Provider OverpaymentsThe Centers for Medicare and Medicaid Services (CMS) recently published a notification to all providers regarding updates to the policy and instructions to portions of the overpayment process. If a Medicare overpayment remains outstanding and collectible, an Intent to Refer (ITR) letter will be issued 66 days from the initial demand letter date. This is a change from 120 days from the initial demand letter date. This new policy will take effect on July 7, 2014. Please make your staff aware of this change.
National Institutes of Health Task Force Reports on Chronic Low Back PainDespite rapidly increasing intervention, functional disability due to chronic low back pain is continuously increasing.
We often cannot identify mechanisms to explain the major negative impact this has on patients’ lives. A task force was convened by the National Institutes of Health (NIH) Pain Consortium with the goal of developing research standards for chronic low back pain. The results include recommendations for definitions, a minimal dataset, reporting outcomes, and future research. The Research Task Force believes these recommendations will advance the field, help resolve controversies, and facilitate future research addressing the genomic, neurologic and other mechanistic substrates of chronic low back pain.
U.S. Ranks First in Health Spending, Last in OutcomesThe U.S. spent more per capita on health care between 2004 and 2014 than 10 other industrialized nations measured, but it ranked last in health outcomes, a Commonwealth Fund study found. The U.S. spends $8,508 per capita for health care, compared with the U.K., which spends $3,405 per person and moved up to first place in outcome indicators. The study reinforces the need for the policymakers and insurers to re-examine DC services for conditions including back pain as a more cost-effective, conservative-care-first approach over the more costly and riskier pharmaceutical-surgical model that currently dominates the U.S. health care system.
- ChiroCode Institute: Providers can take advantage of free, weekly news alerts regarding coding and compliance by signing up for the ChiroCode Institute newsletter.
- Coding Seminar: Dr. Anthony Hamm will be hosting a coding seminar on September 6, 2014.
- PQRS Remittance Advice Remark Codes. Eligible professionals (EPs) participating in the Physician Quality Reporting System (PQRS) will notice new Remittance Advice Remark Codes (RARC) when receiving their Explanation of Benefits (EOBs). Effective April 1, the Centers of Medicare and Medicaid Services (CMS) changed the RARC to differentiate between whether a provider is billing their Quality Data Code(s) (QDCs)/PQRS G-code(s) as a zero dollar line item or $0.01 item. EPs who bill the G-codes with a zero dollar line item will see the new RARC code N620, which reads, “This procedure code is for quality reporting/informational purposes only,” instead of N365. N620 is your indication that the PQRS codes were received into the CMS National Claims History (NCH) database. EPs who bill the G-codes with a $0.01 will see the new RARC N572 indicating that this procedure is not payable unless non-payable reporting codes and appropriate modifiers are submitted. In addition to N572, the remittance advice will show Claim Adjustment Reason Code (CARC) CO or PR 246 (This non-payable code is for required reporting only). For more information click here or contact ACA’s Government Relations Department at Medicare@acatoday.org. For information about participating in PQRS visit www.acatoday.org/PQRS.
- ICD-10 Update. Don’t let the delay in ICD-10 implementation give you a false sense of security, advises the American Chiropractic Association: “Proper clinical documentation is crucial to a successful practice, no matter what code set is being used. The delay of ICD-10 implementation is an opportunity for DCs and other health professionals to focus on documentation improvement.”
Health information management vendor HRS has discovered several documentation issues that organizations across the board struggle with, including: disease type, disease acuity, missing documentation, and more. Many resources are available to help your practice prepare for ICD-10.
- Locum Tenens: If you will be having a non-participating (not contracted with CCMI) doctor fill in for you on a temporary basis —- even if it’s only for an hour —- you are required to inform ChiroCare in writing of your intent, and have written approval from ChiroCare, before the substitution may occur. Please call the ChiroCare corporate office for assistance and forms: (651) 389-2006 or (866) 714-0524.
- Record Keeping Tips:
- ChiroCare follows the Medicare requirement that all patient care entities be signed by the treating doctor (EHR systems have methods to attach signatures).
- Assessments must be updated after each visit.
- Treatments need to have a clear beginning and end date.
- Measurable treatment goals must be clearly stated and updated:
- Using neck and low back indexes to track improvement
- Using Outcome Tools on ChiroCare Connect (Upon logging in, go to Clinical Resources – click Outcomes assessment toolbox at the bottom, and then click an option on the left).
- The treating doctor must match the billing doctor.
- Security Risk Assessment. The Health Insurance Portability and Accountability Act (HIPAA) Security Rule requires that covered entities conduct a risk assessment of their health care organization. A risk assessment helps your organization ensure it is compliant with HIPAA’s administrative, physical and technical safeguards. A risk assessment also helps reveal areas where your organization’s protected health information (PHI) could be at risk. Watch the Security Risk Analysis video to learn more about the assessment process and how it benefits your organization. Earlier this year, the U.S. Department of Health and Human Services (HHS) made available a new security risk assessment (SRA) tool to help guide health care providers in small to medium sized offices conduct risk assessments.
- Sharing Patient Documentation: When supporting document is required to address an insurance concern, providers should always be aware of patient privacy when submitting documentation. Ask the patient if their information may be shared and document their permission by an authorization form that clearly states where the information will be sent. Always send patient information in a secure manner, such as by fax or encrypted CD, in order to avoid a possible HIPAA breach.
- Compliance Hotline: ChiroCare holds its network chiropractors to the highest practice standards and ethical behavior. As part of this expectation, we have established a 24/7 compliance hotline for providers, patients, ChiroCare employees and other individuals who are concerned about a possible compliance issue. Doctors even have a duty to report themselves if a breach occurs (e.g., a laptop with unencrypted patient data is stolen; a flash drive containing patient data disappears).
You may call the hotline to raise concerns or report possible violations to ChiroCare pertaining to suspect actions of ChiroCare, its providers, its employees or its associates. ChiroCare’s Compliance Officer will investigate all reports and ensure that corrective action is taken in response to all confirmed compliance violations. ChiroCare does not allow any retaliation or discrimination against any individual who in good faith reports a compliance concern.