In this issue
- Symposium Update
- Ballot for Elected Directors
- Annual Training
- Mandatory Special Needs Plan Training
- Disclosure of Ownership and Cultural Competency Requirement
- Let Your Voice Be Heard! Provider Satisfaction Survey
- 2019 Center of Excellence Applications Open November 1st
- UCare Renames Three Products for 2019
- Value-Based Care – Where do I start?
- Moving or Retiring? Let us Know!
The October Care Connections Symposium: Building Bridges for Integrative Care successfully facilitated conversations between medical and chiropractic doctors. The event was presented in collaboration with Twin Cities Orthopedics and held at Training Haus, located on the Viking Lakes campus, home of the Minnesota Vikings. Presentations focused on team-based care as an approach to pain management.
Industry experts representing hospitals and health systems, chiropractic providers, payers, rehabilitation professionals, and integrated medicine providers shared research and perspectives on how a team-based approach can influence the patient experience and improve long-term outcomes, along with information about the research behind solutions for provider burnout. Experts discussed how different care providers can come together across the care continuum to find the best course for pain management for each patient.
During the event, we were excited to acknowledge the great work that selected providers completed in regard to our ChiroFirst study with an awards ceremony and photo opportunity. Learn more about our ChiroFirst study.
In accordance with the Fulcrum Health, Inc. (Fulcrum) bylaws, as a network provider, you have the opportunity to vote for candidates to serve on Fulcrum’s Board of Directors. Visit https://www.surveymonkey.com/r/BallotElectedDirectors2019 to access the ballot. The ballot must be completed online on or before Friday, November 9, 2018 in order to be included in the final calculation.
Thank you in advance for your participation in the election process.
The focus of this month’s article will be on the training requirements set forth by the Centers for Medicare and Medicaid (CMS) and the Code of Federal Regulations (CFR).
CMS requires all organizations that provide health care services or administrative services for Medicare-eligible individuals under Medicare Advantage or Part D programs to complete annual Compliance and Fraud, Waste & Abuse Training.
The CMS trainings can be accessed through the Medicare Learning Network (MLN) Learning Management System (LMS) website here: Medicare Compliance & Fraud Waste & Abuse Training. Once registered, you will have to add the Medicare Compliance and Fraud Waste and Abuse Trainings individually.
If you know or suspect fraud, waste and/or abuse is occurring in your place of business please report it immediately to Fulcrum’s compliance hotline at 1-866-714-0526. Tips can be left on this voicemail 24/7 by anyone (provider, office support staff, patients, etc.).
If you have any non-PHI related questions, please direct them to Compliance@FulcrumHealthInc.org .
Minnesota Senior Health Options is a Special Needs Plans (SNPs) product offered by both HealthPartners and UCare. This fully-integrated Medicare and Medicaid product is designed for subscribers age 65 and over who have special health concerns and/or needs.
The Centers for Medicare and Medicaid Services (CMS) requires all doctors and staff to complete an annual Special Needs Training. Instructions, training materials, a FAQ document and tracking log are available now on ChiroCare.com .
Please plan to spend 30 to 60 minutes reviewing the materials with your staff. Then fill out the training log and keep it in your files for reference (you do not need to submit your training log to us).
The deadline for this year’s training is December 31, 2018.
Fulcrum is currently collecting information regarding Cultural Competence training. This is a requirement from 42 CFR 438.10 of the Managed Care Federal Regulation . It requires providers who provide health care services to Minnesota Health Care Programs (MHCP) members enrolled in a Managed Care Organization (MCO) must confirm compliance with the requirement of cultural competency training and accessibility for people with disabilities. There is not a single, specified course that must be completed. There are multiple training opportunities available through a variety of sources. You do not need to validate your course choice with Fulcrum, the discretion is left to you and your clinic.
Fulcrum is requesting that each clinic complete the online form by November 30, 2018. Click here to access the online form. This online form is located on a secure, encrypted webpage.
If you have not done so already, please fill out the provider satisfaction survey that was mailed to network providers last week. Please complete the survey and return it in the self-addressed, postage-paid envelope, no later than Wednesday, November 14, 2018.
We value your opinion. The feedback we gather from this annual survey helps identify areas of interest and of concern to the ChiroCare by Fulcrum Health network. We also use your responses to assist in the development of new programs, supporting materials, and educational opportunities.
If you have any questions or need a survey mailed out to you, please feel free to contact us at email@example.com or 763-204-8570 and we’ll be happy to assist you.
Thank you for taking the time to share your feedback and ideas with us!
Fulcrum is pleased to announce ChiroCare by Fulcrum Health Centers of Excellence (CCoE) application process is open to the entire ChiroCare network. We encourage you to take a close look at the CCoE program overview . The self-assessment tool will assist with determining your readiness to apply.
We will accept applications starting November 1 st from network providers who believe their clinics meet the Centers of Excellence criteria. The application period is open until March 1, 2019.
Current CCoE’s do not need to re-apply. Verification review of records will begin in January 2019.
If you have any questions about the ChiroCare Centers of Excellence program, please contact Dr. Vivi-Ann Fischer at 763-204-8570 or firstname.lastname@example.org .
After introducing a new logo earlier this year, UCare will change the name of three of its product lines beginning January 1, 2019:
- UCare for Seniors, a Medicare Advantage plan, will be renamed UCare Medicare Plans.
- UCare Choices, Individual and Family plans available through MNsure, will be renamed UCare Individual & Family Plans.
Fairview UCare Choices, Individual and Family plans available through MNsure, will be renamed UCare Individual & Family Plans with Fairview.
The new names are effective January 1, 2019. However, you may see them in advertising and various communications preparing members and providers for the new year.
Please update your systems to reflect this change beginning January 1, 2019. When you receive communications from UCare about any of these products in the coming months, you will see both the current and new names listed to help prevent confusion.
For 2019, members in these plans will receive new member ID cards, additionally UCare Individual & Family Plan members as well as UCare Individual & Family Plans with Fairview members will receive new member ID numbers . UCare strongly recommends that providers ask to see the member’s ID card for current information and a photo ID to guard against medical identity theft. Member eligibility and benefits should be checked prior to every scheduled appointment to determine membership status, coverage status, applicable copayment, coinsurance and deductible amounts.
Over the past several years, Medicare and commercial payers have moved toward value-based payment, shifting from payment on the volume of care, to payment more closely related to outcomes of care. New value-based payment models being developed will use measures of quality and cost to determine payment for providers.
Value-Based Care: Self-Assessment Quiz
Take a quick 3-question quiz to identify where you are in the continuum of health care payment reform.
1. Do you know where to find patient reported outcome measures (PROMs)?
2. Which patients are you currently using PROMs?
3. Do you have a clinic work flow process for incorporating PROMs?
Answer to #1
Patient reported outcome measures (aka Outcome Assessment Tools – OATs) can be found at ChiroCare Connect/Clinical Resources/Outcome Assessment Tools. The commonly used outcomes are the low back disability index (The Primary Care Low Back Disability Questionnaire (PCLBDQ)); neck disability index; headache disability index; Koos -Knee injury and Osteoarthritis Outcome Score; Hoos- Hip injury and Osteoarthritis Outcome Score; Lower Extremity Functional Scale, Functional Rating Index, Shoulder Pain and Disability Index; and DASH- The Disabilities of the Arm, Shoulder and Hand.
Answer to #2
Often practitioners use outcomes on Medicare, auto and work comp when all patients should be reporting outcomes to create measurable goals that can be tracked and demonstrate improvement with care.
Answer to #3
- Make sure everyone in your office and billers understand why your practice is collecting outcomes data. Involve everyone with planning and implementation.
- Educate your patients, these measures assist in the doctor determining the best care for them.
- If you are not already using outcomes on all patients, begin using the tool with new patients and returning patient exams. These measures assist with creating and tracking goals in the patient’s treatment plan.
- Begin with the most frequent patient conditions such as low back and neck disability outcomes.
It is vital that you report any practice changes to ensure that we have your current address, phone, fax, and email address. Any changes or corrections to your TIN/name combination should be communicated immediately. TheProvider Update tool within ChiroCare Connect offers a quick and electronic means to report changes. Simply select the “Billing Information Update” option within the Provider Update tool.
Please contact our Provider Services team at 877-886-4941 with any questions about submission of updates.