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October 12, 2018

In this issue

  1. A Few Spots Left! Madison, WI Symposium
  2. Disclosure of Ownership and Cultural Competency Requirement
  3. Let Your Voice Be Heard! Provider Satisfaction Survey
  4. Compliance Article
  5. Fee-For-Service Banished?

A Few Spots Left! Madison, WI Symposium

Register here.

Receive 5 CE credits at no cost to you!
  • Engaging speakers – DC’s, MD’s, and more
  • Audience interactive panel discussion
  • Continuing education credits
  • Lunch & refreshments provided
  • 1 day only – 10:00 a.m. – 5:00 p.m.

Click here to register for this exciting event!

Administration

Disclosure of Ownership and Cultural Competency Requirement

Red FlagIn accordance with regulatory requirements of the Minnesota Department of Human Services (DHS) and the Centers for Medicare & Medicaid Services (CMS) regulations, all payors, including Fulcrum Health, Inc. (Fulcrum) must collect and maintain information regarding disclosure of ownership and management information and cultural competency from all providers in its network on an annual basis.

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.

Let Your Voice Be Heard! Provider Satisfaction Survey

Please look for the Provider Satisfaction Survey in your mailboxes within the next 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, feel free to contact us at info@fulcrumhealthinc.org 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!

COMPLIANCE

This month’s article will focus on the Disclosure of Ownership form Fulcrum asks all clinics to complete each year. This form is related to disclosure of ownership, business transactions and excluded providers.

The Disclosure of Ownership is a requirement set forth by the Code of Federal Regulations ( 42 CFR Part §455 ) and from the Minnesota Department of Human Services (DHS) and the Centers for Medicare and Medicaid (CMS). These entities require all health plans and their delegates, including Fulcrum, to ensure that its network providers submit documentation.

While Fulcrum asks for this information annually, there are additional times you may need to complete this information. The Disclosure of Ownership form must be completed at the following times: upon initial contract with Fulcrum, when your information changes, and/or upon contract renewal. It is important to remember that if there are any changes to the information listed on your Disclosure of Ownership form, you must send an updated form to Fulcrum within 35 days. While Fulcrum asks you to complete the Fulcrum Disclosure of Ownership Form, you are able to submit your disclosure form used for other health insurers when the identical information is requested.

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.

Education

Fee-For-Service Banished?

Adam Boehler, Director of the Center for Medicare and Medicaid Innovation (CMMI), said at a recent briefing, “How much time do doctors spend documenting and coding for revenue? That’s a terrible system.”

He considers the top priorities to be:

  • Patient – how do you build a market [that answers] consumers’ desires” in terms of high quality and low cost?
  • Provider – empowered and accountable
  • Payment for outcomes – “Most of the time [if] you see something wrong in the healthcare system, it’s because we’re paying the wrong way. So we’re looking at a variety of different areas where we say, ‘Does this make sense or not?’ … [For example], if you call 911 today, the ambulance isn’t paid unless it takes you to the hospital. That’s a silly incentive … Let’s pay if somebody can take care of [the patient] in the home if that works”
  • Prevention – “Right now, medical care is siloed from housing, social services, and food stamps. If you were going to design the system today from scratch, you wouldn’t silo those; you’d look at the whole person.”

To read more, please visit https://www.medpagetoday.com/practicemanagement/reimbursement/74864

Where do I start?

  1. Find several outcome tools on ChiroCare Connect under the Clinical Resources/Provider Tools/ Outcome Assessments Toolbox. Begin with the Neck Index and Primary Care Low Back Disability Questionnaire (PCLBDQ)
  2. Use these outcomes with patients during the initial & any re-exams
  3. Incorporate outcome measurable goals into treatment plan

Illustrated Man with Magnifying Glass

Moving or Retiring? Let us Know!

Address Book IconIt 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.

We appreciate your continued partnership!