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January 2019 News Flash

January 31, 2019

In this issue

  1. Fulcrum’s Utilization Management Program
  2. What is the value of a ChiroCare Centers of Excellence (CCoE) designation?
  3. Accepting now – 2019 Center of Excellence Applications
  4. Board of Directors Reelection Report
  5. PHI Practice
  6. ACA Appointment
  7. Patient Experience
  8. Moving or Retiring? Let us Know!

Fulcrum’s Utilization Management Program

To keep us moving on our journey to value-based payment, the adoption phase for B&C tier providers of the ChiroCare network will begin on February 1st, 2019.

QConnect Journey to Value-Based Payment: Tier Assignment A

QConnect Journey to Value-Based Payment: Tier Assignment B & C

What is the value of a ChiroCare Centers of Excellence (CCoE) designation?

Healthcare in today’s world is focused on providing patient options that demonstrate high standards of quality and value. Consumers are demanding clinics that demonstrate this level of quality and affordability while primary care providers are seeking conservative care options to manage their patients’ back pain.

  • Provides visibility as a Center of Excellence clinic on the Find a Doc tool located on ChiroCare.com
  • Positions your clinic to be recognized for increased Pay for Performance incentives
  • Recognition as a quality clinic, facilitating trust and referrals with other care practitioners and patients
  • Opens opportunities to participate in pilot projects demonstrating conservative care value

The CCoE program highlights ChiroCare clinics who achieve and maintain the highest standards of patient-centered care through record keeping, documented outcome measures, and collaboration with other health care providers to achieve the Triple Aim in health care.

Attributes of Excellence

  1. Comprehensive Patient Intake and History
  2. Assessment and Outcome Tools
  3. Cognitive Behavioral Therapy
  4. Shared Decision Making
  5. Conservative Imaging
  6. Treatment Care Plans
  7. Coordination of Care Between Practitioners or Facilities
  8. Management of the Care Plan
  9. Established Referral List of Practitioners and Referral Procedures
  10. Active Care Instruction
  11. Patient Education on homecare and prevention
  12. Wellness Instruction
  13. Patient-Centered Approach to Care Plans and Care Management
  14. Demonstration of Collaboration with Other Practitioners

Accepting now – 2019 Center of Excellence Applications

Fulcrum Centers of ExcellenceFulcrum 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 invite those network providers who believe their clinics meet the Centers of Excellence criteria to apply. The application period is open until March 1, 2019.

Current CCoE’s do not need to re-apply. Verification review of records began 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 v.fischer@fulcrumhealthinc.org .

Board of Directors Reelection Report

In accordance with Fulcrum Health’s Bylaws, the board members listed below confirmed their desire to serve an additional three (3) year term beginning on January 1, 2019 and ending on December 31, 2021 as Directors of the Corporation. Election ballot forms were emailed to all voting members via Survey Monkey in October of 2018, and we are pleased to announce our reelections.

Congratulations to:

  • Molly Magnani, DC
  • Leo Bronston, DC
  • Mark Dehen, DC

We are excited to announce the new Chair of Fulcrum’s Board of Directors, Molly Magnani, DC!

Dr. Magnani is currently practicing at Allina Medical Clinic with Internal Medicine Physicians, Podiatrists, Rheumatologists, Endocrinologists and Mental Health providers to develop optimal treatment plans and referrals for patients. Her practice includes manipulation, acupuncture, physical therapy, massage, nutritional counseling, exercise programs and outcome assessment.

For more information about Fulcrum’s Board of Directors, visit the Board of Directorssection on our corporate website.

Compliance

PHI Practice

With the ease of electronic communications, like email, it is important to remember that risks still exist when sending information to patients. While emailing patients is not prohibited, there are considerations you should take prior to hitting send.

Please Note: Sending protected health information (PHI) through email to Fulcrum Health is prohibited.

If you need to send PHI to Fulcrum Health regarding: (1) an organization determination or prior authorization, please use QConnect; (2) a response to a member complaint or appeal, fax to 763-204-8544.

We encourage providers to always use encrypted emails when sharing any treatment, billing, and appointment information with your patients. If you are using a public email server, you should know that many of these are not considered to be a secured email method. Unsecured emails can be more easily intercepted by unintended users, which may result in PHI being received and used by an unintended recipient. Sending encrypted emails makes it so only the intended recipient is able to view the contents.

Securing patient PHI is a #1 concern – so exercise caution before transmitting any PHI through email – and if you must transmit PHI through email, be sure to encrypt your email before sending.

Under the Health Information Portability and Accountability Act (HIPAA), a patient has the right to ask their provider to communicate with them in reasonable alternative methods. For additional information on the HIPAA Privacy Rule’s guidance on emailing, please visit the US Department of health & Human Service’s website.

If you have any questions, that do not contain PHI, please direct them to Compliance@FulcrumHealthInc.org. Additionally, if you know or suspect fraud, waste 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.).

ACA Appointment

Congratulations to Dr. Leo Bronston! Leo Bronston, DC has been elected to the American Chiropractic Association (ACA) Board of Governors. The legislative, policy, corporate, business, and property powers of ACA are exercised, conducted, and controlled by the Board of Governors. In addition, Dr. Bronston is a Fulcrum Health board member.

https://www.acatoday.org/About/Board-of-Governors

Education

Patient Experience

Patient experience is the primary driver of patients’ consumer loyalty at health systems, hospitals, and physician practices, according to a recent Press Ganey report. According to an article in HealthLeaders , patient experience is five times more likely to influence brand loyalty than conventional marketing tools.

A few key takeaways:

  • Positive patient experience aligns with the mission of acquiring and retaining patients
  • Healthcare organizations should maximize patient feedback through multiple channels such as surveys, text, and email
  • Negative reviews online are an opportunity to improve patient experience

Click Here to read the article in its entirety.

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!