Azalea Health Innovations Friends Newsletter – April 2011
IN THIS ISSUE
* Welcome
* Correction in last month’s newsletter: ICD-10 Compliance Date
* Billing Tip/News: No Date Set for Expanded Ordering/Referring Provider Claim Edits
* GA Medicaid Electronic Health Records Incentives Program
* Medicare Attestation Begins on April 18. Are You Ready?
* New Features
* Upcoming Events
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Welcome
Hello to all of our Azalea Health Innovations friends. Thank you for reading this month’s Newsletter. We hope everyone is enjoying the warm weather!
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Correction in last month’s newsletter: ICD-10 Compliance Date
We apologize for the confusion as there was a typo in last month’s newsletter regarding the ICD-10 implementation date. Please note, the date for which the ICD-10 codes are to replace the ICD-9 codes should have read October 1, 2013 instead of October 1, 2012. Again we apologize for the mis-type, and we hope this did not inconvenience anyone.
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Billing Tip/News: No Date Set for Expanded Ordering/Referring Provider Claim Edits
Medicare has not yet set a date to enact claim edits that would cause rejections for items where an ordering/referring provider was not properly loaded in the new Provider Enrollment Chain and Ownership System (PECOS). Under this requirement, the ordering/referring providers will not see claims denials. Instead, the claims of providers who provide services under the order of another physician, including physical therapists, will be denied under this new requirement.
The following message was recently released from CMS regarding this issue:
“It has come to CMS’ attention that there was an editorial oversight in the OIG Compendium of Unimplemented Recommendations (March 2011 Edition). The OIG report states that the CMS will delay the implementation of Phase 2 of Change Request (CR) 6417 and CR until Tuesday, July 5, 2011. This is incorrect.
CMS has not yet determined when it will begin to apply the ordering/referring provider claim edit to ordering/referring providers that do not have a record in the Provider Enrollment, Chain, and Ownership System (PECOS). As previously stated, CMS will give providers ample notice before the ordering/referring provider claim edit is applied. Recent revisions to CRs #6417 and #6421 require MACs to delay rejecting claims until receiving further direction from CMS.”
Want to know if you or your provider is properly loaded in PEOCS? Go to the PECOS page on the CMS website and download the “Medicare Ordering and Referring File”. All providers successfully loaded in PECOS will be on this list.
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GA Medicaid Electronic Health Records Incentives Program
Georgia Medicaid is participating in the Centers for Medicare and Medicaid Services (CMS) Electronic Health Records (EHR) Incentive Program.
The Program is supported through the Centers for Medicare and Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC), as part of the American Recovery and Reinvestment Act of 2009.
The Georgia Medicaid EHR Incentives Program will provide incentive payments to eligible professionals (EP) and eligible hospitals (EH) as they adopt, implement, upgrade, or demonstrate meaningful use of certified EHR technology in their first year of participation and demonstrate meaningful use for up to five remaining participation years.
Eligible Professionals may receive up to $63,750 over the six years that they choose to participate in the program.
EPs under the Medicaid EHR Incentive Program include:
- Physicians (primarily doctors of medicine and doctors of osteopathy)
- Nurse practitioners
- Certified Nurse-Midwives
- Dentists
- Physician Assistants who furnishes services in a Federally Qualified Health Center or Rural Health Clinic that is led by a physician assistant.
To qualify for an incentive payment under the Medicaid EHR Incentive Program, an eligible professional must meet one of the following criteria:
- Have a minimum 30% Medicaid patient volume
- Have a minimum 20% Medicaid patient volume, and is a pediatrician
- Practice predominantly in a Federally Qualified Health Center or Rural Health Center and have a minimum 30% patient volume attributable to needy individuals
Children’s Health Insurance Program (CHIP) patients do not count toward the Medicaid patient volume criteria.
Eligible Hospitals’ incentive payments are based on a number of factors, beginning with a base payment that will be adjusted according to pre-determined formula. Hospitals eligible to participate in the Medicaid EHR Incentives program are:
- Acute care hospitals (including CAHs) with at least 10% Medicaid patient volume; and
- Children’s hospitals (no Medicaid patient volume requirements)
Registration for the Georgia Medicaid incentive payments are scheduled to begin in the 2nd quarter of 2011. Payments are scheduled to begin in the 3rd quarter of 2011. Please visit our website at www.dch.georgia.gov/ehr for more information regarding the program.
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Medicare Attestation Begins on April 18. Are You Ready?
Attestation for the Medicare Electronic Health Record (EHR) Incentive Program begins on April 18, 2011. In order to receive your Medicare EHR incentive payment, you must attest through CMS’ web-based Medicare and Medicaid EHR Incentive Programs Registration and Attestation System.
Today you can preview selected screenshots of the Attestation System to help you understand what the attestation process will involve. Please note that these screenshots are only examples and that the final appearance and language may incorporate additional changes. CMS will release additional information about the Medicare attestation process soon, including User Guides that provide step-by-step instructions for completing attestation, and educational webinars that describe the attestation process in depth.
Here is more information to help you prepare for Medicare attestation:
You need to understand the required meaningful use criteria to successfully attest. Meaningful use requirements for eligible professionals (EPs), eligible hospitals, and critical access hospitals (CAHs) participating in the Medicare EHR Incentive Program are different:
EP Meaningful Use Criteria – Must report on 15 core measures, 5 of 10 menu measures, and 6 clinical quality measures, consisting of 3 required core measures and 3 additional measures.
- Go to the Stage 1 EHR Meaningful Use Specification Sheets for EPs for information on core and menu measures for EPs.
- Go to the Clinical Quality Measures page for information on the required clinical quality measures for EPs.
Eligible Hospital and CAH Meaningful Use Criteria – Must report on 14 core measures, 5 of 10 menu measures, and 15 clinical quality measures.
- Go to the Stage 1 EHR Meaningful Use Specification Sheets for Eligible Hospitals and CAHs for information on core and menu measures for eligible hospitals and CAHs.
- Go to the Clinical Quality Measures page for information on the required clinical quality measures for eligible hospitals and CAHs.
You should also make sure that you begin your 90-day reporting period in time to attest and receive a Medicare payment in 2011. The last day to begin your 90-day reporting period for 2011 incentive payments is:
- July 3, 2011, for eligible hospitals and CAHs, and
- October 1, 2011, for EPs.
Under the Medicaid EHR Incentive Programs, the date when participants can begin attestation for adopting, implementing, upgrading, or demonstrating meaningful use of certified EHR technology varies by state. Go to the Medicaid State EHR Incentive Program web tool for more information about your state’s participation in the Medicaid EHR Incentive Program.
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New Features
UB04 is now available in Azalea PM! Look out Monday for the New Features – April 2011 email to view the additional new features available in Azalea PM.
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Upcoming Events
AHI will be exhibiting Azalea PM™ and many other products and services at the upcoming MGMA/ Annual Conference in Orlando, FL. The conference will be held at the Caribe Royale Resort, May 9-10, 2011.
AHI will be showcasing Azalea LabHub™ at the CLMA ThinkLab 2011 Conference in Baltimore, MD. The conference will be held at the Baltimore Convention Center, May 22-24, 2011. We will be located at booth # 325. Come by and say hello!
AHI will be promoting Azalea PM™, EMR solutions, and our Revenue Cycle Management
services at the Alabama Academy of Family Practitioners (AAFP) 2011 Annual Meeting and Scientific Symposium. The conference will be held June 23-25, 2011 at the Sandestin Resort in Destin, FL.
AHI will be exhibiting our Azalea PM™ product, Revenue Cycle Management Services, and much more at the MGMA / Summer Conference in Destin, FL. The conference will be held at the Hilton Sandestin Beach and Golf Resort. August 1-3, 2011.
We hope to see all of you at our upcoming events!
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Thank you!
Azalea Health Innovations, Inc.
100 North Patterson Street
Valdosta, GA 31601
Toll Free: 877-777-7686
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Web: http://www.AzaleaHealth.com
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