Anthem Blue Cross (Anthem) has network leasing arrangements with a variety of organizations, which we call Other Payors. Other payors and affiliates use the Anthem network.

Under the terms of your provider agreement, members of other payors and affiliates are treated like Anthem members. As such, they’re entitled to the same Anthem billing considerations, including discounts and freedom from balance billing. You can obtain the Other Payors list on the Availity web portal, at www.Availity.com. From the Availity site, select Home > Anthem California > Education and Reference Center, or email us at CAContractSupport@Anthem.com.

Connecting with Anthem Blue Cross and staying informed will be even easier, faster and more convenient than ever before with our Network eUPDATEs.

Network eUPDATE is our web tool for sharing vital information with you. It features short topic summaries and links that let you dig deeper into timely critical business information:

• Important website updates
• System changes
• Fee Schedules
• Medical policy updates
• Claims and billing updates

……and much more                                                                                                                         

Registration is fast and easy. There is no limit to the number of subscribers who can register for Network eUPDATEs, so you can submit as many e-mail addresses as you like.

Anthem Blue Cross (Anthem) providers should now submit changes to their practice profile using our online Provider Maintenance Form.

Online update options include: add an address location, name change, tax ID changes, provider leaving a group or a single location, phone/fax numbers, closing a practice location, etc. Visit the Anthem.com/ca form page to review more.

The new online form can be found on www.anthem.com/ca/provider/ > Find Resources for California >  Answers@Anthem tab>Provider Forms bullet>Provider Change Forms> Provider Maintenance Form.  In addition, the Provider Maintenance Form can be found on the Availity Web Portal by selecting California> Payer Spaces-Anthem Blue Cross> Resources tab >Provider Maintenance Form.

Important information about updating your practice profile:

• Change request should be submitted using the online Provider Maintenance Form
• Submit the change request online. No need to print, complete and mail, fax or email demographic updates
• You will receive an auto-reply e-mail acknowledging receipt of your request and another email when your submission has been processed
• For change(s) that require submission of an updated IRS Form w-9 or other documentation, attach them to the form online prior to submitting
• Change request should be submitted with advance notice
• Contractual agreement guidelines may supersede effective date of request

You can check your directory listing on the Anthem Blue Cross: “Find a Doctor tool”. The Find a Doctor tool at Anthem is used by consumers, members, brokers, and providers to identify in-network physicians and other health care providers supporting member health plans. To ensure Anthem has the most current and accurate information, please take a moment to access the Find A Doctor tool (www.anthem.com/ca) and review how you and your practice are being displayed.

To report discrepancies please make correction by completing this Provider Maintenance Form online.

It is extremely important that we have accurate and up-to-date information about your practice in our directories. Senate Bill 137 (SB 137), which went into effect on July 1, 2016, requires that Anthem Blue Cross (Anthem) provide our members accurate and up-to-date provider directory data. As a result, Anthem will be conducting ongoing outreaches to all practices to confirm the information we have on file is accurate. Without verification from you that our Provider Directory information is accurate, we will be required to remove your practice from the directories we make available to our members. We appreciate your attention to this matter.

Our Provider Network Education team offers quality complimentary educational programs and materials specially designed for our providers. For a complete listing of our workshops, seminars, webinars and job aids, log on to the Anthem Blue Cross website: www.anthem..com/ca. Scroll down the page to Partners in Health > Tools for Providers. In the middle of the page select the box

Find Resources for California. From the Answers@Anthem page, select the link titled Provider Education Seminars and Webinars link.

In an effort to better service our contracted providers right the first time, Anthem Blue Cross has improved our provider claim escalation process. Just click, Provider Claim Escalation Process to read, print, download and share the improved process with your office staff.

Our Network Relations Team is available by email at CAContractSupport@anthem.com to answer questions you have about the process.

We want to remind providers that they can utilize fax number 1-855-211-3699 to submit requests for Urgent (Expedited) grievances. 

Urgent (Expedited) grievances are pre-service or concurrent requests for which a delay may cause:

• An imminent and serious threat to the health of the member
• Severe pain, potential loss of life, limb, or major bodily function
• Delay of end-of-life care and treatment

 Thank you for assisting us in serving our members in a timely manner.

As a reminder, the Workers’ Compensation Physicians Acknowledgments is required by California Code of Regulations §9767.5.1, “Medical Provider Networks” (MPN). The “MPN applicant shall obtain from each physician participating in the MPN a written acknowledgment in which the physician affirmatively elects to be a member of the MPN.” 

To maintain and affirm your participation in all MPNs that you have been selected for and have subscribed to Anthem’s Provider Affirmation Portal, go to Availity and login. Once in, click on the Payer Spaces drop down menu in the top right hand corner, and select Anthem Blue Cross from the options available to you. On the next page click on “Resources” in the middle of the page and look for “MPN Provider Affirmation Portal.”

Availity>Payer Spaces>Anthem Blue Cross>Resources>MPN Provider Affirmation Portal

If you cannot go online, call Anthem Workers’ Compensation at 1-866-700-2168 and we can take action on your behalf in the Provider Affirmation Portal. Please also keep an eye out for email notifications from “Anthem MPN Admin.”

Please also be advised the Provider Affirmation Portal will also notify participating medical providers when an MPN is terminating its relationship with Anthem and/or the Division of Workers Compensation.

The Let’s Vaccinate website electronically delivers free turnkey solutions for providers to help increase vaccination rates for children, adults, and pregnant women. Because disparities in vaccinations can lead to disease outbreaks, this website also provides tools to address vaccination disparities across race/ethnicity, age, socioeconomic status, and geography (urban vs. rural). This site also provides a vehicle for connecting providers to their state immunization programs and local immunization coalitions. Let’s Vaccinate is an initiative created by Anthem, Inc., Vaccinate Your Family: The Next Generation of Every Child by Two, and Pfizer, Inc. 

In the March 2019 edition of our newsletter, we announced the exciting updates we’ve made to the Medical Attachment submission tool. As you start using the updated medical attachment tool on the Availity Portal, you will notice the following changes from the information we shared in March:

• File size – each attachment can be up to 10 MB with a maximum of 30 MB as the file size limit
• The addition of logos in your dashboard make it easy to quickly identify each payer
• The Medical Attachment tool will be retired from the Availity Portal soon, so we encourage you to start utilizing the ‘Attachment – New’ option now. Once a date has been determined for the Medical Attachment Tool retirement we will begin communication.

Other features of the updated medical attachment include:

• The ability to submit an itemized bill
• A different link tilted “Attachment – New” where you will now submit medical records when Anthem has requested additional information to process a claim
• A new link on the attachment page called “Send Attachment” will allow you to start the process
• A record history of each entry provides you increased visibility of your submission

The Medical Attachment tool makes the process of submitting an electronic documentation in support of a claim, simple and streamlined. You can use your tax identification number (TIN) or your NPI to register and submit solicited (requested by Anthem) medical record attachments through the Availity Portal.

NOTE: We will continue to keep you informed of upcoming changes to the ‘Attachment – New’ platform as we progress toward streamlining our electronic documentation functionality.

How to Access solicited Medical Attachments for Your Office

Availity Administrator, complete these steps:

From My Account Dashboad, select Enrollments Center > Medical Attachments
Setup, follow the prompts and complete the following sections:

From My Account Dashboard, select Enrollments Center > Medical Attachments
Setup, follow the prompts and complete the following sections:

1. Select Application>choose Medical Attachments Registration
2. Provider Management>Select Organization from the drop-down. Add NPIs and/or Tax IDs (Multiples can be added separated by spaces or semi-colons)
3. Assign user access by checking the box in front of the user’s name. Users may be removed by unchecking their name

Using Medical Attachments

Availity User, complete these steps:

1. Log in to www.availity.com
2. Select Claims and Payments > Attachments-New >Send Attachment Tab
3. Complete all required fields of the form
4. Attach supporting documentation
5. Submit

Need Training?

To access additional training for this Availity feature: Log in and select Help & Training | Get Trained to open the Availity Learning Center (ALC) Catalog in a new browser tab. It is your dedicated ALC account. Search the Catalog by keyword (attachments) to find training demo and on-demand courses. Select Enroll to enroll for a course and then go to your Dashboard to access it any time.

Additional enhancements are now available for Benefit/Service Types in the Availity Portal to better serve you. Now you will be able to access more service types when utilizing the Eligibility and Benefits Inquiry via Availity for many Anthem Blue Cross (Anthem) members.

You may have noticed fairly new additions to Service Types that include:

• Medically Related Transportation
• Long Term Care
• Acupuncture
• Respite Care
• Dermatology
• Sleep Study Therapy (found under Diagnostic Medical)
• Allergy Testing

Although there is an extensive list of available benefit types when submitting an eligibility and benefits request, they vary by payer.  Some important points to know about when selecting service type:

• The benefit/service type field is populated with the last benefit type you selected. If you don’t see a specific benefit in the results, submit a new request and select the specific benefit type/service code.
• You have the ability to inquire on 50 patients at one time using the “add multiple patients” feature.

In response to your feedback, we have added additional service types to share even more valuable information with you electronically.  So if your practice works with the new service types, now you will be able to view more detailed information on those services electronically. Check them out today.

Have you had more patients present with their ID card on their smartphone? We want to remind you of the ways you can access your own copy of their ID card.

In the October 2017 issue of Network Update, Anthem Blue Cross (Anthem) informed you about our mobile app called Anthem BC Anywhere that allows members to manage their benefits on their smart phones, including the option of an electronic only version of their ID cards.  We want to ensure a member’s electronic only ID card meets your needs. 

Based on member requests and growing trends, we anticipate that by the year 2020, nearly 50% of our Local Plan members may choose the electronic ID card option, so we urge you to start using the available retrieval tools today. 

Provider options for obtaining a copy of an electronic Member ID card

Note: as with all E&B Inquiries on Availity, providers must have the member ID number (including the three-character prefix) and one or more search options of date of birth, first name and last name.

These options are available for your patients who are members covered by our affiliated health plans in CO, CT, GA, IN, KY, ME, MO, NH, NV, OH, WI, VA, and NY. 

Members are still required to have a copy of their card in one format or another, whether hard copy or electronic, in order for services to be rendered.  See our Quick Reference Guide for further details.

Quick Reference Guide

See our Electronic Member ID Cards – Quick Reference Guide  for more details and information on:

• Frequently Asked Questions
• Details on provider options for obtaining a copy of an electronic Member ID card
• Sample electronic Member ID cards

In a continuation of our CRA reporting update articles throughout 2019, Anthe Blue Cross (Anthem) requests your assistance with respect to our Commercial Risk Adjustment (CRA) reporting processes.

As a reminder, there are two approaches that we take (Retrospective and Prospective) to improve risk adjustment reporting accuracy.  We are focusing on performing appropriate interventions and chart reviews for patients with undocumented Hierarchical Condition Categories (HCC), to close the documentation and coding gaps that we are seeing with our members enrolled in our Affordable Care Act (ACA) compliant plans.

This month we’d like to focus on the Prospective approach, and the request to our Providers:

Anthem network providers -- usually primary care physicians -- may receive letters from our vendor, Inovalon, requesting that physicians:

1. schedule a comprehensive visit with patients identified to confirm or deny if previously coded or suspected diagnoses exists, and
2. submit a Health Assessment documenting the previously coded or suspected diagnoses (also called a SOAP Note -- Subjective, Objective, Assessment and Plan).

Incentives for properly submitted Health Assessments (in addition to the office visit reimbursement):

• $100 submitted electronically
• $50 submitted via fax

Health Assessment requests through Inovalon

We have engaged Inovalon -- an independent company that provides secure, clinical documentation services -- to help us comply with provisions of the ACA that require us to assess members’ relative health risk level.  In the coming weeks and months, Inovalon will be sending letters to providers as part of our risk adjustment cycle, asking for their help with completing health assessments for some of our members.

This year will bring a new round of assessments. As a reminder, chronic conditions must be coded every year, and we encourage you to code to the greatest level of specificity on all Anthem claim submissions.  If you have questions about the requests you receive, you can reach Inovalon directly at 1-866-682-6680.

Maximize your Incentive opportunity: submit electronically via Inovalon’s ePASS® tool

Join an ePASS webinar to learn how to submit a Health Assessment electronically and maximize your incentive opportunities.  They are offered every Wednesday from 3:00 - 4:00pm EST.  Register by sending an email to ePASSProviderRelations@inovalon.com with your name, organization, contact information and the date of the webinar you wish to attend.

• Teleconference: Dial 1-415-655-0002 (US Toll) and enter access code: 736 436 872  
• WebEx: Visit https://inovalonmeet.webex.com and enter meeting number: 736 436 872
• Once you join the call, live support is available at any time by dialing *0

Alternative reporting engagement

ePASS is our preferred method for submission for the Prospective approach. However to improve engagement and collaborate with our Providers who are not submitting via ePASS, we have identified other alternatives which may be helpful and provide more flexibility with your current processes.

If you are interested in any of these alternative options, please contact our CRA Network Education Representative: Socorro.Carrasco@anthem.com. Select the attachment to view some of the Alternative Reporting Options.

As a contracted provider with Anthem Blue Cross (Anthem) in California, please remember that you are obligated when medically appropriate to refer Anthem members to in-network providers. This includes physicians and all provider types including, but not limited to, ambulance transport (ground and air), ambulatory surgical centers, behavioral health services, physical medicine providers and ancillary providers. Referring to in-network providers allows members to receive the highest level of benefits under their Health Benefit Plan.  As a reminder, call Anthem first for prior authorization if required by the member’s policy. 

Ground Ambulance Providers

You can search for participating ground providers using our online tool, Provider Finder, located at www.anthem.com. Search parameters include distance from your location (zip code, address or county). To use the tool, go to www.anthem.com and follow these steps in our “Find a Doctor” tool:

1. Select “all plans/networks”
2. Select type of coverage
3. I am looking for a : “other medical services”
4. Who specializes in: “ambulance companies”
5. Located near: add your address, zip or county

Air Ambulance Providers

The providers listed in the attachment are participating air ambulance providers with Anthem in California.  This means that these providers have contractually agreed to accept the Anthem Rate as payment in full for covered services, and they will bill members only for allowable benefit cost-share obligations when transporting members who are picked up in California. 

Some air ambulance providers choose not to participate with payers like Anthem. 

• These air ambulance providers may charge members rates that are much higher than the Anthem contracted provider rates.
• Depending on their benefits, members who utilize non-participating air ambulance providers can be left with significant out-of-pocket expenses, which the ambulance providers and their billing agents may seek to collect.

To avoid these situations, we ask that, whenever possible, you use a participating air ambulance provider for your patients who are our members.  Utilizing participating providers:  

• Protects the member from balance billing for what may be excessive amounts,
• Assures the most economical use of the member’s benefits, and
• Is consistent with your contractual obligations to refer to in-network providers where available.

To schedule fixed wing or rotary wing air ambulance services, please contact Anthem for prior authorization if required by the member’s policy, then call one of the phone numbers listed below. Please have the following information ready when you call:

• Basic medical information about the patient, including the patient’s name and date of birth or age.  If the service was not precertified with Anthem, the air ambulance provider will also need to receive a full medical report from the attending facility.
• Current location of the patient, the name of the hospital or facility caring for the patient and its address (city and state).
• Location where patient is to be transported, including the name of the destination hospital/facility and address.
• Approximate transport date or time frame.
• Special equipment or care needs.

Should you have questions regarding the air ambulance network, including providers contracted for air ambulance pickups outside of California, please contact your Provider Solutions Contract Manager.  To arrange air transport originating outside the U.S., U.S. Virgin Islands and Puerto Rico, call 1-800-810-BLUE for BCBS Global Core formerly Bluecard Wordwide.

The providers listed in the attachment are participating air ambulance providers with Anthem in California.

The Department of Managed Health Care’s (DMHC) routine medical survey includes evaluation of a Health Plan’s compliance with California Health and Safety Code section 1368(a)(2); 28 CCR 1300.68(b)(6) and (7). These regulations require Health Plans to ensure that grievance forms, a description of grievance procedures, and assistance in filing grievances are readily available at each contracting provider’s office, contracting facility, or Plan facility.

We ask that you please review and distribute the Anthem Blue Cross (Anthem) grievance form to all your participating offices.  It’s important to implement a process that will ensure that the attached grievance form is provided to Anthem members upon request.

Information can be accessed on the process of submitting member grievances and appeals, grievance forms, definitions and appeal rights, on Anthem’s website at www.anthem.com/ca/forms. Go to View by Topic and click on the drop down menu and select Grievance & Appeals, then select the desired resource link.   
                 

Also, grievance forms, grievance procedures and additional information about Anthem’s expedited grievance and appeals review process, can be found in your Provider Operations Manual. An annual survey will be distributed via Availity to confirm if provider offices have implemented processes to provide grievance forms and assistance to enrollees.

We appreciate your cooperation and support.

As part of our commitment to provide you with the latest clinical information and educational materials, we have adopted nationally recognized medical, behavioral health, and preventive health guidelines, which are available to providers on our website.  The guidelines, which are used for our Quality programs, are based on reasonable medical evidence, and are reviewed for content accuracy, current primary sources, the newest technological advances and recent medical research. All guidelines are reviewed annually, and updated as needed. The current guidelines are available on our website. To access the guidelines, go to https://www.anthem.com/ca/provider/.   From there, scroll down and click on Read Polices.  This will take you to Medical Policy, Clinical UM Guidelines (for Local Plan M, and Pre-Certification Requirements. Then click on the Practice Guidelines on the Health & Wellness tab.

For updated information, see the MMP Prior authorization requirements for DME repair and portable oxygen concentrator.

Anthem Blue Cross (Anthem) has identified that providers often bill a duplicate evaluation and management (E&M) service on the same day as a procedure, even when the same provider (or a provider with the same specialty within the same group TIN) recently billed a service or procedure which included an E&M service for the same or similar diagnosis. The use of Modifier 25 to support separate payment of this duplicate service is not consistent with correct coding or Anthem policy on use of Modifier 25. Read the full article.

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Anthem Blue Cross (Anthem) is working with Optum CiOX Health (CiOX) to request medical records for risk adjustment. Risk adjustment is the process by which CMS reimburses Medicare Advantage plans, such as Anthem, based on the health status of their members. Risk adjustment was implemented to pay Medicare-Medicaid Plans (MMPs) more accurately for the predicted health cost expenditures of members by adjusting payments based on demographics (age and gender), as well as health status.

In 2019, Anthem will work with Optum, using their copy partner CiOX, to request medical records with dates of service for the target year 2018, through present day, then review and code the record.

Jaime Marcotte, Retrospective Risk Program Lead, is managing this initiative. Should you have any questions regarding this program, please contact Jaime at Jaime.Marcotte@anthem.com or 1-843‑666‑1970.

History of risk adjustment

As a part of risk adjustment implementation, CMS initially collected hospital inpatient diagnoses for determining payment to MMPs. In 2000, Congress mandated a change to include ambulatory data. This change took place gradually, with full implementation in 2007. CMS selected a payment model that included diagnosis data reported from physician office, hospital inpatient and hospital outpatient settings — the CMS-Hierarchical Condition Category (CMS-HCC) payment model.

Physician’s role

Physician data is critical for accurate risk adjustment as physicians are the largest source of ambulatory data for the risk adjustment model. The CMS-HCC model relies on ICD-10-CM coding specificity.

What is the provider notification process?

Optum using the copy partner CiOX, will initiate the record retrieval process. The process begins with telephonic or fax outreach to the provider, which is followed by a written request, to include:

• Role of the vendor.
• Purpose of the medical record retrieval request.
• Action being requested (for example, submission of the entire medical record).
• Name of the member.
• Date rangeof service being requested.

The provider should supply the medical records within two weeks following receipt of the request. If the provider did not see the member during the requested dates of service, the provider should return the request to the vendor with an explanation that no information relative to the request appears on the patient’s medical record

How does risk adjustment impact physicians and members?

It’s important to keep in mind that the risk adjustment process also benefits you and your patients. Increased coding accuracy helps Anthem identify patients who may benefit from disease and medical management programs. More accurate health status information can be used to match healthcare needs with the appropriate level of care.

Risk adjustment also helps you meet your CMS provider responsibilities regarding reporting ICD-10-CM codes, including:

• Secondary diagnoses, to the highest level of specificity.
• Maintaining accurate and complete medical records (ICD-10-CM codes must be submitted with proper documentation).
• Reporting claims and encounter data in a timely manner.

With your help in providing accurate and timely coding for risk adjustment, we can avoid unnecessary and costly administrative revisions, and provide your patients and our members with superior customer service.

Why is medical record documentation important for risk adjustment?

• Accurate risk adjusted payment relies on complete medical record documentation and diagnosis coding.
• CMS conducts risk adjustment data validation by medical record review.
• Specificity of the ICD-10 diagnosis coding is substantiated by the medical record.

Importance of ICD-10-CM diagnosis coding

• ICD-10-CM is the official diagnosis code set for Medicare and is used for risk adjusted payment.
• Medical record documentation dictates what code is assigned.
• Appropriate coding requires use of the most specific code available.

Medical record documentation

• Documentation should be clear, concise, consistent, complete and legible.
• Document coexisting conditions at least annually.
• Use standard abbreviations.
• Utilize problem lists. (Ensuring they are comprehensive, show evaluation and treatment for each condition relating to an ICD-10 code on the date of service, and are signed and dated by the physician or physician extender.)
• Identify patient and date on each page of the record.
• Authenticate the record with signature and credentials.

Major points

Federal regulations require Medicare and its agents to review and validate medical records to avoid underpayments or overpayments.

It is important for the physician’s office to fully code each encounter; the claim should report the ICD‑10‑CM code of every diagnosis that was addressed and should only report codes of diagnoses that were actively addressed.

Contributory (comorbid) conditions should be reported if they impact the care and are therefore addressed at the visit, but not if the condition is inactive or immaterial. It should be obvious from the medical record entry associated with the claim that all reported diagnoses were addressed and that all diagnoses that were addressed were reported.

Requests for medical records

Anthem continually conducts medical record reviews to identify additional conditions not captured through claims or encounter data and to verify the accuracy of coding.

In addition, if CMS conducts an annual Data Validation Audit on the MMP health plan, the provider will be required to assist Anthem by providing medical record documentation for members included in the audit. 

Concerned about HIPAA privacy?

The collection of risk adjustment data and request for medical records to validate payment made to MMP organizations is considered a health care operation and, as such, does not violate the privacy provisions of HIPAA (45 CFR 164.502).

CMS data validation

Data validation ensures the integrity and accuracy of risk-adjusted payment. It is the process of verifying that the diagnosis codes submitted by the MMP organization are supported by the medical record documentation for a member.

MMPs are selected for data validation audits annually.

It is important for physicians and their office staff to be aware of risk adjustment data validation activities because medical record documentation may be requested by the MMP organization. Accurate risk-adjusted payment relies on the diagnosis coding derived from the member’s medical record.

Additional risk adjustment information is available at http://csscoperations.com.

Additional information, including frequently asked questions and answers, will be available at https://mediproviders.anthem.com/ca > Important Medicare-Medicaid Plan (MMP) Updates.

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Check out additional information about the latest updates to Electronic Data Interchange Gateway migration.

View more information online about electronic claim payment reconsideration.

On August 17, 2018, October 9, 2018, and November 16, 2018, the pharmacy and therapeutic (P&T) committee approved Clinical Criteria applicable to the medical drug benefit for Anthem Blue Cross (Anthem). These policies were developed, revised or reviewed to support clinical coding edits.

The Clinical Criteria is publicly available on the Anthem provider website, and the effective dates are reflected in the Clinical Criteria updates notification. Visit the Clinical Criteria website to search for specific policies.

Email for questions or additional information.

Please continue to check Important Medicare Advantage Updates at anthem.com/ca/medicareprovider for the latest Medicare Advantage information, including:

• Medicare Advantage Group Retiree PPO plans and National Access Plus FAQ 
• Group Retiree members and National Access Plus
• Special Need Plans training required

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Check out additional information online about the evaluation and management with Modifier 25 update.

View more information online about the prior authorization requirements for DME repair and portable oxygen concentrator.

Check out additional information about the new incentive program for reimbursement for select CPT Category II codes.

Medicare Advantage plans under Anthem Blue Cross follow original Medicare guidelines and billing requirements for partial hospitalization services. CMS regulations (42 CFR 410.43(c)(1)) state that partial hospitalization programs (PHPs) are intended for members who require a minimum of 20 hours per week of therapeutic services as evidenced in their plan of care. All partial hospitalization services require prior authorization. Read the full article online.

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Modifier 63: Procedure Performed on Infants Less Than 4 kg – Policy 06-015

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In 2019, Anthem will work with Optum, using their copy partner CiOX, to request medical records with dates of service for the target year 2018, through present day, then review and code the record. Read the full article online.

Additional information, including frequently asked questions and answers, will be available at www.anthem.com/ca/medicareprover > Important Medicare Advantage Updates.

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Each year, falls result in more than 2.8 million ER visits; 800,000 hospitalizations; and 27,000 deaths. Additional information about helping patients enrolled in Medicare Advantage prevent falls is available here.

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