 Provider News ColoradoSeptember 2018 Anthem Provider Newsletter - COPlease join us for one of our upcoming provider seminars in Colorado. The sessions include important updates and information about doing business with us. Topics include: Product overview for 2019, Affordable Care Act updates for 2019, Medicare Advantage PPO, CU Exclusive updates, WellChoice overview, New Provider newsletter/communication template, Anthem.com Provider website enhancements, Availity Portal enhancements, plus more!
For locations and dates, see our Provider Seminar Invitation.
Online registration that’s quick and easy!
Our registration process is available online for both our “In-person” meetings, as well as “webinars”.
NOTE: The content covered in the Provider Seminars and Webinars is the same, but we split the webinars into two content parts to make the online learning experience a little easier and shorter length.
The online registration includes automated acknowledgement of your registration, an appointment to add to your calendar, and reminder notifications. If you do not have access to the internet to register, you may email your information to us as indicated on the bottom of the Provider Seminar Invitation. If you can’t attend but have questions about any of the information we’ll cover, please contact your Anthem Provider Relations representative.
Register online using one of the following links:
Go to anthem.com. Select Providers, then Providers Overview. Select Find Resources for Your State, and pick Colorado. From the Provider Home page, under the Communications and Updates heading, select the Provider Seminars link. Next, under the Fall 2018 Provider Seminars heading, select the link titled “Fall 2018 Provider Seminar Invitation – online registration form”, select either “IN-PERSON” or “WEBINARS”. Or go to the appropriate URL listed below:
The new Healthcare Bill Payments feature on the member portal at anthem.com allows many Anthem members to make payments to providers for their out-of-pocket expenses as soon as claims are processed. This new payment option offers members the convenience of making secure payments from the same place they go to view their claims, and helps providers receive payments faster and with less effort.
Ready to get started?
Register today to receive these payments faster as direct deposit.
Want to learn more?
Watch the on-demand webinar
Learn how Healthcare Bill Payments works, including:
- How providers can collect patient payments faster with direct deposit
- Why patients prefer to make payments with Healthcare Bill Payments
- How Healthcare Bill Payments can help you reduce staff effort and billing costs
- Payment options and how to register
Exciting changes are coming to the public provider site on anthem.com this September. As a result of surveys and interviews with numerous health care professionals as well as in-depth analytics research, Anthem will launch our first new pages to the public provider site since the initial home page launch in January 2018.
The redesign will be rolled out in multiple phases with the goal of improving the ease in which providers find the right information and resources they need in order to do business with us.
The new site features an updated look and feel, consistent with the rest of anthem.com. It is designed to make all provider content easier to use and understand. A few of the highlights include updated pages for:
- Join Our Network and Credentialing
- a redesigned Provider News page
- an easy-to-navigate Provider Resources area
- and more
This mid-September release is the first in a series of quarterly updates. Each will redesign helpful resources for providers that will replace older content on the public provider site. We’ll keep you posted on upcoming changes, as we continue to work to streamline our Web platform and other business processes. Anthem continues to work with Inovalon – an independent company that provides secure, clinical documentation services – to help ensure that members who have purchased health care plans on or off the Health Insurance Marketplace (also called the exchange) get their diagnoses confirmed, corrected, and updated every year, as well as have potential preventive care gaps addressed. To accomplish this goal, as a network provider with Anthem (usually primary care physicians) you may receive letters from Inovalon on our behalf, asking you to perform patient outreach to identified Anthem patients so that patients can schedule an in-office visit with your practice.
Electronic SOAP notes
Once you see the patient, the next step is for you to complete a subjective, objective, assessment, and plan (SOAP) note – a standardized documentation format of a medical record. By submitting your SOAP notes electronically via Inovalon’s ePASS® tool, you will receive $100 for each fully and properly completed SOAP note submitted for 2018 dates of service.
ePASS is a powerful clinical resource tool. Here’s how:
- Meets the Centers for Medicare & Medicaid Services’ (CMS) SOAP note standards.
- Supports documentation of a comprehensive history and physical as well as a medication review for confirmed chronic conditions.
- Identifies screening and preventive care measures and potential gaps.
- Provides relevant quality metric reporting opportunities.
- Saves time as ePASS submissions are faster than manual submission of paper notes
Questions or assistance
Need help with ePASS or have questions? Simply email your inquiry to Inovalon at ePASSsupport@inovalon.com with your name, organization, contact information, and any questions that you might have. Trained representatives are available to assist you. If you prefer to reach Inovalon by phone, please call 1-877-448-8125, Monday - Friday, 8 am - 8 pm ET; Saturday - Sunday, 10 am - 6 pm ET.
For a practical overview of ePASS, please refer to Inovalon’s online document: Frequently Asked Questions.
Join a Live Weekly Webinar
Availible every Wednesday from 3 pm – 4 pm ET, we encourage you to register in advance by sending an email to ePASSProviderRelations@inovalon.com with your name, organization, contact information and the date of the webinar you wish to attend.
How to Join Webinar:
The following information can be used to join all webinars scheduled in 2018
- 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
GO TO ePASS WEBSITE
We have completed the HEDIS data collection for 2018 and want to thank all of our provider offices and their staff who assisted us. Your collaboration in this process allows us to strive for the best HEDIS results possible.
This is the 7th year for our incentive program to acknowledge some of our providers who either responded in a timely manner or went “Above & Beyond” to help make our HEDIS data collection successful. Any practices that responded within 5 business days of our initial request or who went out of their way by taking additional steps to help us with data collection were entered in a drawing to receive a gift. We are pleased to announce that our incentive winners are as follows:
Colorado Winners - HEDIS Drawing:
- Phillip D Wiley MD PC
- Ob Gyn Affiliates
- Cedar Point Urgent Care
- Boulder Cognitive and Linguistic Center Inc.
- Gastroenterology Associates of Colorado Springs LLP
Colorado Winner - Above and Beyond:
- The Women’s Clinic of Northern Colorado
Our HEDIS results reflect the care you provide to our members. Now is the time to review your patient’s records to ensure that they have received their preventative care and/or immunizations before the end of the year.
An overview of our HEDIS rates will be published in the 4th quarter provider newsletter. In addition more information on HEDIS can be found online.
Go to anthem.com. Select Providers, then Providers Overview. Select Find Resources for Your State, and pick Colorado. From the Health & Wellness page, select Quality Improvement and Standards . Under the HEDIS Information heading, select either: HEDIS 101 for Providers, HEDIS Physician Documentation Guideline, or HEDIS Annual Calendar.
Thanks again to all of our provider offices and their staff for assisting us in collecting HEDIS data. We look forward to working with you next HEDIS season!
HEDIS® is a registered trademark of the National Committee for Quality Assurance (NCQA). We invite you to go to anthem.com to learn about the many ways health care reform and health insurance marketplace / affordable care act information may impact you. New information is added regularly. To view the latest articles on health care reform and/or health insurance marketplace / affordable care act, and all achieved articles, go to anthem.com. Select Providers, and Providers Overview. Select Find Resources in Your State, and pick Colorado. Select the Provider Home tab at the top of the page. Under the Communications and Updates heading, choose Health Care Reform Updates and Notifications or Health Insurance Exchange Marketplace / Affordable Care Act information. As we advised you on April 1, 2018 in a separate Provider Communication, in our efforts to improve payment accuracy and reduce post-payment recoveries, beginning with dates of service on or after July 13, 2018, Anthem updated our Claims Requiring Additional Documentation policy to include the following requirement:
- Inpatient stay claims reimbursed at a percent of charge with billed charges above $40,000 require an itemized bill to be submitted with the claim.
For more information, view this policy online. Go to anthem.com, select Providers, then Providers Overview. Select Find Resources for Your State, and pick Colorado. From the Answers@Anthem page, select the Reimbursement Policies – Facilities link, then Claims Requiring Additional Documentation.
In addition, visit our anthem.com provider website to view the instructions on how to submit your itemized bill to Anthem. On the date the new edit becomes effective, Clear Claim Connection, our web-based editing tool, will be updated to incorporate the new editing rules outlined above and will include an interface that will allow you to view the clinical rationale for the edit when you enter claim scenarios. If you have not used Clear Claim Connection previously, we would like to take this opportunity to encourage you to access this user-friendly tool to explore the ClaimsXten edits. Clear Claim Connection is located on the Availity Portal. Log into Availity.com. Once logged in, select Payer Spaces, and choose the Anthem icon. Under Applications, select Clear Claim Connection. To help our members receive the DME equipment they need and help ensure no disruption in care, it is important to document that they physician, nurse practitioner, physician assistant or clinical nurse specialist has had a face-to-face encounter with the patient. Additional details on this requirement and other information that will help ensure that your prior authorization request for a wheelchair is processed efficiently will be available at Important Medicare Advantage Updates at anthem.com/medicareprovider. The Centers for Medicare & Medicaid Services recently issued regulations related to opioid analgesics to help improve patient safety and reduce the misuse of opioid analgesics: https://www.cms.gov/Medicare/Health-Plans/MedicareAdvtgSpecRateStats/Downloads/Announcement2019.pdf
Beginning January 1, 2019, all short- and long- acting opioids will reject at the point of sale if prescribed for more than seven days. This edit applies to members who do not have an opioid prescription in the previous 60 days. The edit excludes members with cancer or members in hospice.
These edits are intended to allow those with intractable pain an opportunity to maintain their pain control while helping reduce the potential for misuse or addiction among those who are experiencing acute pain. MyDiversePatients.com features robust educational resources to help providers address health care disparities. You will find:
- CME learning experiences about disparities, potential contributing factors and opportunities for you to enhance care.
- Real life stories about diverse patients and the unique challenges they face.
- Tips and techniques for working with diverse patients to promote improvement in health outcomes.
Visit MyDiversePatients.com today to learn more. |