Centers for Disease Control and Prevention's Immunization Safety Office is proud to offer afree continuing education (CME and CE) activity titled "Real Talk About Influenza Vaccine - Be Informed and Be Prepared" now on Medscape. The CME and CE offer includes a roundtable discussion with three vaccine safety prevention experts and is intended for clinicians who routinely administer influenza vaccines and who evaluate and treat patients experiencing adverse events following influenza immunization, including family medicine and internal medicine physicians, pediatricians, obstetricians/gynecologists, nurse practitioners, physician assistants, and nurses. To participate in this activity, please visit http://www.medscape.org/viewarticle/732969

• If you HAVE NOT tested by December 31, 2011: You are required to submit a "transition plan" to your Medicare contractor that details your plans for moving to 5010 and when you think you will be able to test with Medicare.  You will have 30 days to do this once you have been contacted by your Medicare contractor.
• No prescribed format for transition plan: It can be sent via letter, email, or fax and can be a brief explanation of your transition plans
• Keep evidence plan was submitted: Submitters are strongly encouraged to retain evidence that a plan was sent (i.e. return receipt email, fax transmission confirmation, copy of an email, etc.)
• All submitters must test: Unless submitters have tested with their Medicare contractor, even if you submit compliant 5010 transactions, your claims will be rejected
• If you HAVE tested successfully by December 31, 2011: You will be contacted by Medicare and told you have 30 days to move over to use of the 5010 standards. Submitters that have not yet tested with Medicare prior to the compliance date will be contacted and asked to submit the transition plan described above.

      Physicians who use a clearinghouse or billing service to submit their claims

     If you are a physician who relies on a billing service or clearinghouse to submit your claims to Medicare, you are NOT required to file a transition plan to Medicare. The entity they use to submit their claims is the Submitter and is the one required to submit a transition plan. These physicians should contact their billing services or clearinghouses to determine their ability to generate the physician's claims and other transactions using the Version 5010 format. 

For More information:

     For more information on 5010 please visit http://www.cms.gov/MFFS5010D0/ and http://www.ama-assn.org/go/5010

AMA testifies before NCVHS to promote administrative simplification

     In mid-November, the AMA was called to testify before the National Committee on Vital & Health Statistics (NCVHS), a federal advisory committee to the U.S. Department of Health and Human Services on the Health Insurance Portability & Accountability Act (HIPAA), on several possible additional standards that could significantly reduce administrative hassles for physicians. The AMA testified on the need for national standards governing claims attachments, claims edits, payment rules, provider enrollment and audits. The Affordable Care Act (ACA) called for several of these standards, and the AMA has long championed greater uniformity in each of these areas. The AMA has been called upon numerous times by NCVHS to provide critical input on HIPAA standards development. Access copies of the AMA's testimonies to learn more.

     Also, read the Council for Affordable Quality Healthcare's (CAQH) press release about CAQH CORE's operating rules being adopted by HHS for patient eligibility and health claim status transactions.

     Atlantic Health Partners is pleased to announce a new program with TransactRx that enables physicians to provide vaccines to most Medicare Part D patients. As you may know, Atlantic offers our members the lowest prices on Sanofi and Merck vaccines, and now with TransactRx your practice can provide vaccines like Zostavax (available from Merck) and Adacel (Tdap) to Medicare patients.

    The TransactRx program endorsed by Atlantic provides you:

• Easy online access to patient specific Part D vaccine coverage
• Ability to get fairly reimbursed for vaccines covered under Part D
• Real-time out-of-pocket (copay) cost and reimbursement information
• Electronic claims submission for vaccines covered under Part D

There is no cost to join Atlantic Health Partners or to benefit from this new service.

      And don't forget these additional Atlantic benefits:

• Discounted medical, surgical and office supply programs
• Discounts on a patient recall program
• Immediate customer service to address any vaccine related issues

     Please contact Jeff or Cindy at info@atlantichealthpartners.com or 1-800-741-2044 to find out how your practice can benefit from Atlantic Health Partners Savings and TransactRx.  www.atlantichealthpartners.com