Greetings Dr.
November 19, 2010 - Issue 11 |
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 Protect Yourself with Professional Boundaries |
Did you know that even with a patient's permission to conduct a specific treatment, you may be at risk for claims of inappropriate touch and a criminal investigation? Or that complimenting the appearance of a patient whom you haven't treated in 18 months but run into at the grocery store may jeopardize your chiropractic license? Because of the level of direct physical contact that occurs during the delivery of chiropractic care, and the perception of a superior/subordinate relationship, providers often find themselves in situations that while seemingly harmless to the provider, make the patient uncomfortable. The challenge with professional boundaries is that each patient defines their personal boundaries differently, yet it is largely the patient who determines when a provider has acted inappropriately. And even when providers think they have taken all steps necessary to protect themselves, often times they are relying on patient communication that does not provide ample defense in an investigation. Furthermore, misconstrued words alone can result in significant consequences for a well-intentioned provider. To help you protect yourself from wrongful complaints and awkward patient interactions, ChiroCare has made the following resources available to contracted providers: - Online Professional Boundary Education Seminar by Joe Ferezy, D.C.
- Best Practice Check List for Conducting Sensitive Exams
To view Dr. Ferezy's presentation, click here. In addition to educating yourself, 1 hour of continuing education credit is available for those who view the video and successfully pass a related exam. To obtain the Best Practice List, log on to ChiroCare Connect and go to the Clinical Practice Guidelines section of the Clinical Resources tab. |
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State of MN Chiropractic Benefit Change Approved | |
After much discussion, the state of Minnesota has obtained approval from the federal government to implement its proposed change to include coverage of one annual chiropractic evaluation/examination per year. The change is effective January 1, 2011 and applicable to patients covered through PMAP, MNCare, Minnesota Senior Care Plus and some Special Needs Contracts. Additional details regarding this change will be distributed via a Provider Alert later in the year. To view the statute language, click here and scroll down to Subd.8e. Chiropractic services.
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Updated Resources Available on ChiroCare Connect | |
To better support contracted providers, ChiroCare has recently posted a new policy to the Admin Resources section of ChiroCare Connect. Information now available for viewing in this section include:
- Office Standards (Credentialing/Recredentialing Criteria)
- Requirements and Recommended Form for Patient Billing of Non-Covered Services
- List of Pre-Approved Relief Providers
Also, please note that an updated resource for medical record documentation has been posted to the Clinical Resources/Clinical Practice Guidelines section of ChiroCare Connect. Application of these guidelines may help protect you against potential liability claims.
Click here to log on or register an account with ChiroCare Connect.
If you have suggestions for other materials that would be helpful to you or your office, please send those to info@chirocaremn.org or call ChiroCare's executive office at (651) 389-2006 or toll-free at (866) 714-0524.
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Electronic Payment Option Coming in 2011 |
As we all look for ways to streamline the operational side of our business, ChiroCare is preparing to roll out a pilot program regarding electronic claim payments. Approximately 15 providers are participating in the pilot which uses electronic funds transfers to pay providers rather than issuing hard copy checks. Unlike some other electronic payment programs, refunds for ChiroCare overpayments, etc. will not be withdrawn from provider accounts. Additional details about this optional claim payment program, and registration instructions, will be distributed during the first quarter of 2011.
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Discounted History Theatre Tickets Offer | |
Looking for a fun way to celebrate the holidays with your office staff or family? ChiroCare has negotiated a discounted rate for tickets to the History Theatre in St. Paul during this holiday season and is extending that offer to its contracted providers and their staff. The discount, $5 off standard tickets, or $7 per ticket for groups of 12 or more, is applicable to their upcoming shows which include:
- The Christmas Schooner
- Buddy-The Buddy Holly Story
- A Tale of Twin Cities
- Adrift on the Mississippi
- American as Curry Pie
Additional information about each of these programs can be found at www.historytheatre.com.
Standard ticket prices vary by show and age of attendee but range from $10 to $32. Please note that the discount does not apply to tickets for college students or children which are already reduced.
To order up to 11 tickets, call the box office at 651-292-4323. For orders of 12 or more, contact Jill Vaughn at 651-292-4320 or jvaughn@historytheatre.com. To obtain the discounted price, simply mention that you are part of Chiropractic Care of Minnesota when ordering your tickets.
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2011 Health Plan Growth |
Despite challenges and an ever-changing health care environment, ChiroCare-contracted health plans anticipate membership growth through expanded service areas in 2011. Effective in January, UCare will introduce or expand its Medicaid products in Becker, Clay, Cass and Crow Wing counties in Minnesota. In addition, HealthPartners is expanding its service area to focus on growth of its commercial products in South Dakota.
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Last Chance to Share Your Thoughts |
Today is the final day for providers to submit their 2010 ChiroCare satisfaction survey. If you have not yet completed yours, please do so--your opinion matters to us and will be used to help determine the future direction of ChiroCare. Information necessary to complete the survey was emailed by our survey vendor on October 11th and again on October 29th.
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Still Need 2010 Continuing Ed Credits? |
Looking for a convenient way to fulfill your required continuing education hours? ChiroCare's online provider education tools offer up to 4.5 credits for providers licensed in Minnesota and South Dakota. The online tools include videos of a Dr. Joe Ferezy presentation hosted by ChiroCare in December of 2009. Topics covered include the facts regarding strokes and manipulation, and defining professional boundaries.
Providers who attended the original seminars offered very positive feedback:
Value of Information presented: 9.46
Quality of Speaker: 9.88
Level of Speaker's Knowledge: 9.75
*Values were averaged for the two classes and represent a 10 point scale, 10 being best.
To obtain the available hours, view the videos posted to the Online CE Course section of our web site and submit your completed exams to ChiroCare. If you successfully pass both exams, you will receive a certificate of completion letter with the applicable hours noted. |
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UM Tiering Update |
Very soon, all ChiroCare providers will receive written notice of their Utilization Management (UM) Tier effective January 1, 2011. As communicated in our July 30, 2010 Provider Alert, these tiering adjustments will be the only tiering changes made in 2011. Following the January 1, 2011 adjustments, provider data will be reviewed, but will not result in changes to UM Category assignments until January 1, 2012. Instead, providers will receive summarized performance information including trend indicators and when applicable, proactive identification of a potential category change. We believe this revised approach better supports our providers through delivery of a more consistent Utilization Management experience, proactive communication and the opportunity to self-monitor.
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Reminder: Return Your Board Election Ballot |
Earlier this week, ChiroCare distributed a Ballot for Elected Directors. Please remember to return your completed ballot to ChiroCare no later than December 15, 2010. |
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Answers to Common ChiroCare Questions |
Do you ever have questions about ChiroCare or the programs administered by ChiroCare but don't know where to find the answers? To help support our contracted offices and providers, ChiroCare has recently posted a Frequently Asked Questions (FAQ) document to its web site that provides quick answers to many commonly asked questions. Click here to view the FAQ document available on ChiroCare's home page.
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Holiday Schedule | |
In recognition of the upcoming holiday season, please note that both the ChiroCare's administrative and executive offices will be closed the following days:
- Thursday, November 25th
- Friday, November 26th
- Thursday, December 23rd
- Friday, December 24th
- Friday, December 31st
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Fast Facts
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Oct 2010 |
Performance Goal | |
Average speed to answer the phone |
32 seconds |
Less than 30 seconds | |
Volume of calls answered within 30 seconds |
83% |
Minimum of 80% | |
Call abandonment rate |
3.8% |
Less than 3% | |
Volume of all claims received electronically*
*Per MN Statute 62J.536 all providers in MN are to be submitting claims electronically as of 12/15/09 |
92% |
Minimum of 90% |
Note: Unscheduled staffing issues resulted in slower phone response times in October. Steps have been taken to ensure that you and your staff experience a faster response rate in November.
To access some of the links and materials referenced above, your system must be able to open PDF documents. If you are not able to open PDF documents, you may download Adobe Reader for free by going to http://get.adobe.com/reader. |
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