Provider News
Greetings Dr.   
 
January 21, 2011 - Issue 13

In this Article

 
Provider Marketing Tools:  Delivery Scheduled

 
Get Set Up for Success in 2011


Board Updates

 
Newsletter Changes


Fast Facts
Article1Provider Marketing Tools:  Delivery Scheduled

The provider marketing tools first introduced at the Business Development Meeting a few months ago are in the final stages of development. Distribution to the ChiroCare network is tentatively scheduled for mid-February. Please watch your email for a Provider Alert with all of the exciting details next month.

Article2Get Set Up for Success in 2011


With the holiday celebrations behind us, there are a few tasks that each chiropractic office should complete to help achieve timely claim payments and a smooth transition in the New Year. If your office hasn't already done so, please ensure your staff does the following:

  • Insurance/benefit verifications
    • Many employer-based medical insurance plans renew at the beginning of the year. Since changes to the insurance company, patient/group ID numbers and benefit levels are most likely to occur during renewal, it is important that providers obtain a current copy of the patient's ID card and confirm all applicable information prior to issuing treatment. If changes are identified, please ensure that submitted claims reflect the correct information for all billed dates of service. In some cases, this may require splitting a claim into two submissions based on the date (year) of service.
    • For ChiroCare business, three notable benefit changes were implemented on January 1, 2011:
      • Most patients with Medicaid coverage through HealthPartners or UCare now have coverage for one annual exam. Details regarding this change were distributed via a December 29 Provider Alert.
      • The application of hot and cold packs (CPT 97010) is no longer a covered service for the Patient Choice program and can not be billed to patients. This change is noted on the 2011 Patient Choice Fee Schedule available on the Admin Resources tab of ChiroCare Connect.
      • A small number of previously covered DME items have been terminated by CMS without a replacement code. Please review the health plan specific 2011 Fee Schedules on the Admin Resources tab of ChiroCare Connect to identify DME items that are eligible for reimbursement through ChiroCare. 
  • Be aware of any new administrative requirements
    • For ChiroCare business, there are two possible changes to be aware of:
      • The state's new authorization requirement for ALL providers who treat Medicaid patients.  Details regarding this change were distributed via a December 29 Provider Alert and can be found in the Authorization section of the updated Plan Summaries available on the Admin Resources tab of ChiroCare Connect.
      • The January 1 effective date of any changes to a provider's Utilization Management (UM) Category. All contracted providers were notified of their 2011 UM Category in the fourth quarter of 2010. If there was a change to your UM Category, it's important that you and your office understand the revised requirements to avoid unnecessary paperwork and/or unnecessary claim denials. If you are unsure of your UM Category, please log on to ChiroCare Connect and go to the UM Requirements tab.
  • Be aware of any rate changes
    • For 2011, ChiroCare was able to maintain provider rates without reductions. The 2011 Fee Schedule documents have been updated to include rate information for the newly covered Medicaid exams and the other benefit changes previously mentioned. ChiroCare's Fee Schedules are posted to the Admin Resources tab of ChiroCare Connect.

 

 

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Article3Board Updates

As a follow up to the Board structure changes announced in ChiroCare's 2010 Year-End Letter, two new providers have been added to ChiroCare's Board of Directors: Leo Bronston, DC and Molly Magnani, DC.

 

Leo Bronston, DC

Academic accomplishments, in addition to Leo's demonstrated understanding of key health care initiatives, were instrumental to his election to ChiroCare's Board of Directors. Some of those accomplishments include:

·         Diplomat Status in Chiropractic Orthopedics

·         Certified Clinical Chiropractic Neurologist

·         Certified Chiropractic Sports Physician

·         Fellow of the Academy of Chiropractic Orthopedics

·         Masters of Applied Science Degree in Musculoskeletal Management  

·         Harvard Medical School attendee

·         Published author

 

In addition to his new role with ChiroCare, Leo owns and oversees operation of a private practice in Onalaska, Wisconsin and five additional branch offices.  He currently serves on the Board of Directors of the Wisconsin Chiropractic Association. In the past he has served as Chairperson for the Scientific Review Committee of the American Chiropractic Academy of Neurology, was an alternate delegate for Wisconsin on the American Chiropractic Association and a member of the Board of Examiners.

 

Leo's comprehensive understanding of the chiropractic profession, and the challenges it faces, will help ChiroCare assist providers through the evolving landscape of the health care industry.  "Our profession is uniquely positioned to serve the public's health and will need to create a cultural authority within the broad spectrum of health care in order to seize opportunity," he said. "Continuing to demonstrate efficacy in the treatment of health care conditions by providing quality care with emphasis on cost containment will not be without challenges."

 

In conjunction with his service to others, Leo has been recognized with a number of awards including USA Hockey Volunteer Ice Hockey Coach of the Year, American College of Chiropractic Orthopedists Distinguished Service Award, Ted Griffith Outstanding Leadership Award from the LaCrosse Area YMCA, and Wisconsin Public Health Association Basic Prevention Award in Public Health. Leo lives in Onalaska with his wife Kim, and three of their seven children. His first grandchild, a girl, is due in May.

 

Molly Magnani, DC

Molly was selected to join ChiroCare's Board of Directors based on her leadership skills and her experience working in an integrated delivery system (Allina Health System).  As Lead Chiropractor at Allina, Molly has developed and grown the delivery of chiropractic services across the medical clinics. More specifically, she established credentialing processes and practice guidelines to support the successful integration of chiropractors into medical clinics. Additionally, she developed support staff training policies to help ensure the needs of the integrated chiropractors would be met. 

"I have always been interested in ChiroCare and have been impressed at its changes over the years," she said. "I would like to bring in the unique perspective of working in an integrated model and provide insight on how we could expand this idea to more chiropractors outside the actual system."

At Allina, Molly practices alongside Internal Medicine Physicians, Podiatrists, Rheumatologists, and Mental Health providers who all work together to develop and implement optimal treatment plans and referrals for Allina patients.  "We need to educate more of the medical community on the benefits and our impact on reducing health care costs," she added. 

She actively participates in several organizations and committees designed to educate and promote chiropractic as a treatment modality. Some of those include Allina Medical Advisory Council, American Chiropractic Association, American Spine Foundation, Metropolitan Complementary Therapies Research Group, Minnesota Chiropractic Association and Who's Who in American Colleges and Universities.

Molly lives in Eden Prairie with her husband, 17-year-old and 9-year-old triplets. She enjoys the outdoors and sports, staying active by running and playing tennis.

 Rick Zarmbinski, DC

Rick was re-elected in December to serve another term on ChiroCare's Board.  He currently chairs the Quality Improvement Committee and participates on several others including Credentialing, Finance, Board Recruiting, Provider Services and Business Development.

 

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Article4Newsletter Changes

To help improve the value delivered through its Provider Newsletters, ChiroCare will be working with its Field Advisory Committee to discuss potential content, format and distribution changes. If you have suggested changes or topic ideas you would like considered, please send those to info@chirocaremn.org.  Additional information regarding our revised Provider Newsletters will be sent in the upcoming months.

 

If you are interested in taking a more active role in improving ChiroCare's program to deliver more value to providers, please consider participating on ChiroCare's Field Advisory Committee. Interested providers should send an application request to info@chirocaremn.org.

 

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fastfactsFast Facts 

 

Dec 2010

Performance Goal

Average speed to answer the phone

13seconds

Less than 30 seconds

Volume of calls answered within 30 seconds

94%

Minimum of 80%

Call abandonment rate

1.0%

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

90%

Minimum of 90%

















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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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