Sept. 6, 2013
Covering Colorado: Health insurance marketplace opens in Oct.
Download new members-only guide and read Colorado Medicine coverage

Starting Oct. 1, consumers and small businesses will be able to shop for and purchase health insurance through the state's new insurance marketplace, Connect for Health Colorado. Experts hope this phase of health care reform will spur competition and make it easier to bridge the gap for uninsured populations.

The latest issue of the Colorado Medicine explores how Connect for Health Colorado will increase access to health insurance and why Colorado as a whole will benefit from having a state-facilitated exchange.

Additionally, CMS policy staff have developed a new resource to help physician members understand and prepare for up to 240,000 newly insured patients that are projected in 2014 thanks to the exchange. "Connect for Health Colorado: A Physician's Guide to the State's Health Insurance Exchange" covers important topics including:

  • Participating health plans;
  • Patient churn between these new marketplace products and Medicaid;
  • 90-day grace period and how your practice may not be reimbursed for services delivered to patients that don't pay premiums; and
  • Impacts of patient cost sharing.

Click here to go to the Covering Colorado page of CMS.org to download "A Physician's Guide to the State's Health Insurance Exchange" and learn about these issues and more. Please note that this content is for members only. If you have any issues with your member log-in, contact Tim Yanetta at [email protected].

Click here to view the online version of the September/October issue of Colorado Medicine and to read the cover story "Covering Colorado." Also in this issue are features on the new health insurance cooperative, Colorado HealthOP; Colorado's State Innovation Model grant; the federal Sunshine Act; the launch of Choosing Wisely Colorado; and more.

Register for Oct. 12 advocacy training
Free event is mandatory for CMS COL members

Prepare for the 2013 election cycle and the 2014 legislative session by attending the Regional Campaign and Grassroots Seminar on Saturday, Oct. 12, 2013, in Denver. Registration is now open; click here.

Presented by the American Medical Association PAC, the Colorado Medical Society PAC and the Colorado Academy of Family Physicians Political Committee, attendees will learn about the top issues and how to increase your political effectiveness with featured speaker Stephanie Vance.

Vance is a 25-year veteran of the Washington, D.C. political scene and has held positions as a lobbyist, grassroots consultant and Congressional aide. She is the author of five books including the recently released "The Influence Game." The first 100 registrants will receive a copy of her book.

Members of the CMS Council on Legislation: It is mandatory that you attend this event in order to participate in COL activities in 2013-2014. Questions or conflicts? Please contact Chris McGowne at (720) 858-6326 or [email protected].

Register for Sept. 24 physician documentation session

What do ICD-10 and E&M coding have in common? The answer is documentation. Appropriate physician documentation matters more today than perhaps ever before - not just because of audits, but also because of the looming conversion to ICD-10. Many practices fall down here and needlessly expose themselves to risks, financial and legal. Make sure you are doing it right.

Plan to attend this interactive training session specifically geared for physicians and their practice teams and taught by the recognized physician documentation experts at Physician Reimbursement Systems. The session will be held Tuesday, Sept. 24, 6-8:30 p.m. MDT at the Colorado Medical Society building in Denver. Learn how you can code better, get paid and still sleep at night.

Click here for more information and to register.

Colorado task force releases rules, asks for public review

The Colorado Medical Clean Claims Transparency and Uniformity Act Task Force has released its second set of rules for public review. They span the topics of age, gender, place of service, anesthesia, new patients, maternity and more. Click here to download these documents.

Reviewers are asked to post comments to the public comment section of the website located at www.hb101332taskforce.org/comment-form by Oct. 4, 2013.

The task force has posted their response to public comments to the first wave of rules, originally released on June 6, 2013. Click here to download the response to the first set of public comments.

The task force strives to create a standardized set of payment rules and claim edits for payers and providers in Colorado, and they consider the public review to be an integral part of this mission.

Novitas to send revalidation notices to providers on Sept. 20

In accordance with the health reform law, all new and existing providers for beneficiaries of Medicare, Medicaid and the Children's Health Insurance Programs must be reevaluated under new screening guidelines. The so-called revalidation effort applies to providers and suppliers enrolled prior to March 25, 2011.

Novitas Solutions, the Medicare Administrative Contractor for Colorado, will send revalidation notices on a regular basis to all affected providers and suppliers. They recently released an updated revalidation request mailing schedule. Click here to view the full schedule. Note that the first mailing to roughly 7,000 providers and suppliers will now be issued on Sept. 20, 2013.

The Centers for Medicare and Medicaid Services will publish the listing of providers and suppliers included in this mailing on their website on or around Oct. 31, 2013, approximately three to four weeks after all contractors have provided their mailing information for the month of September.

Questions about the revalidation initiative? Click here to visit Novitas' Enrollment Center.

Survey: How's the service provided by your
Medicare Administrative Contractor?


The Centers for Medicare and Medicaid Services wants to know how satisfied physicians are with their Medicare Administrative Contractor (MAC). To gather this information, the federal CMS is asking physicians or physician office staff to complete a form indicating interest in completing the MAC Satisfaction Indicator (MSI).

The MSI is a questionnaire that asks about your satisfaction with specific services your MAC provides you, such as claims processing, Medicare enrollment, educational opportunities and responsiveness to inquiries.

The federal CMS first needs interested providers to complete the MSI Participant Registration form. The form itself is not a survey; it is a method for gathering pertinent contact information such as name, e-mail address, state, etc. This form should take less than one minute to complete. For each MSI administration, CMS will randomly select an MSI sample from a list of providers who register to become participants.

If you are a Medicare FFS provider, or work on behalf of a Medicare FFS provider (such as a billing agency), and are interested in participating, please take a moment to register your contact information by completing the form. Don't miss this opportunity. Click here to register.

AMA prescription for a healthier practice:
Move toward real-time adjudication


The American Medical Association aims to move the health care system to real-time adjudication or estimation at the time of service to eliminate the need for patient invoicing and related follow-up communications, as it allows practices to reconcile patient accounts prior to the patient leaving the office. In order to reduce the most administrative burden, the goal would be 0% of claims paid after 30 days. A practice would typically incur rework costs when it pulls an accounts receivable report for claims paid after 30 days and begins the claim follow up.

The point-of-care pricing toolkit can help your practice save money that would otherwise be spent tracking and writing off bad patient debt, which would increase cash flow, and reduce administrative costs and burdens. This toolkit can help your practice obtain eligibility verification and information about patient financial responsibility upfront.

Click here to download the point-of-care pricing toolkit.

This tip is part of the AMA Practice Management Center's "Prescription for a healthier practice" series.

Exclusive member benefit: DocbookMD

The Colorado Medical Society is proud to present a FREE member benefit, DocbookMD. DocbookMD is a HIPAA-compliant mobile app that allows physicians to send messages, text patient information, and exchange images such as X-Rays or EKGs over a secure mobile platform. It functions in a way that complements what we already do daily, but not in a way that adds work, wastes time, or burdens us with new systems.

Download DocbookMD from the Apple App store for iPhone, and iPad, or Google Play for Android devices. Click here for more information or go to docbookmd.com.

CO Drug Card Colorado Medical Society
endorses Colorado Drug Card


The Colorado Medical Society has teamed up with the Colorado Drug Card to enable you to provide FREE discount prescription drug cards to your employees and patients. Click here to view the announcement. 

Encourage your patients to print a free Colorado Drug Card at www.coloradodrugcard.com. The cards are even customizable to your practice; click here for more information.

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