In This Issue
Upcoming Event
Network Updates
Credentialing Corner
ICD-10 Update
Formulary

Check out our latest Formulary, accessible from our website:  www.wpsic.com or  click here.

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The Doctor's Note
July 2014

Here at WPS, we hope all of you are having a great summer and enjoying the weather outside, despite it being construction season!

 

We have some important announcements in this e-newsletter that we'd like to highlight for you.

  • Starting next month, we'll post important announcements and updates directly to your online provider homepage. You'll still receive a quarterly provider e-newsletter that brings all of those announcements together in one easy-to-read email, but if you would like more timely updates, be sure to log in to your account! The Credentialing Corner has more information about this new process.
  • Are you ready for the upcoming ICD-10 compliance date in 2015? If you have any questions on this transition, check out the WPS ICD-10 Update for additional information and a contact number to call.
  • We'd like to invite you to register for a special CMS conference on Appropriate Use Criteria (AUC) and the Road to Clinical Value in September at the Monona Terrace. This event has been approved for 5.0 AMA PRA Category 1 Credits™. Check out the article below for more information and to register. Hope to see you there!

 

Thank you for your time! We hope you find these e-newsletters useful. If there are any additional announcements or updates you would like to see each quarter, let us know!  

 

Best of health!

Upcoming Event

Conference: Incorporating Appropriate Use Criteria into Clinical Practice

 

The Wisconsin Medical Society and WPS invite you to register for a special Continuing Medical Education (CME) conference on Appropriate Use Criteria (AUC).

 

The incorporation of AUC into clinical practice is intended to reduce geographic or unwarranted variation, and improve patient care.

 

Some recent state, federal, and private initiatives promoting AUC include:

  • Congress has proposed legislation to include a requirement to incorporate AUC into high-end radiology test ordering as part of a the Centers for Medicare and Medicaid Services (CMS) "sustainable growth rate (SGR) fix."
  • CMS has recently granted Wisconsin a $15 million Innovation grant to deploy the SMARTCare program across five Wisconsin provider group sites. SMARTCare (developed by physicians in Wisconsin and Florida) incorporates AUC at the point of care for CAD patients.
  • The Alliance (Employer Health Care Alliance Cooperative) is seeking to promote stronger adherence to evidence-based guidelines for knee and hip replacements through its QualityPath program. 

Speakers will present evidence of geographic variation in the state, describe the results of strategies to incorporate AUC at the point of care, and discuss barriers to implementation. The conference will feature a keynote address by Rita Redberg, MD, MSc, FACC, editor JAMA Internal Medicine. This event has been approved for 5.0 AMA PRA Category 1 Credits™.

 

At the end of this session, learners should be able to:

1. Identify geographic variation within their practice settings and understand how AUC can help reduce practice pattern variation that deviates significantly from evidence-based criteria.

2. Understand how AUC are developed.

3. Identify multiple barriers to the implementation of AUC into clinical practice and describe how some of the barriers have been overcome in the past and may be addressed in the future.

 

 

 

When: Monday, Sept. 29, 2014, 8 a.m. to 3 p.m.

Where: Monona Terrace Community and Convention Center, Madison, WI

Who Should Attend? Primary care physicians, all specialty physicians, allied health professionals and health care executives

Cost: $49 per person

 

Go to  https://www.wisconsinmedicalsociety.org/_WMS/professionalism/professional_development/continuing_medical_education/2014/pdf/2014_AUC_conference_reg_form.pdf to download a registration form or call 608-442-3796 if you have questions.

 

This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of the Wisconsin Medical Society and WPS. The Wisconsin Medical Society is accredited by the ACCME to provide continuing medical education for physicians.  

 

The Wisconsin Medical Society designates this live activity for a maximum of 5.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Network Updates

Attention Solo Practitioners: Electronic Claims Submission (EDI) Reminder

 

If you are the owner, as well as the solo practitioner at your clinic, please remember to include your personal NPI number when submitting claims electronically. Omitting this important piece of information may result in delayed processing or denial of your claim.  

 

Questions regarding submission of electronic claims submission should be directed to 1-800-782-2680, option 2.  

Credentialing Corner

News Updates Right from Your Account!

 

In an effort to provide you with timely announcements from WPS, each month we'll be updating the News & Notices tab of your online provider account homepage. Announcements and updates will range from policy changes and credentialing reminders, to network updates and important account information.

 

Each quarter you'll still receive the provider connection e-newsletter, with a round-up of the news & notices from the past few months. To stay current with WPS, log in to your account often and read the news!
 

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What can I do from my online account?

Providers are able to:

  • Check Provider Remittance Advices (PRA)
  • Conduct a patient inquiry
  • Submit or check the status of claims
How do I access my online account?

To access your account, you need to be registered.

If you are already registered, click the Log In button above. Enter your username and password and click Log in.

 

If you still need to register your account, follow these quick and easy steps.

 

Provider registration:

Email register@wpsic.com with the following information from your site administrator:
  • First and last name
  • Email address
  • Tax ID number
  • Name of the practice you represent
  • Physical address of all your locations
What happens if I'm not registered for my online account?

Since this is a paperless initiative, it means we are cutting back on printing paper materials. If you don't have access to your online account, you might not have access to some of your important documents. Don't miss out, register today!

WPS ICD-10 Update

WPS ICD-10 Update

 

With the anticipated ICD-10 compliance date of 10/1/15, WPS is in our final stages of internal testing. We are preparing for limited external end-to-end testing yet this year, and there will be additional opportunities for external end-to-end testing in 2015.

 

WPS will be ready to accept only ICD-10 codes after the compliance date is finalized. For additional information, click here for the ICD-10 Provider FAQ

 

If you have any concerns about this transition, please contact Jim Sarnosky immediately at  James.Sarnosky@wpsic.com or at 608-226-4159.

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