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GREETINGS FROM BEACON HEALTH
and NETWORK MANAGEMENT! |
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We hope our inaugural newsletter finds you in good spirits and hopeful that spring is indeed right around the corner. The intent of this Beacon Health newsletter is for us to establish and build a strong relationship with you, our contracted and member providers and frontline staff. We don't want to fill your inboxes with unnecessary information, so we want to ensure the content within the newsletter is useful and relevant to your everyday work. Please be sure to share with us any suggestions for future issues. We want to make sure we are providing a useful tool.
So ... WHAT IS BEACON HEALTH?
Let's start with what Beacon Health is not. We don't deliver healthcare - we look to you, our trusted provider network, for that important service for our patients. Beacon Health is here to provide assistance, expertise, and structure that will best support consistent high-quality care as we move into the new world of population health. Currently, more than 100,000 of our friends, family, and neighbors across Maine are receiving healthcare services supported by Beacon Health.
Also, did you know that Beacon Health nurse care coordinators are embedded throughout all EMHS primary care practices? They are part of the care team and support both providers and patients. We know anecdotally and through utilization data these new relationships are proving to be quite remarkable. The Beacon Health nurse care coordination program is the only clinically driven program in the country to be accredited by NCQA.
With your commitment to healthcare transformation we believe we can achieve the Triple Aim plus one and make sure all our communities have access to the care they need close to home. Beacon Health is here to support an integrated high value network built on a culture of trust and collaboration fueled by data analytics and real-time data.
As you know, healthcare is changing and Beacon Health is here to help our providers, frontline staff, payors, and patients move from the old pay-for-service model to the new pay-for-value! To learn more or be inspired with stories of real change,please visit our website:
WHO IS THE NETWORK MANAGEMENT TEAM?
We're Here to Help You!
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Your Beacon Health Network Team (from left to right) Mike Durgin, Network Manager, Karen Eldridge, Administrative Assistant, Steve Ryan, Director of Network Management, and
Melinda Wood, Credentialing Specialist |
We are here to support the contracting, credentialing, reporting, and provider-relations for Beacon Health's provider network.
We will make sure the providers
within our network are properly set up with all contracted payors for the Geisinger TPA and population health.
We are here to make your life easier.
It is our promise to keep you informed,
to help remove barriers, update information, and to be your one-stop resource. We look forward to working alongside you. |
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We're very excited to begin sharing the latest in our heatlhcare transformation with you. We hope you find the information useful and helpful as we work toward improving the quality of life for those living in our communities.
If you would like more information or have a story to share, please contact Lanie Abbott at 973-9621 or lwabbott@emhs.org |
A Change in the EMHS Medical Plan Win-Win for Patients and Providers: What YOU Need to Know |
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As of January 1, EMHS Medical Plan participants are eligible to receive the in-system benefit level for all care delivered at an EMHS facility, even if the provider rendering the service is not an in-system provider. This means that participants will pay a lower out-of-pocket cost for the services they receive, and the contracted in-network providers will receive a larger portion of their payment directly from the medical plan's administrator, Geisinger Health Plan. It is a win-win for both providers and EMHS/Geisinger participants!
However, we need in-network providers' help to ensure claim forms contain the necessary location of service information for EMHS participants benefits to be applied correctly. Below, we have provided helpful information to help providers take the necessary steps.
What do in-network providers need to do? Two steps:
- DESIGNATE TWO DIFFERENT NPI2s: Your practice probably already has an NPI2 specifying your location or business unit. The EMHS Plan and Geisinger are asking in-network providers to obtain a separate and distinct NPI2 number for Box 33 of the CMS 1500 which is to be used when the service is rendered at an EMHS facility. Again, in-network providers can use this second "In System Facility NPI2" to denote services rendered to your EMHS participants at an EMHS facility.
- SEND YOUR NEW "IN-SYSTEM FACILITY NPI2" TO BEACON HEALTH. Submit both your in-network (standard) and your in-system facility NPI2s to Beacon Health to be set up with Geisinger. Online Beacon Health form.
How does my practice obtain a second NPI2?
You can easily request an additional NPI2 (to be used for services at an EMHS facility) online. This is the most efficient method for requesting an additional NPI2 number with turnaround times for these requests averaging seven - ten days. Written requests can also be sent to NPI Enumerator, PO Box 6059, Fargo ND 58108-6059.
Who do I call with questions?
NPI2 QUESTIONS: If you have any questions about how to obtain an additional NPI2, please contact National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free).
EMHS BENEFITS: If you have questions regarding this benefit change, please call Geisinger Health Plan's Maine representative, Pam Hageny at (570) 490-7863.
Why is doing this important?
This change is being made at the overwhelming request of both EMHS participants who correctly believe these services should be covered at the highest level of their benefits and in-network providers who feel that their services at an in-system facility should be appropriately recognized. We appreciate your extra effort and cooperation in ensuring your patients participating in the EMHS Medical Plan experience the highest level of benefits.
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Why Secure email?... Because Our Patients Expect it!
You may have noticed that all emails from Beacon Health employees come secure. It might seem like an extra, unnecessary step, but it's not. Every day in the news you read about data breeches and personal information falling into the hands of the wrong people. We can't be too careful when it comes to keeping our information safe and secure, and accessible only by the people who need it.
We apologize if our new precautions are causing you some extra time, but we offer these tips to make the process a bit easier:
WHAT IF I AM NOT ABLE TO OPEN AN EMAIL?
- Click on the "Business Relationship" box in the email; then either sign in with your password, or set up a password
- Look for the "Register" link on the sign-in page
WHAT IF I AM NOT ABLE TO OPEN AN ATTACHMENT?
A common cause of this issue is when the sender's encryption method is higher than the receiver or one or the email systems stripped the extension. This application has been shown to resolve the issue. Keep in mind, it is not a Beacon file. Please be sure to review with your IT/Security team prior to loading.
CAN I "RESPOND ALL"?
No, at this time functionality for visitors to respond to all recipients is not available, please respond separately to each as you feel is needed.
WHO CAN I CONTACT IF I NEED HELP?
For help, call EMHS Information Systems support at 207-973-7728
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Provider-Driven Transformation - Proof Positive Results! |
The numbers are hard to dispute and the anecdotal stories difficult to deny. Beacon Health is proving that when you engage lead providers and develop care teams you can bring about a new way of providing consistent, personalized care that is supported by real-time data. "We are becoming more proactive, rather than reactive. It's really the way we always wanted to care for patients," shares Michael Ross, MD, lead provider Eastern Maine Medical Center Pediatrics.
Beacon Health started with nearly 10,000 Pioneer Medicare patients in January 2012; four years later, our Medicare population is closer to 30,000 and commercial population is more than 70,000 patients. By working closely with providers, frontline staff, and patients the Beacon Health care delivery model continues to grow and mature.
The EMHS employees and dependents on the medical plan are the cornerstone of our transformation. "Nurse care coordination was life-changing! Our nurse helped us be proactive about our children's asthma. Since working with her, none of my three children have been to the emergency department or missed any school activities because of their asthma," smiles Marci McCafferty, lead business systems analyst at EMHS.
Since 2012, primary care practice visits are up 24 percent, emergency department visits are down three percent, and total hospital admissions are down 21 percent.
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Beacon Health's New Chief Population Health Officer
is Rolling up His Sleeves for a New Adventure! |
 Providing high-quality consistent patient care and experience is one of the top priorities of Beacon Health's new chief population health officer, Claus Hamann, MD, MS, FRCPC, FACP. Dr. Hamann brings to Beacon Health a wealth of knowledge and experience in internal and geriatric medicine, population health, clinical informatics, risk contracts, accountable care, and as a practicing geriatrician.
"I believe in strong collaboration and that everyone has a voice. That's how collectively we can create something that works. It's always about our patients, our providers, our enterprise, and how we can do the best for the communities and the populations we serve. "
Dr. Hamann's vast experience will serve the Beacon Health network well. Board-certified in the USA and Canada, he has provided and taught patient care in emergency departments, hospitals, primary care practices, and nursing homes. He has led providers as a chief medical officer and medical director, and served as the bridge person between clinicians and clinical IT systems in care redesign and electronic health record implementation and optimization.
"My passion is being a doctor that communicates the connection of seeing one patient at a time to a population perspective, which will be the key to our success."
He has a keen understanding of the role technology is playing in healthcare delivery and looks forward to finding ways to improve patient engagement along with improving provider engagement and satisfaction. "As new technologies emerge and gain in popularity, the healthcare landscape is shifting, and I think Beacon Health is perfectly situated to implement solutions. With engaged patients, providers, and care teams we can ensure our statewide network is sustainable and supports the health of all our communities."
Dr. Hamann and his wife Dianne are excited about their new adventure getting to know and enjoy Maine. He officially joins the Beacon Health team on April 27. He plans on spending much of his first few months on the road doing a lot of listening and learning in order to build on the excellent foundation laid by Mike Donahue, EMHS vice president network development and Beacon Health executive director, Iyad Sabbagh, MD, EMHS chief quality officer and associate chief medical officer, and colleagues to lead the next chapter in our healthcare transformation. |
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Getting to Know the Beacon Health Network Staff...
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Karen Eldridge is the administrative assistant for the network team, performing credentialing, analytic, organizational, and administrativ e functions. Karen joined Beacon Health in January 2015 and hit the ground running. She formerly worked at the Verso mill in Bucksport for 27 years, supporting executive teams across the company. Karen is fitting right in and enjoying her new career in healthcare. In addition, she is married with two grown children and two grandsons. When she's not at work, Karen can be found somewhere on her 100-acre property in Orland, walking her German shepherd. She's currently on a mission to expand her family by getting her "boy" a little sister ... a pug puppy!! |
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Who to Contact at Beacon Health Network Management:
Contracting:
Steve Ryan, Director
stephenryan@emhs.org 207 973-9793
Credentialing and General Service:
Mike Durgin, Manager
mdurgin@emhs.org 207 973-6689
Credentialing Applications and Processes:
Melinda Wood, Credentialing Specialist
mwood@emhs.org 207 973-8176
Administrative Support or Questions:
Karen Eldridge, Administrative Assistant
keldridge@emhs.org 207 973-9799
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We're currently in the planning stages of our Annual Fall Event. This has historically been one of our biggest fundraisers of the year, and we could always use more help. To learn more about how you can volunteer, please email Rick Todd at rt@email.com. . Learn More.
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