· Web viewAndrea Baldrica, MBA, Vice President HUB International Services was our Keynote Speaker...

MAY - SEPTEMBER 2016 PIKES PEAK PAHCOM

NEWSLETTER EXTRA ... EXTRA .... READ ALL ABOUT IT IN THE PPP-N!!

_____________________________________________________________PIKES PEAK PAHCOM CORPORATE SPONSORS:

ALL CORPORATE SPONSORS' -- THANK YOU FOR PARTICIPATING IN OUR JULY 20TH (VALUE-BASED DAY MEETING). IT WAS GREAT TO HAVE YOU PRESENT AT THE MEETING AND AVAILABLE FOR MEMBERS TO LEARN ABOUT YOUR SERVICES. WE COULD NOT HAVE PUT IN SUCH AN AMAZING MEETING WITH OUR NATIONAL SPEAKER SARAH FONTENOT, WITHOUT YOUR CONTINUED SUPPORT OF PIKES PEAK PAHCOM.

Please see Pikes Peak PAHCOM's website and find important information about our sponsors. Just click their logo scrolling in the middle of the meeting registration page!!!! http://www.pahcom.com. Choose "Membership/Community" -- "Chapters" -- "Pikes Peak."

VAL CHAVEZ CMM, MEMBERSHIP/CORPORATE SPONSORS' DIRECTOR: Val is the Corporate Sponsors' primary contact. She sends out all sponsor renewal information, schedule monthly presenting sponsors, etc. Contact information: Valerie Chavez, CMM, Practice Manager, Womens' Associates, [email protected]; 719 473-2424 Ext. 117. Thank you to Val for being the Sponsors' Director in addition to the Membership Director.

MONTHLY PIKES PEAK PAHCOM CORPORATE SPONSORS' RECOGNIZED:

o May Colorado Payer Day Sponsors : UCH-Memorial Hospital, WSI Staffing, Colorado Hi-Tech, Penrad Imaging, Colorado Health Neighborhoods/Full-Well, Agency of Credit Control, WSI Staffing, Carr Reality, MyTech, MMIC, United Healthcare, Lewan Technology

o June Meeting Sponsor : Penrose-St. Francis Health Services. Sponsor liaison is Jodi Feist, Physician Liaison Surgical/Imaging - 719.776.5843, Cell 719.205.1852, [email protected].

MAY - SEPTEMBER 2016 -- PIKES PEAK PAHCOM NEWSLETTER

https://www.pahcom.com/

o July Meeting Sponsors : All Pikes Peak PAHCOM Sponsors were invited to be part of the "Value-Based Day!" Pikes Peak PAHCOM could not provide such valuable medical manager education without their ongoing generous support of our organization. Please see all Pike Peak PAHCOM Sponsors on our webpage to learn more detailed information about their products and services and for specific contact information. https://www.pahcom.com

o August Meeting Sponsors (Co-Sponsored Event with CMGMA :

Penrose-St. Francis Health Services/Centura supported this meeting including to include providing our speaker: Samantha Lippolis, Telehealth Director, Centura .

Colorado MGMA's sponsor : Colorado Business Bank (Co-Biz Bank) is Lauren Eskanos Tulper, VP Deposit & Treasure Management - 720.264.5619, Cell 303.909.5450, [email protected].

o Pikes Peak PAHCOM would like to thank ALL of OUR SPONSORS for their

“constant” support of our Pikes Peak PAHCOM Community!!! We could NOT provide such valuable education programs without ALL of their ongoing support!

MAY CHAPTER MEETING REPORT - COLORADO PAYER DAY 2016: This was Pikes Peak PAHCOM's second co-sponsored event with Colorado MGMA! Another wonderful event with an opportunity to visit with representatives from almost all of the Colorado Medical Insurance Payers. There were 135 attendees; Sponsors from both CMGMA and PP-PAHCOM supported the event. Payers addressed multiple topics:

NARROW NETWORKS, THE PROCESS? Narrow Networks and how are providers/practices being chosen for your narrow-network model(s)? What is the process for notification as to whether or not a practice is "included" or "excluded" from a network. What would be the criteria that a practice needs to meet to be in your "narrow" network?

ICD-10 IMPLEMENTATION, NOW WHAT? We all survived the Implementation! Nationwide, no one is reporting an increase in denials and most non-specific codes are being paid. The one-year anniversary is October 1st and what should the providers/practices be prepared for in terms of non-specific code denials and will there be an increase in requests for supporting documentation. What is the continuation plan of your organization?

BENCHMARKING FOR PERFORMANCE-VALUE: What are some of the benchmarks and performance-value criteria that providers/practices should be looking at to implement to successfully continue to partner with your organization (primary care and specialist). An example: Medicare is transitioning from a volume reimbursement model to a blended quality/penalty reimbursement what should a provider/practice have in place to remain an important asset to a payer.

MAY - SEPTEMBER 2016-- PIKES PEAK PAHCOM NEWSLETTER


BEHAVIORAL HEALTH/MEDICAL ACCESS ADEQUACY: With the initiative to incorporate behavioral health into primary and specialty care, what are you doing to insure access to behavioral health services for our patients? It is often difficult to find providers that can see patients in a timely, cost effective basis.

Andrea Baldrica, MBA, Vice President HUB International Services was our Keynote Speaker and provided great insight on the proposed Colorado Amendment 69 -- Colorado's Single Payer Model --- What it Mean to You and What You Need to Know! This Amendment will affect everyone in Colorado!

Our sponsors for the event included: Colorado Health Neighborhoods/Full-Well, UHC-Heath-Memorial Hospital, Agency of Credit Control, WSI Staffing, Carr Reality, MyTech, MMIC, United Healthcare, Penrad Imaging, Lewan Technology, and Colorado Hi Tech Solutions.

Another successful Colorado Payer Day and we are looking forward to 2017!

JUNE CHAPTER MEETING: Penrose-St. Francis Health System was our June Presentation Sponsor. Margaret Sabin, CEO & Penrose-St. Francis Health System provide support for six Pikes Peak PAHCOM meetings annually and we appreciate their support of healthcare office management education in our community! Below is a brief recap of important updates from leaders of the hospital and they included some special things for medical managers in reminding us to take care of "ourselves" and "work-life balance!"

o Margaret Sabin, CEO. Spoke about the “wellness” side of healthcare. She provided a brief update regarding both Penrose & St. Francis Hospitals, expansion of SFMC NICU and Emergency room and the new location for upcoming Penrose-St. Francis Hospital up on Fillmore Hill.

o Larry Seidl, VP of Mission Integrity: Spoke about “whole person care.” He offered slides and resources for “work life balance.”New Insights Which Link Spirituality to Work:

Place matters Meaning matters Connection counts Then importance of the story.

o Carolyn Coleman, RN, Clinical manager of the 11 th floor: Representative from Patient experience council.

o Dan Karpel, MBA, MHA, CMPE, Director of Business Development: Top 50 hospital market is unique to only one competitor. Partnership with YMCA. Population Health Initiatives. Moving to a level one trauma center.


o Jenna Bruce: Manager of Wellness Center: Guided relaxation to begin the day.

o Diane Williamson: Supervisor for The Center for Women’s Imaging: New technology for screening mammograms. 3D mammography utilizing tomography offered to all patients.

o Our Pikes Peak PAHCOM sponsor liaison is Jodi Feist, Physician Liaison Surgical/Imaging - 719.776.5843, Cell 719.205.1852, [email protected].

JULY CHAPTER MEETING: MACRA! WOW!!! from everyone that attended this very important "Value-Based Meeting!!!" Sarah Fontenot, BSN, JD, CSP "aka" Famous National PAHCOM Speaker, gave us so...... much that no one else has yet heard about MACRA, MIPS, APMs! Sarah taught us that MACRA, MIPS, APMs is going to forever change medicine but she started us on a great pathway! If you were not able to attend this very valuable meeting, please email Sandra to make an appointment to come by her office to review Sarah's slides. Her slides are very confidential and were only made available to attendees.

Rae Stapp, Practice Manager, Vision Institute and Sandra Robben-Weber, CMM, HITCM-PP, Practice Administrator, Colorado Springs Pulmonary Consultants, PC presented important information from the National MGMA Financial & Payer Conference! Those slides and spreadsheets are available by requesting them from Sandra - [email protected]. Excellent points for contracting with the payers and great points on value contracting. ICD-10 is so important to the contracting process now that we are moving to quality vs quantity!

Nancy Engle, UCH-Memorial Hospital, Government Liaison, provided important legislative updates at the federal, state and local levels. She discussed some important information surrounding many pieces of legislation and specifically spoke about Amendment 69 - Colorado Single Payer legislation that will be on the general election ballot in November. Nancy's update was very important for medical office managers, especially this year with the Presidential Election.

ALL Pikes Peak PAHCOM Sponsors were invited to attend the event and provide "value-added items/services" to all the membership. We would not be able to offer such important education program without our sponsor's financial and services support!

AUGUST CHAPTER MEETING: Co-Sponsored Event with CMGMA. Telemedicine is for every practice is what we learned from Samantha Lippolis, Telehealth Director for Centura Health. She provided an excellent presentation and provided managers with some excellent takeaways to look at "telehealth" in their practices. The definitions have changed and Samantha provided nuts and bolts of telehealth definitions, reimbursement MAY - SEPTEMBER 2016-- PIKES PEAK PAHCOM NEWSLETTER

opportunities, technology and operational aspects. All excellent ideas and practical steps for all practices to get started.

VALUE-BASED PAYMENT MODIFIER - VBPM (MEDICARE): PQRS 2015 and VBPM reports will be available we anticipate late September (fall). Informal reviews will be for a 60-day period. Watch the CMS website for a special September meeting on how to interpret the Reports (QRUR). Get registered on the EIDM website, it takes times and keep your password up-to-date every 60 days! Please Keep This On You Radar!!! -- It will affect your practice's reimbursement in 2017! A program that includes a modified payment under the Medicare Physician Fee Schedule based on Quality and Cost Performance. If your practice is currently not participating in the PQRS Program, now might be a good the time to start or more negative Medicare adjustments in the coming years. The Value-Based Payment Modifier started with large practices first and all providers by 2017. The data from 2015 PQRS is what will be used by CMS for calculating part of the 2017 VBPM, 2016 composite scores for practices/providers. There can be a positive adjustment, stay neutral or receive a negative adjustment; separate from PQRS penalties and EHR penalties or incentives. Also, start having your providers’ document chronic conditions, as this will help in the goal of providing "triple aim healthcare," the new pathway of healthcare. It is all about the changes forthcoming in reimbursement!! Free resources through CMS and Navicure Clearinghouse.http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/index.htmlhttp://www.navicure.com/Navicure Site: Learn from us, scroll to free webinar on Value-Based Payment Modifier

WELCOME PIKES PEAK PAHCOM NEW MEMBERS 2015 - 2016: Networking is the best part of Pikes Peak PAHCOM. We have several new members over the last couple of years and the Executive Committee wanted to let them know how important they are to the chapter!!!!!

2015 New Pikes Peak PAHCOM Chapter Members:Corinne Colburn, Printer’s Park OB-GYNTeresa Dryer, Skin Cancer & Dermatology Center of COSFrankie Gales, El Paso County Medical SocietyAmanda Hall, Pikes Peak Nephrology AssociatesRae Stapp, Vision Institute Debbie Trittschuh, Matthews Vu Medical GroupKen Zito, Colorado Springs Imaging

2016 New Pikes Peak PAHCOM Chapter Members:Rachel Brown, Apex Physical Medicine/RehabDenny Flint, Peak MSOJulie Fritschel, Matthews Vu Medical GroupShaun Klein, Storms Allergy ClinicMAY - SEPTEMBER 2016-- PIKES PEAK PAHCOM NEWSLETTER

http://www.navicure.com/

http://www.cms.gov/Medicare/Medicare-Fee-for-Service-Payment/PhysicianFeedbackProgram/index.html

Jessica Petty, El Paso County Medical SocietyJana Sodiac, Eye Associates of Colorado SpringsSusan Townsand, Matthews Vu Medial GroupNancy Turkal, Mountain View Medical GroupErin Yazdi, Pediatric Gastroenterology of COS

HR UPDATE: (by Chris Hall, CMM, Chapter Vice President) Sharing information from our colleagues and members at the El Paso County Medical Society. Beginning on and after August 10, 2016 and based on signed House Bill 16-1114, Colorado employers will be relieved of the additional verification and retention obligations related to the Form I-9, Employment Eligibility Verification (the Colorado Affirmation Form) which eliminates additional verification and retention obligations for Colorado employers. It is important to note that Employers must continue to complete the Form I-9 under federal law within three days of hire.Suggested steps to take to prepare for the upcoming change in the law:

1.) Continue to complete the Colorado Affirmation Form and retain documents as required for all new hires through August 10, 2016.

2.) Continue to retain the Colorado Affirmation Form for Active Employees. Although the new law does specifically speak to record retention of the state affirmation form for active employees hired between January 1, 2007, and August 10, 2015, it is likely best practice to keep the documentation.

3.) Create a plan to phase out the use of the Colorado Affirmation Form (i.e. remove from all new hire packets on August 10, 2016).

4.) Review current I-9 practices and ensure compliance under Federal Law (The El Paso County Medical Society can assist you with this process by conducting a Form I-9 Audit).

MEANINGFUL USE UPDATE: Important Dates:

Reporting period is NOW any 90-day period. Stage 2 criteria will be used with additional modifications especially in the areas of

patient engagement. Some are only "1" patient CMS released ECQMs for 2016. Visit the CMS Website Often and sign-up to receive emails updates.

https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2016ProgramRequirements.html

INSURANCE NETWORK ADEQUECY - PHYSICIAN ADVISORY GROUP: A coalition asked for by the Colorado Insurance Commissioner. Great job PP-PAHCOM & CMGMA Members many of us were in attendance. CMS (Colorado Medical Society) staff met with practice administrators from CMGMA and Pikes Peak PAHCOM to get front line input on the issues the Physician Advisory Group will be discussing with the Insurance Commissioner. The topics were


https://www.cms.gov/Regulations-and-Guidance/Legislation/EHRIncentivePrograms/2016ProgramRequirements.html

based on those identified by the Division after the group met on June 23, 2016. Comments related to the topics of their next meeting on July 22nd will be shared with the physicians. More forthcoming information from the CMS Team as they continue to meet with the Colorado Insurance Commissioner.

Click this link to the Division of Insurance bulletins. The ones that were developed through the stakeholder meetings earlier this year are B-4.90, B-4.91, B-4.92 and B-4.93. The Division also released a bulletin on telehealth (B-4.89) which we have concerns with as it lets telehealth count toward network adequacy without any parameters or limitations.

PIKES PEAK PAHCOM TREASURER'S REPORT: Lori Trivelli, Treasurer, has post the 3RD Quarter 2016 Financials on the website. We just recently finalized the Payer Meeting Joint Expenses. Go to -- My membership, Chapter, Chapter Treasury Report. https://www.pahcom.com/

EDUCATION PROGRAMS SURVEY: (by Judi Spurgeon, Chapter Secretary)Happy Fall PAHCOM friends! Thank you for all that completed the recent education survey. What was included in the survey was asking for input on how the education programs will be designed in the future. The executive committee and the breakfast club work hard at bringing you the best and most up-to-date information through our meetings to help you stay in the know. This year, our attendance appears to be down at our meetings. I will share the results with you at an upcoming meeting and/or newsletter. Some of the questions asked......

How many meetings per year would you attend?

Should we plan our meetings to exclude the summer months?

Do Thursday meetings still meet your needs, or should we mix it up on different days of the week?

2016 PIKES PEAK PAHCOM MEDICAL MANAGER OF THE YEAR: It is the Executive Committee’s Privilege to announce the 2016 Pikes Peak PAHCOM Medical Manager of the Year -- Lori Trivelli, CMM, Practice Manager, Age Well Medical Associates

Debbie Adams, CMM, Office Manager, Dr. Laura Feldman’s Office received a wonderful nomination as well.

Each of these well-deserving nominees met the seven traits to become the Chapter's Medical Manager of the year:



https://www.colorado.gov/pacific/dora/node/94966

o Integrityo Independenceo Confidenceo Decorumo Relevanceo Courageo Commitment

We honored these two nominees September 22, 2016, with a fun social event sponsored by Penrose-St. Francis Health System. PAHCOM Members, sponsors, family members and colleagues were engaged in bits and pieces from the inaugural year 2014 to the present year 2016.

CONGRATULATION AGAIN TO BOTH LORI & DEBBIE.

TRANSFORMING CLINICAL PRACTICES INITIATIVE: On a first come first serve basis. Please review the below website regarding a program sponsored by the Colorado Department of Health Care Policy Financing. This is for all specialties and the first 2000 physicians will be taken into the program on a first come first serve basis. https://www.colorado.gov/pacific/healthinnovation/TCPI. Please contact [email protected]. for additional questions.

GOING GREEN! The "going-green" process will continue in 2016! PP-PAHCOM Meeting RSVPs; speaker handouts/presentations; newsletters, etc., will remain electronic! Please expect continued multiple changes again this year in how we automate and "go green" using the Pikes Peak PAHCOM website through the National website. There will be "multiple challenges" and we ask you to be patient as we learn the processes as well. If you cannot get the payment portion of the website to work, payments should be sent immediately after registering to Lori Trivelli, Treasurer:

Address: Lori Trivelli, CMM, Practice ManagerAgeWell Medical Associates2350 International CircleColorado Springs, CO 80910

PIKES PEAK PAHCOM UPCOMING MEETING SCHEDULE:


https://www.colorado.gov/pacific/healthinnovation/TCPI

WEDNESDAY, November 8, 2016 -- PP-PAHCOM Executive Committee, 4:00 - 5:30 p.m., Age-Well Medical Associates, 2350 International Circle, Colorado Springs, CO 80910. Please let Sandra know if you are attending. Members of the board are automatically RSVP.

THURSDAY, November 17, 2016 -- ICD-10 UPDATE, NOW 1-YEAR POST IMPLEMENTATION/CODING FOR MIPS WITH ICD-10-FUTURE, Speaker: Denny Flint. Memorial – MAC; 7:30 a.m. networking; 8:00 presentation.

BREAKFAST CLUB -- November, canceled, chapter meeting the day prior (see above)

THURSDAY, DECEMBER 8, 2016 -- ANNUAL HOLIDAY CHARITY EVENT. More details forthcoming!

THURADAY, DECEMBER 18, 2016 -- BREAKFAST CLUB. 7:15 - 8:30 a.m. , Colorado Springs Neurological Associates, 3rd Floor Conference Room.

FUTURE MEETINGS: (Subject to Change)Pikes Peak PAHCOM:FEBRUARY 2017 -- OSHA ANNUAL UPDATE (3 Hours)MARCH 2017 -- HIPAA/OTHER HEALTHCARE TOPICS APRIL 2017 -- EDUCATION COLLABORATIVE ANNUAL EVENTMAY 2017 -- COLORADO PAYER DAY 2017 EVENT (6 Hours)

COLORADO MGMA MEETINGS:See CMGMA Website for additional information & registration:

http://www.cmgma.com/

MEMBERSHIP: The word is out.... Pikes Peak PAHCOM is a true leadership organization in the Pikes Peak

region. We have new members interested all the time. Talk to your colleagues that are not members. Bring them to a meeting and let them see the value. The Executive Committee keeps the sponsor ratio of 2:1 and we have a waiting list of really good sponsors that want to support PP-PAHCOM! We need more members!!!


http://www.cmgma.com/

Membership with Pikes Peak PAHCOM requires both a National PAHCOM Membership and PP-PAHCOM Chapter Membership! Yes, there are separate dues $$! Renewals for National PAHCOM Membership can be completed on-line www.pahcom.com; renewals for Pikes Peak PAHCOM are emailed from the Membership Director -- Val Chavez, CMM, can now be paid on our PP-PAHCOM chapter website that is embedded with the National PAHCOM website. Please keep both memberships current! If you are a CMM or HITCM-PP, do not let your recertification(s) expire every other year. Check your membership page on the national website and make certain you affiliate with our chapter on your membership page, just two clicks and you are done. Otherwise, you do not receive any notices, newsletters, etc.

Did you know that you can save $100 when renewing the National PAHCOM Membership by choosing "auto renew." This does require a secure credit card to be on file but that saving could be put toward your Pikes Peak PAHCOM Chapter dues which are currently $125.00/year.

Add your professional photo to your National PAHCOM Membership profile. It is really simple. www.pahcom.com

Recruit your colleagues!! Bonus $$ -- a discount on your next local chapter renewal when you refer a new member to join!!

PIKES PEAK PAHCOM MEETING REFUND POLICY: Pikes Peak PAHCOM Refund Policy (Educational session registrations only– membership dues are non-refundable and non-transferable). Unless otherwise specified, refunds for educational sessions are available as follows:You submit your request to Lori Trivelli at [email protected] a minimum of ten (10) days prior to the event. Include the name of the attendee the refund is being requested for

– The event name and date– Reason for refund request

Once approved, Pikes Peak PAHCOM will deduct 5% of the amount paid as a processing fee and issue a refund check or a credit to the charged card account.

MANAGEMENT POSITION AVAILABLE: None known at this time.

2016 Pikes Peak PAHCOM Chapter Officers: o Sandra Robben-Weber, CMM, HITCM-PP, 2016 Presidento Chris Hall, CMM, 2016 Vice Presidento Judi Spurgeon, 2016 Secretaryo Lori Trivelli, CMM, 2016 Treasurero Val Chavez, CMM, 2016 Membership Director/

Corporate Sponsors' Director


mailto:[email protected]

http://www.pahcom.com/

http://www.pahcom.com/

QUOTE:

"Opportunities don't happen. You create them."

-- Chris Grosser

Sandra Robben-Weber, CMM, HITCM-PP, PP-PAHCOM 2015 President [email protected]


· Web viewAndrea Baldrica, MBA, Vice President HUB International Services was our Keynote Speaker...

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