IPS Newsletter Independent Physician Services, LLC March 2014 - Volume 35 - Issue 35 IPS Website Redesign announcement We are proud to announce the release of our newly redesigned website for IPS. Take a peek! Our Marketing Department has been hard at work refining our website design, but they couldn t have done it without the help of all the managers who provided well-written content. Our new website, aside from being aesthetically pleasing, is more agile, interactive, and is easier to read and navigate. Enabling visitors to find what they need quickly. Just as importantly, our key messages and value propositions are evident and clear. We are confident that our new web presence will effectively present our new branding, and give us the fresh, innovative look we are trying to achieve. We hope you will visit the new website at our same address, www.ips-mso.com and acquaint yourself with the new site. While you re there, let us know what you think, and provide feedback! Email terra.banal@ips-mso.com to give us your much-appreciated opinion. We re quite proud of the new site, but we know there is always room for improvement. In the coming months, we hope to continue improving the site and adding an employee login, full of information for all of you to easily access. We will provide you with your very own login information when that resource is available. We are also doing the same for our clients! Thank you for being a part of the IPS website redesign! In this issue HR News... page 2 Faces of IPS... page 3 HR News... page 3 National Nutrition Month... page 4 Client Services...page 5-6 Mark your Calendar Daylight Savings Start... March 9th St Patrick s Day... March 17th Easter Day... April 20th Mother s Day... May 12th Memorial Day... May 26th Father s Day... June 16th Independence Day...July 4th Labor Day...September 1st Columbus Day... October 16th Daylight Savings End...November 2nd Veterans Day...November 11th Thanksgiving Day...November 27th Christmas Day...December 25th New Year s Eve...December 31st
HR News United Healthcare In Network Labs Over the past month, the has worked to partner with LabCorp to provide reference labs as In Network for all United HealthCare participants. The partnership allows our employees and community members to complete their lab work In Network and keep their out-of-pocket costs down. To assist you with finding an In Network lab in your area, please reference the lab listing below. In Network Labs Cochranton 104 E Adams Street Cochranton, PA 16314 814-425-2981 Conneaut Lake Dr. Spencer 12387 Conneaut Lake Road Conneaut Lake, PA 16316 814-382-3100 Erie 240 W 11th St., Suite 101 Erie, PA 16501 814-454-8886 LabCorp 2564 W 12th Street Erie, PA 16505 814-836-2874 Franklin 1263 Elk Street Franklin, PA 16323 814-437-3674 Lakeland 1238 Conneaut Lake Rd. Conneaut Lake, PA 16316 814-382-3100 Linesville 210 N. Mercer Street. Linesville, PA 16424 814-683-4636 Meadville 1012 Water Street Meadville, PA 16335 814-333-2022 Pittsburgh Suburan Clinical Laboratory 100S Jackson Ave. Pittsburgh, PA 15202-3428 412-734-6020 Pittsburgh LabCorp 200 Northpointe Cir, Suite 203 Seven Fields, PA 16046 724-722-0760 550 Corporate Drive, Suite 226 Pittsburgh, PA 15237 412-364-4364 301 Ohio River Blvd., Suite 306 Sewickley, PA 15143 412-749-2127 1000 Integrity Drive, Suite 320 Pittsburgh, PA 15235 412-371-7310 2550 Mosside Blvd., Suite 214 Monroeville, PA 15146 412-856-5557 1976 Lincoln Way White Oak, PA 15131 412-678-1891 9173 State Route 30, Suite 5 Irwin, PA 15642 724-864-7118 Seneca 3334 State Hwy 257 Seneca, PA 16346 814-678-4970 LCA Subcontracted - Clarion Hospital 1 Hospital Drive Clairon, PA 16214 814-226-1395 Ohio LabCorp 4476 Darrow Road Stow, OH 44224 330-686-0194 1 Park West Blvd., Suite 290 Akron, OH 44320 330-865-3624 LCA Subcontracted - Portamedic 470 White Pond Drive, Suite 400 Akron, OH 44320 330-864-9480 Pathology Laboratories 3618 W. Market St., Suite 103 Fairlawn, OH 44333 330-666-6644 Page 2
Faces of IPS HR News United Healthcare Human Resources has been getting several requests recently because employees have misplaced their ID cards, would like a copy of their EOB, or are in search of in-network providers. We would like to remind you that you can visit www.myuhc. com to answer these questions and more. If you have not done so already, registration for www.myuhc. com is quick and simple: 1. Go to www.myuhc.com Beth Gais is one of our Billing Representatives in the Pittsburgh office. She has been doing medical billing for over 30 years. She enjoys the accomplishment of seeing payments coming in on an A/R that she s been working on for days. Beth has taken several classes in accounting at WCCC but has not completed her degree. Beth currently resides in Latrobe, Pennsylvania with her partner, Debbie. Her two proudest accomplishments are her son, Andrew, and daughter, Danielle. Her daughter is a graduate of Clarion University and has worked for Verizon Wireless since graduating. Her son was a gymnast in junior high and was on a competition cheerleading squad. His squad was one of the first squads in this area to have boys on the team. They won 3 national championships in South Carolina, 3 years in a row! Some of Beth s favorite hobbies are: reading and listening to music. Her favorite artists are Pink, Melissa Etheridge, Annie Lennox, Katy Perry and Lady Gaga. Her ideal weekend is relaxing and going out with family and friends. She feels her best quality is her sense of humor and her dedication to family and friends. 2. Click on Register Now. You will need your health plan ID card, or you can use your Social security number and date of birth to register. Your Account Number is your social security number and the Group Number is 901709. 3. Follow the step-by-step instructions to create a log on and password. Another great tool for United Healthcare is the UnitedHealthcareHealth4me Mobile App. You can download this app to your apple or android smartphone or tablet for free. If you are traveling, this app can provide you with nearby innetwork physicians. It can also allow you to check the status of a claim, see your account balance, or speak directly to a nurse. You can even pull up an image of your health plan ID card if it s not in your wallet. If you have any questions regarding these United Healthcare tools or are unable to find the answer to the issue you are having, please reach out to your Human Resource Manager and we will assist you. Beth most admires her Father. She says he was the kindest, most loving, generous man she has ever met. He would do anything for anyone one. Beth tries very hard to follow in his footsteps to make him proud. After her Mom got ill, he retired from his job to take care of her. He would do anything for her. He was very big on family; Beth would go to their house every Sunday for dinner. If you didn t go to dinner, you had better have a really good reason for not going, because he would be mad at you. Beth would give a million dollars to have another family dinner with him and her mom. Lastly, one of the most interesting thing that most people don t know about Beth is that her nick name is Frog. Beth used to play softball when she was young and was a catcher. Her coach didn t remember her name during one of her games, and when Beth jumped up from behind home plate and caught a foul ball, he yelled, Good catch, Frog! and it stuck. There are still some people that she runs into from softball days that call her that. Please join me in welcoming Frog, I mean Beth, to IPS! Page 3
march IS NatIoNal NutrItIoN month Usda s MyPlate Food guide MyPlate is an updated version of the old food pyramid. It offers a more practical visual for consumers. Read on for more details. RED /FRUITS Fruits may be fresh, canned, frozen, or dried, and may be whole, cut-up, or puréed. Any fruit or 100-percent fruit juice counts as a fruit. Vary your fruit choices. Fruits differ in nutrient content. When eating canned fruits, select fruit canned in 100-percent fruit juice or water rather than syrup. Choose whole or cut-up fruit rather than juice to get the extra benefits of dietary fiber. ORANGE/GRAINS The Grains group includes any food made from wheat, rice, oats, cornmeal, barley, or other grains. Bread, pasta, oatmeal, breakfast cereals, tortillas, and grits are examples of grain products. Following recommended dietary guidelines just got easier. The USDA has created a new visual called MyPlate to help you make healthy, balanced food choices. MyPlate replaces the 19-year-old MyPyramid which used stripes to identify different food groups. By using an actual plate as a visual, experts say the new icon is a more realistic and practical tool than the food pyramid. Referring to MyPlate (ChooseMyPlate.gov) can help you prioritize your food choices. The icon features a plate split into 4 sections: Fruits Vegetables Grains Protein A cup, representing dairy, is off to the side. The breakdown reminds you to make half of your plate fruits and vegetables. It also highlights the other important food groups for a well-balanced meal: whole grains, lean proteins, and low-fat dairy. the Food groups MyPlate offers tips about each food group all color-coded. Here is a summary: GREEN/VEGETABLES This group, which makes up the largest block on the plate, includes any vegetable or 100-percent vegetable juice. The items can be raw, cooked, fresh, frozen, canned, or dried. Vegetables are organized into 5 subgroups based on nutrient content. Included are dark green, starchy, red and orange, beans and peas, and others. The more varied your choices, the more nutritious your diet will be. Whole grains, packed with fiber and other nutrients, are better than refined grains. The recommendation to make at least half your grains whole has not changed. This means choosing foods like whole-wheat breads and cereals, oatmeal, brown rice, and bulgur. These are preferred over processed grains, such as white breads and white rice. PURPLE/PROTEINS This group includes all foods made from meat, poultry, seafood, beans and peas, eggs, processed soy products, nuts, and seeds. Beans and peas are also part of the Vegetable group. Select a variety of protein foods for optimal nutrition. Opt for leaner protein choices, such as fish, white meat chicken and turkey without skin, and lean red meat. Include vegetarian protein sources, such as beans, soy, and nuts, which provide fiber and offer a variety of other vitamins and minerals not found in animal products. BLUE/DAIRY All fluid milk products and many foods made from milk are considered part of this calcium-rich food group. Choose fat-free or low-fat milk, yogurt, and cheese. Calcium choices for people who do not eat dairy include calcium-fortified juices and soy or rice beverages. IN ADDITION Other key concepts of MyPlate include: The importance of balancing calories Avoiding oversized portions Drinking water instead of sugary drinks Choosing lower-sodium foods For more information, go to ChooseMyPlate.gov. Page 4
Providing Excellent Service To Our Clients Is Top Priority PQRS Physician Quality Reporting System education and tracking is one of the many services we offer our clients. As the Health Care Reimbursement system continues to evolve and change, so too must the physicians we serve. Quality and value are beginning to replace quantity and fee for service. Physicians are beginning to enter a new age of being paid for the quality of care that they provide to their patients. In the near future, if physicians cannot demonstrate that they provide quality, their reimbursements for charges will continue to decline as will their client base. The Physician Quality Reporting System is one way that CMS (Medicare) is rating its physicians for the care that is provided. Many changes have been made to PQRS this year in order to prepare for the years to come and to prepare for the next phase when the Value Modifier plays a large role in 2017. 2014 is the reporting year (period) for 2016. If physicians are not successful reporters this year, they will receive a 2% penalty on their Medicare earnings in 2016. Physicians can receive an incentive of 0.5% for the 2014 reporting year if they are successful with all measures. So, exactly what patients are included in this program? All Medicare Part B FFS patient claims are analyzed in this program. In simpler terms, any patient with straight Medicare or Railroad Medicare-Red, White and Blue Cards. What makes a physician successful? Good question! A physician is successful when they receive an incentive and avoids the penalty. Many physicians do choose only to ensure that they do not receive a penalty. Whatever any of our physicians should choose, we will help them get there. Currently, our physicians can participate in this program by submitting the quality codes on claims. What does a physician need to do to avoid the penalty? A physician will need to report 3 measures. Each measure has a threshold of 50%. This means that any measure a physician chooses, he or she needs to complete that measure on 50% or more of the Medicare patients that fall into the eligibility of that measure. What does a physician need to do to receive the incentive as well as avoid the penalty? The physician will need to report on 9 measures each with a threshold of 50%. The measures need to be completed on all eligible Medicare members that fall into the measure. After reading the above questions, many physicians are saying to themselves, well I can just avoid the penalty and not do the extra work. Although this seems like an easier way to complete the task and not receive a penalty, it is not the best choice. The Value Modifier, which assesses both quality of care as well as cost of care will be phased in and completed for all physicians by 2017. Implementation of the Value Modifier is based on your participation in PQRS. The Value Modifier will be based on cost and quality. Physician PQRS performance in the program will be analyzed. Physicians will receive two composite scores (quality of care and cost of care). These scores will be based on the national mean. Physicians who are high quality and low cost will be receiving higher compensation for their services while physicians who are tiered at low quality and high cost will receive less compensation for their services. The result? Patients will have to pay more for physicians who are low quality and high cost resulting in patients going elsewhere for the same service at a lower price. The goal? Being successful at reporting as many measures as possible this year and increasing to 9 measures over 50% threshold for the next two years unless CMS decides to change things along the way. The latter has happened before! UR/QA is available to provide educational information to the physicians and staff as well as make sure the resources are available to the physicians and staff to be successful. Once again, this year, our IT team has worked hard at placing all measures in accessible folders in the EHR s for staff and physicians to access. UR/QA has selected all measures for each specialty and primary care practice. The measures were selected with some thoughts in mind; aligning with insurances, Meaningful Use and selecting those measures used most in the practices while making sure that these measures are able to be submitted through claims data. UR/QA will be educating clients on the PQRS program and providing tools for success by the end of February. Hopefully, all questions can be answered and submission of the codes can be user friendly for physicians and staff alike. Page 5
Providing Excellent Service To Our Clients Is Top Priority Dr. Pless Implementation The start of February signaled the full implementation of EHR in Dr. Peter Pless s dermatology office. This Go-live is the result of more than a year of preparation by Dr. Pless, PA Jillian Kelly, the office staff and IT. Countless hours have been spent customizing the system so that accurate and detailed records can be produced quickly and efficiently using protocols, templates, diagrams and procedure entry rules. The workflow at Dr. Pless s office is slightly different than other offices. In this office, the staff enters all information into the encounter as scribes during the visit. Dr. Pless then reviews the notes, makes any necessary revisions and signs off. Everyone is doing a fantastic job with learning the new duties and processes that are now in place. These duties include entering histories, scanning, sending referral letters electronically, noting pathology results electronically and documenting the visits. The next big step will be charge passing. Initially, the schedule was cut back to 10 patients each morning and afternoon. They are now up to around 15 each am and pm, seeing up to 34 patients a day. As the office looks to return to a full schedule, additional staff are being sought to assist in the effort. One addition has already been made with Denise McKinsey coming on to enter historical information into the chart before the visit. Another scribe is planned for the near future. Dr. Pless and Jill also chose to start receiving electronic results for labs and procedures. This was another area that workflow had to be addressed so that everything was properly documented, staff notified and patients called. Again, everyone has worked to find practical solutions and implement them. Meaningful Use Update The IT department worked with two IPS clients throughout 2013 to demonstrate and attest for meaningful use. One physician has successfully completed his second year of meaningful use Stage 1, which consisted of a demonstration period for the full year. He has successfully attested and should be receiving his incentive within the next month. In 2014, the IT department will work with this practice to demonstrate Stage 2 of meaningful use, which brings many new requirements for patient care. Another client has successfully completed their first year of meaningful use Stage 1, which consisted of a demonstration period of 90 days. All four physicians were successfully attested and so far 2 of them received their incentive. The other 2 providers should be receiving their incentive within the next month. In 2014, the IT department will work with these physicians to demonstrate their second year of Stage 1, which also presents some new requirements for 2014. INDEPENDENT PHYSICIAN SERVICES, LLC 300 Penn Center Blvd. Suite 701 Pittsburgh, PA. 15235 Phone: 412-823-4510 Fax: 412-823-4517 Client Services Is Our Top Priority Happy Birthday March Birthdays Desiree Shorey 3rd IT Terra Banal 5th Marketing Erica Brown 20th Administration