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Minnesota Medical Group Management Association
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August E-News

In This Issue:
 

Featured Articles

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Support the Coding Flexibility (Code-FLEX) in Healthcare Act

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Government Affairs Committee encourages you to contact your member of Congress to support HR 3018, CodeFlex Legislation. Our industry has worked hard to change the rules allowing for a transition period from ICD-9 to ICD-10. The legislation would address a critical concern of medical groups by establishing a transition period of 180 days following the Oct. 1, 2015 ICD-10 compliance date where providers would be able to submit claims using either ICD-9 or ICD-10 codes. This would permit the submission of ICD-10 codes for those practices that are ready, but, most critically, allow additional time for those that are not.

Please share your support with your member of Congress when he or she is home for August recess. Your outreach prior to Sept 8th will help add our industry's voice to this important issue. MGMA has made it easy to contact your representative through the Advocacy Portal.

Thanks for a Fantastic Summer Conference!

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What a great Summer Conference at Breezy Point Resort! The conference included a beautiful golf round, informative speakers, lots of networking and rockin’ with Elvis. Click here to view the event photos.

Mark your calendars for more great MMGMA events! The 2016 MMGMA Winter Conference will be March 1-2 at the St. Paul River Centre, and the 2016 Summer Conference will be in Duluth on July 27-29.

CMS Issues ICD-10 Flexibility Clarifications

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In a series of FAQs, the Centers for Medicare & Medicaid Services (CMS) clarified its earlier policy announcement regarding expanding flexibility for practices submitting Medicare claims containing ICD-10 diagnosis codes. CMS reiterated that all claims with dates of service of Oct. 1, 2015 or later must be submitted with a valid ICD-10 code and that ICD-9 codes will no longer be accepted for these dates of service. Additionally, in certain circumstances, a claim may be denied because the ICD-10 code is not consistent with an applicable policy, such as Local Coverage Determinations or National Coverage Determinations. This reflects the fact that current automated claims processing edits are not being modified as a result of the flexibility guidance. The permitted 12-month flexibility only applies to Medicare review contractors—they will not deny claims billed under the Part B physician fee schedule through either automated medical review or complex medical record review based solely on the specificity of the ICD-10 diagnosis code, as long as a valid code from the right family of codes (defined now as the ICD-10 three-character category) was used.
Source: MGMA Washington Connection (August 5, 2015). Reprinted with permission from MGMA.

Payers Respond: ICD-9 Prior Authorizations Submitted Before October 1, 2015

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The following question was addressed to the payer representatives on the ICD-10 Collaborative via email:

“Is a reauthorization required if the ICD-9 diagnosis that was authorized isn’t mapped to an ICD-10 code? Do you need to request re-authorization in this scenario? If so, can staff select a new diagnosis or does a clinician need to do so?”

Payer responses from payer representatives on the collaborative:

Blue Cross: You do not need to request a re-authorization. Blue Cross will handle any requests that are received in ICD-9 for services that are actually performed after October 1, 2015.

Medica: If a Prior Authorization (PA) is submitted and approved prior to October 1 with a 9 code, it does not need to be resubmitted.

PreferredOne: No resubmission will be required for PreferredOne for authorizations approved prior to October 1, 2015.

HealthPartners: PAs submitted and approved prior to October 1, 2015, with ICD-9 codes do not need to be resubmitted if the service is occurring after October 1, 2015.

Minnesota Health Care Partners will not require a new authorization if one was approved with ICD-9 for dates of service that continue through October 1, 2015. It will not deny claims solely because the authorization is approved with an ICD-9 code and the claim is submitted with an ICD-10 code.

Sanford Health Plan: No resubmission is needed.

ICD-10 Testing Updates – Payers are Prepared

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The Minnesota Credentialing Collaborative held its regular conference call on August 6, 2015. ICD-10 Testing Updates from this meeting include:

Sanford: 80 percent done with providers and clearinghouses. Everything is looking good so far. Two vendors are completing testing.

Blue Cross: 95 percent complete. In the next week or two will close down testing. Most issues have been related to provider coding differences and date spans of test claims overlapping with contract date changes.

HealthPartners: 100 percent complete. No issues.

PreferredOne: 95 percent done. No issues.

Medica: 60-65 percent complete. Continuing to test on 3 different platforms. No major concerns.

DHS: 90 percent done with internal testing; continuing with regression testing. Plan to start IP interim payment testing in next week.

PrimeWest: 95 percent complete. It has not identified any issues.

The current recommendation is to contact your clearinghouse/EDI vendor to confirm its testing status with the Minnesota payers.

If You Are Not Yet Ready for ICD 10, You Are Not Alone

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The Workgroup for Electronic Data Interchange (WEDI) announced the results of its most recent ICD-10 readiness survey.  For the survey results and additional Administrative Uniformity Committee (AUC) Updates, click here.

Futurists Speak at MMA Annual Conference

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If you are interested in the future of medicine, then the 2015 MMA Annual Conference in St. Louis Park is the place to be. Two preeminent futurists will offer their assessments on the future of medicine and health care technology. The conference, which will be offered Friday and Saturday, Sept. 25-26, will feature programs on wellness and well-being, physician-team-patient communications and emerging technologies. MMA welcomes practice administrators to this conference. MGMA members should register at MMA member rates. ($89 early registration rate before September 1, 2015). Half-day programming options are also available. See conference program for details.

 

Committee Updates

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Communications Committee

THANK YOU to those MMGMA members who stopped by the Communications table at the Summer Conference to offer a brief testimonial about their membership with MMGMA.   Look for their comments and smiling faces coming soon on our MMGMA homepage!

Exhibitor & Sponsorship Committee

THANK YOU to all of the outstanding sponsors and exhibitors who contributed to this year’s Summer Conference. We had great participation in our X-hibitor Quest contest, and the winner of the drawing for the $100 Visa gift card was Lisa Arrington (Twin Cities Spine Center).

Golf Volunteers

Thank you to our fabulous sponsors and golfers for a great day at Whitefish Golf Club. It was a beautiful, albeit BREEZY, day and a good time was had by all.

MMGMA’s next golf event is September 17th at Prestwick Golf Club in Woodbury. Golfers and sponsors can register here.

Government Affairs Committee

Thank you to the many visitors to the Government Affairs Committee (GAC) table at this year's Summer Conference. Our 2015 Legislative Summary is still available in both electronic and print forms. A special thank you to those who made contributions to our political action committee (PAC). Our PAC funds will support our efforts to build relationships with key members of the Minnesota Legislature. MMGMA members are encouraged to actively engage with their local state senator and state representative, and GAC is available to help in that regard.

At the Summer Conference, National MGMA Government Affairs Representative, Jennifer McLaughlin, provided attendees with an update. Members are asked to contact their member of Congress and support H.R. 3018, the Coding Flexibility in Healthcare Act.

GAC has scheduled a meeting in August with Representative Erin Murphy to discuss improving the state's approach to Certified Healthcare Homes.

The No Fault Insurance Task Force, which includes representation from MMGMA, has begun its work.  Please let any GAC member know if you have input for this task force.

Membership Committee

The Membership Committee invited MMGMA members to help bring new attendees and potential members to the Summer Conference and conducted a drawing among existing members. Congratulations to Brent Wilde (Kidney Specialists of Minnesota) who won free registration to the MMGMA 2016 Winter Conference for making this referral. Look for this incentive program to continue.

We had a great attendance at our new MMGMA member/new conference attendee breakfast. New members/attendees were connected with existing members at the meeting. Hopefully these relationships will continue and were not just a BFT (Best Friends Today) situation.

Payer Relations Committee

The Payer Relations Committee is scheduled to meet with BCBS MN provider representatives on August 27. If your clinic has worked through BCBS provider service channels and you still have concerns related to recoupment issues, unresolved appeals, or other problems, please contact Melissa Larson at mlarson@ihnhealth.com. The Payer Relations Committee is happy to bring your issues forward.

 

Events Calendar

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September

October

March

  • MMGMA Winter Conference – March 1 - 2, St. Paul RiverCentre (St. Paul, MN)
 

Job Listings

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  • Clinc Manager (Courage Kenny Rehab Associates) - Allina Health - St. Paul, MN - posted 08/11/15
  • Chief Operating Officer - Canvas Health - Oakdale, MN - posted 8/11/15
  • Director of Nursing – Emergency Room – Duluth, MN (22946BR) – posted 7/10/15
  • Department Administrator Assistant – posted 7/10/15
  • Chief Nursing Officer – posted 7/7/15
  • Patient Care Supervisor – posted 6/23/15
  • Director of Finance – posted 6/18/15
  • Director of Cancer Care & Research Center – posted 6/9/15
  • Hutchinson Health Clinic Manager – posted 5/29/15
Visit our job board to read more about these and other job postings.
 

Featured Sponsor

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Cushman & Wakefield/Norhmarq

Cushman & Wakefield/Northmarq

Cushman & Wakefield/NorthMarq provides real estate advisory services to medical practices and hospital systems. Services include site selection, acquisition and disposition, strategic planning, lease negotiation, ownership structuring, and relocation analysis. Ancillary services include lease administration, project management, facilities management and property accounting.

Platinum Sponsors

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Cushman & Wakefield/NorthMarq Logo
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MMIC Group