Physicians were given credit for March meetings due to the Open Meeting I cancellation. Your credit is listed under Open Meetings. You should double-check your attendance for April since the meetings were held remotely.
PRACTICE CHANGES AND UPDATES
- Charles Ho, MD will be leaving Beverly Anesthesia Associates effective 5/10/2020. Effective 5/18/2020,
Dr. Ho will be joining Pain Modulation Associates
480 Maple Street Suite 203 Danvers, MA 01923
(978)304-8601 Fax: (978)304-8621
- The following Essex County OB/GYN Associates providers will be providing coverage at
Lynn Women’s Health 280 Union Street Lynn, MA 01901 (781) 596-3800 Fax: (781) 596-3830
- Mary Boyd, MD
- Cara Chuderewicz, MD
- Elizabeth Scannell, MD
- Stacy Veitch, MD
NEWS FROM NEPHO
A P R i l 2020 EDITION
IN THIS ISSUE:
SAVE THE DATE
MAY 2020 TELEHEALTH MEETINGS
(contact Shawn.M.Bromley@Lahey.org if you wish to attend)
TELEHEALTH & PRACTICE READINESS FOR E/M CHANGES
Date: Wednesday, May 13, 2020 @ 10:00 a.m.-11:00 a.m.
CODING AND BILLING BEST PRACTICE AFTER COVID 19
Date: Wednesday, May 20, 2020 @ 10:00 a.m.-11:00 a.m.
VIRTUAL VISITS BEST PRACTICE & 2021 E/M UPDATES
Date: Wednesday, May 27, 2020 @ 10:00 a.m.-11:00 a.m.
Please check the meeting calendar on our website to get the latest meeting status, notification of new TeleHealth Google Meet calls, Specialty Specific meetings, and POD/IPA meetings. Due to the COVID-19 directive regarding social distancing for meetings we will be providing conference call information and links for upcoming meetings on the meeting invites and via email reminders.
A COVID-19 tab is provided on our site which we hope you will visit to read the latest updates and the various helpful links regarding the coronavirus.
Support our frontline medical colleagues by staying home and staying safe!
COMMUNITY RESOURCE GUIDE UPDATE
The Northeast PHO Care Management Community Resource Guide Team has updated the Community Resource Guide. This new version contains important and updated information that is now accessible to anyone who accesses the NEPHO website.
Some of the highlights include:
● Links to TRIAD programs which include lock box programs.
● The file of life and yellow dot programs which target safety concerns.
● Scamicide, a website created by local elder attorney Steve Weisman which
XXXgives up to date information about scams that target older adults and others.
● Increased resources for Veterans, transportation, equipment, pets, and more.
● Our final highlight is a new program from The Open Door which provides
XXXmedically tailored meal kits, cooking demonstrations, and one on one
XXXcounseling with a registered dietitian for people with special dietary restrictions
XXXdue to chronic illness.
The Community Resource Guide will continue to be updated as new resources become available. Click here to be directed to the Community Resource Guide.
AN UNEXPECTED GIFT OF COVETED N95 MASKS
REHABILITATION TELEHEALTH SERVICES
As essential medical personnel, our physical, occupational and speech therapists and audiologists will maintain office hours to treat our patients who are in urgent need of our care. In order to meet the needs of patients who can’t or shouldn’t be coming to our offices, we are now offering telehealth visits for our CURRENT as well as NEW patients.
Patients will be able to get real-time treatment from one of our physical, occupational or speech therapists or audiologists via video conferencing or a telephone visit. Sessions will last about 30 to 45 minutes and can be booked by calling:
• Physical and Occupational Therapy scheduling line: 978-816-3255
• Speech Therapy and Audiology scheduling line: 978-816-2690
We can also conduct a telehealth telephone visit for patients who do not have the above technology. Your therapist will work with you to identify the best fit of accessibility whether through MyLaheyChart, Google Hangouts or phone.
We appreciate the power of virtual service delivery and that every individual’s needs are different.
85 Herrick Street
Beverly, MA 01915
Blue Cross Blue Shield of Massachusetts
April 2020 Medical Policy Announcements
BCBSMA posted a list of policies which include the following: 1) New and revised policies; 2) Clarified policies; 3) Retired policies. A full draft version of each policy is available only by request, to ordering participating clinician providers, one month prior to the effective date of the policy. To request draft policies, contact Medical Policy Administration at firstname.lastname@example.org. To view the list, click here.
Medical Policy Update: Outpatient Prior Authorization Code List
The following codes were added: G2082, G2083, J2001. Policy #072 Esketamine Nasal Spray (Spravato) and Intravenous Ketamine for Treatment-Resistant Depression. BCBSMA posted a new Outpatient Prior Authorization Code List. To view the complete notification, click here.
CMS – Medicaid and Medicare
COVID-19 Frequently Asked Questions (FAQs) for State Medicaid and Medicare
The following has been added or revised: A. Emergency Preparedness and Response: added questions 4 and 5; B. Eligibility and Enrollment Flexibilities: added questions 5-7; C. Benefit Flexibilities: added questions 11-13; D. Cost-Sharing Flexibilities: added question 2; E. Financing Flexibilities: added questions 10-25. Additional revisions provided throughout the document. To view the notification click here.
National Correct Coding Initiative (NCCI) Quarterly Update
Here are the (NCCI) Procedure-to-Procedure (PTP) edits. Please be sure to update your coding and billing staff to ensure accuaracy in reimbursement. View these links for more information.
Modifier Payment Policy
Fallon Health has revised the Modifier Payment Policy. Updated modifier tables. To view the policy, click here.
Vaccine Payment Policy
Fallon Health has revised the Vaccine Payment Policy. Updated coding. To view the policy, click here.
Harvard Pilgrim Health Care
Provider Manual Update – Claims
Harvard Pilgrim has updated claim submission address. For additional information and to view the notification, click here.
Updated Medical Policy: Diabetes Management Devices
Harvard Pilgrim has updated the Diabetes Management Devices policy as follows: 1) Management of professional CGM’s and documentation requirements adjusted. To view the policy, click here.
Reminder: New PCP Change Functionality in Portal
Updated Payment Policy: Certified Nurse Midwives, Certified Professional Midwives, Nurse Practitioners and Physician Assistants
Harvard Pilgrim has updated the Payment Policy for Certified Nurse Midwives, Certified Professional Midwives, Nurse Practitioners and Physician Assistants as follows: 1) revised credentialing and enrollment standards for Mid-level practitioners effective 04/01/20; 2) updated the Provider Billing Guidelines and Documentation section. For additional information and to view the notification, click here.
In response to the COVID-19 outbreak, the Massachusetts Health Connector announced an extended enrollment period for uninsured Massachusetts residents through May 25, 2020. The Health Connector is working to ensure that Massachusetts residents losing their jobs and job-based health coverage can swiftly and easily make their way into health coverage through the Health Connector. In Massachusetts, we are especially fortunate to have the unique ConnectorCare program which connects qualifying Massachusetts residents with affordable health coverage with low or $0 premiums and low co-pays and no deductibles. The Health Connector has created a new webpage.
Tufts Health Plans
Coronavirus (COVID-19) Updates for Providers – Telehealth/Telemedicine
Last updated 4/10/2020 with information on pre-payment billing review and post-payment billing audit pauses and referrals and out-of-network authorizations. During the rapidly evolving situation around COVID-19, Tufts Health Plan’s Pandemic Planning work group continues to meet on a regular basis to respond to changing events. It continues to monitor and follow recommendations from the Centers for Disease Control and Prevention (CDC), World Health Organization (WHO), State Public Health Departments (Connecticut, New Hampshire, Massachusetts and Rhode Island) and other official sources on an ongoing basis. To view the complete notification, click here.
Please reach out to Alycia Messelaar at 978-236-1758 or
Alycia.Messelaar@lahey.org to keep NEPHO informed of changes in practice schedules due to COVID-19 (office closures, limited office hours, scope of appointment, telehealth use, phone line to reach staff, etc.) or if you have questions about other practice schedules.
The Northeast PHO is here to ensure you are not alone and that we are in this together. We are doing our best to keep your practice as updated as possible with all things COVID-19. Please take a moment to visit the COVID-19 tab on the website by clicking here .
NEPHO POD / IPA SUMMARIES
April POD / IPA Summaries
- Dr. Joseph Peppe shared that we have a prepared agenda and presentation slide deck for the meeting; however, in light of being in a transition period to a new normal, he invited attendees to share current state in their practices and concerns that the PHO can assist with.
- Dr. Peppe provided follow-up that non-licensed care team members can perform telephone calls for transitional care management, provided that they are supervised by a provider and the documentation of the call is co-signed by a provider.
- The metrics tracking to the PHO Dashboard were reviewed.
- The Q3 Physician Risk Share Report Card was shared.
- Carol Freedman shared a BILPN FAQ document for staff to use when speaking with patients about COVID-19.
- Carol shared a detailed ASHP reference document for assessment of evidence for COVID-19 related medications.
- Carol shared the ACE2 mechanism in coronaviruses and that the current evidence does not support discontinuing ACEI and ARB medications.
- Carol shared details of a CME offered by BILHPN Pharmacy for Type 2 Diabetes medication. The CME was intended to be in person, however, it can be done via video/conference call.
- Carol Freedman shared an update of items completed for the Diabetes Care Collaboration pilot practices.
- At this time, the program in its original design will be paused; an alternative outreach program that complements practice outreach efforts will be implemented to connect with diabetes and hypertensive patients.
- Liz Isaac shared that BCBS has sent us the 2020 patient lists for the AQC contract.
- In light of the situation, the quality team is preparing focused lists for when practices are ready to do outreach for quality.
- The 2020 AQC scorecard will be made available for providers in June.
- For Patient Experience updates, MHQP plans to field its statewide Primary Care Patient Experience Survey as usual from April through June.
- Cigna has posted primary care and select specialist patient experience reviews and comments on their website. Information on how to access the reviews was provided.
- Congratulations to the PHO providers for making the HPHC Honor Roll for Quality. Measures and detailed performance report was shared.
2020 Quality Patient Lists
The Quality Team is busy working on action lists and cancer screening lists so that when practices are ready to outreach patients, the lists will be ready too. As was mentioned at the Primary Care Quality Meetings held in early March, patient lists will be formatted as follows:
- Diabetes & Hypertension Action Lists
- Will include patients with BCBS HMO/PPO, HPHC, Tufts Health Plan, Allways Health Plan & Fallon needing a PCP or Specialist appointment scheduled.
- Cancer Screening Lists
- Cancer Screening lists will be based on the Health Plan Registries as in prior years.
- Lists will exclude patients who have had the screening already, are not active patients or are otherwise not appropriate for outreach.
- Only patients who are engaged in their care will be included on the list for practices to outreach.
- Health Coach, Lucia Kmiec, will outreach patients who repeatedly cancel, no show, or have lost contact with the practice.
- Well Child & Chlamydia Screening Lists
- Well Child Visits & Chlamydia Screening Lists will be based on the Health Plan Registries.
- Patients who have already had physicals will be removed from the lists – for all practices for which the members of the Quality Team have EMR access.
- Patient List Format and Delivery
- The Quality Team will work with each practice to ensure patient lists enhance quality efforts and work flow within each practice.
- We are able to make lists available in Google Sheets or Excel formats.
- We are able to utilize Email, Google Shared Drive or secure Fax to send patient lists.
Patient Outreach Activities
Patients with chronic conditions (ex. Diabetes, Hypertension) may be at risk for worsening of their condition due to loss of a job and health insurance, being home, limited access to food and lack of regular contact with their PCP and specialists.
How NEPHO is helping:
In a collaborative effort, the NEPHO Care Managers, Pharmacist and Health Coach are outreaching at-risk patients to assess risk factors, current state of their condition, educate patients about existing resources and the availability of telehealth and telephone visits with providers.
If you have any questions please reach out to Carol or Lucia.
May is Mental Health Awareness Month
The anxiety and stress during the current COVID-19 pandemic and the impact this crisis is having on us and our loved ones can be overwhelming. Social distancing makes it even more challenging. Please take a moment to click on the links below and read about taking care of our Mental Health During the COVID-19 Outbreak:
OPTUM Newsletter – April 2020 Focus: Alcohol and substance use
Telehealth Is Here to Stay
The future of health care will include telehealth as we progress out of COVID 19. The implementation of telehealth came very quickly for the NEPHO practices. Telehealth is a business model that will help increase patient access while adding another source of revenue stream coming into the practice. Providers will need to have an understanding of what type of telehealth business model they will create.
Plans To Think About:
- Develop a practice strategy for building a telehealth program by understanding where to focus funding.
- What will you be focusing the funding on; telehealth equipment, HIPAA compliant patient platform, telehealth program management, telehealth marketing.
- Know your current monthly revenue stream.
- Use telehealth as a way to improve patient satisfaction.
- Improve patient access to care by incorporating telehealth into your daily workflow.
- Make a plan with staff as to how telehealth will impact day-to-day operations.
- Review your high risk patients and consider if telehealth could help support a monitoring program to better support management of care for high risk patients.
- Have solid knowledge in regards to building a HIPAA compliant telehealth program.
- Telehealth is a way to engage your patients in better management of their healthcare as it will; help improve their compliance to medications, help monitor their chronic conditions, improve access to patient care, and increase overall patient satisfaction.
How NEPHO Can Help
Telehealth will have an impact on your day-to-day operations and there will be a new workflow to your practice. A new workflow will need to be developed with your clinical and administrative staff as both will need to have a plan in place to adjust to the workflow. NEPHO can help support the development of a practice task-force that will include providers who will be using telehealth, administrative staff who will be scheduling appointments and helping patients adjust to the new workflow, IT resources, coders and billers who will be supporting the revenue transition, and other team members who will be involved in implementation of telehealth program. NEPHO telehealth committee will keep practice team members engaged early in the development of the Telehealth program so they have the opportunity to help shape the program. Items to think about prior to program development:
- Understand the State and Federal Rules
Most practices are currently providing telehealth services and the state and federal rules are changing daily due to COVID 19. It is important to stay current.
- Make a plan
Telehealth activities should be designed to complement your standard practices, not complicate or interrupt them. NEPHO can work with your practice to discuss the plan to implement services into your current business structure.
- What percentage of your time will you dedicate to telehealth?
- How will this fit into your current schedule?
- Bring key people from your practice together, which can include but is not limited to:
- Nurses, LPN’s, or CNA’s – these individuals will be helpful in creating a clinical workflow to support telehealth patient visits
- Practice Champion– someone in an operational role with project management experience who can lead the telehealth program implementation
- Telehealth practice coordinator – this role will help support the Practice Champion and take the lead on patient education for telehealth visits
- Front Office Staff
- Billing/Coding and Finance
- IT Staff – IT specialist and/or network analyst
- Legal – this role will support the business model change and ensure implementation of the telehealth program is compliant within the current healthcare environment
- Check your technology
- What equipment will you use for telehealth; PC, Mac, or tablet with a high-quality integrated camera, microphone, and speakers?
- Optimize results by having a reliable, high speed internet.
- Patient Education Plan
- Start with your providers: Your providers are your best advocates for promoting and educating patients about telehealth services. Discussing new patient access opportunity with patients will help support their interest and buy in for the program
- Educate your patients: All patients are not candidates for telehealth services. Having a patient advocate that can help support patients through this workflow transition will help better manage patient onboarding to telehealth services
- Promote across all platforms: Utilize all your practice channels; website, email promoting, appointment confirmation text messaging, face book/social media, practice patient portal, flyers, online advertising, referrals, to help promote and educate patients on this new program development
- Make the appointment process simple: For those patients who are candidates for telehealth services, ensure that they can easily make a telehealth appointment
- Have workflow for patient connection to providers documented and provided to patients prior to scheduled visits
- Make sure to do testing prior to patient visit to ensure a successful visit experience for the patient
- Understand your new visit workflow: It is important to understand how many patients you can add into your schedule offering telehealth services
- Marketing your new Telehealth program
- Promote Telehealth as an option for patients on your website, in your practice newsletter, via email, and on your social media page
- Place information in your patient informed consent packets
- Email your patients with new service details
- Add a message to your billing statements
- Offer a coupon to try out the service
- Send a focused mailer to patients
- Have all patients complete a patient survey to track areas of improvement opportunity
- If patients call to book or reschedule appointments, offer telehealth as an alternative
Please contact Shawn Bromley directly if you are interested in discussing a telehealth program implementation. NEPHO will directly with you and your staff to ensure a sustainable program is developed. Contact email@example.com and/or 978-236-1704.
PHO SHOWS SUPPORT FOR BH AND AGH FRONTLINE STAFF
Pizza for Hospital Staff
Carol B Freedman RPh, MAS, BCGP, Manager of Pharmacy Services, Northeast PHO worked with Elizabeth Toabe, PharmD, Clinical Pharmacy Specialist – Population Health at Winchester Hospital to collect donations for a Pizza Fund that hospital staff could use as they needed to.
Ms. Toabe reported that she has recently concluded that fundraiser and it was a huge success.
Many PHO staff donated. She writes that, “ Together, in less than four weeks, we raised a total of $1322 to feed frontline staff! Of the total, $872 went to sending pizzas to inpatient staff at Winchester Hospital, Lahey Burlington, Lahey Peabody, and Beverly Hospital.
For the remaining $450, we chose to donate to Off Their Plate, a nationwide organization that started in Boston. Off Their Plate partners with amazing local restaurants (including Pagu, Flour Bakery, and one of my favorites, Cafe Sushi) to feed frontline staff of Boston area hospitals including Beth Israel Medical Center, MGH, Boston Children’s Hospital, Boston Medical Center and more.
It was amazing to see the response of so many friends, family and colleagues helping to show appreciation for frontline staff. We will not be raising any further funds for this cause at this time, but will let you know next steps as we look to raise funds for other groups in need. Thank you all again!”
A Sweet Tribute to Our Fellow Case Managers and Social Workers
The Case Management Team with Dr. Joseph Peppe and Ken King, RN, RAC-CT, CCM wanted to show their support to the hospital case managers during this difficult time so Betsy Bocuzzi, RN, BSN, CCM organized an Easter Candy Collection from Nichols Candy in Gloucester. On April 14, 2020, Karen Richard RN, BSN, CCM was able to deliver the 2 pound boxes of candy to all of the BH and AGH Care Management offices. All were so pleased to have this special acknowledgement for the important behind the scenes work they do.
PATIENT EXPERIENCE COMMENTS
Blackburn Medical Center – 1 Blackburn Drive
- Dr. Jay Isaac is amazing! He takes an enormous amount of time at visit, he’s caring and very knowledgeable!
Cape Ann Medical Center – 1 Blackburn Drive
- Dr. Janet Doran has a wonderful healthcare attitude in explaining and understanding and helping me.
- Dr. James Maguire and all of the staff are excellent! I feel comfortable with all of them.
Cape Ann Pediatrics – 298 Washington Street
- Dr. Thomas Carbone, his staff and providers are always kind, friendly and trustworthy!
Danvers Family Doctors – 140 Commonwealth Avenue
- Dr. Subroto Bhattacharya is a very caring, knowledgeable and kind physician. He is there for me always.
Lahey Health Primary Care, Beverly – 30 Tozer Road
- Dr. Tina Waugh and Courtney are amazing, smart and attentive to patients especially during this COVID-19 crisis.
Lahey Health Primary Care, Beverly – 900 Cummings Center
- Dr. Daniel McCullough has been our healthcare provider for many years – he is EXCELLENT not only in knowledge, but in knowing who we are and what we need.
Lahey Health Primary Care, Danvers – 480 Maple Street
- Been seeing Dr. Manju Sheth for years and I am very happy with my care.
Lahey Health Primary Care, Gloucester – 298 Washington Street 4th Fl
- Meeting Dr. Yuliya Mandel was positive all around. Her knowledge and understanding of my health issues was above all of my expectations….her expertise in all aspects of medicine was amazing.
- I can’t say enough about the great care I received from Dr. Victor Carabba and the staff!
- Dr. Karen Damico’s office filled w/love of helping all patients! Best practice ever!
Lahey Health Primary Care, Gloucester – 298 Washington Street 1st Floor
- Dr. Amy Esdale and her staff are caring and compassionate providers and I am very pleased with the care given by this practice.
Lahey Health Primary Care, Hamilton – 15 Railroad Avenue
- I have complete confidence and trust in Dr. William Medwid. He has a very compassionate dr./patient relationship, sincere.
- Dr. Hugh Taylor was exceedingly thorough, compassionate, respectful and he followed up personally with a phone call. I feel like I’m in excellent hands.
Lahey Health Primary Care, Manchester – 192 School Street
- Dr. Nicholas Avgerinos has been great. He listens, explains, consults and shows empathy.
- Dr. Jana Oettinger I finally have a doctor that I can really feel comfortable with and can ask her anything and she will listen.
North Shore Pediatrics – 480 Maple Street
- I have such confidence in Dr. Maureen Mathews and North Shore Pediatrics. I’ve been with them for a long time and have 3 children who belong to their practice. I am so thankful to have this practice for my children. We have had all positive experiences with every practitioner we have seen from the NP’s to the MD’s. Also the administrative staff is always helpful, kind and responsive to our needs.
Dr. Brian Orr Pediatrics – 1 Blackburn Drive
- Dr. Brian Orr and all of his staff and providers are always kind, friendly and trustworthy.
Patton Park Medical Center – 42 Asbury Street
- Good Experience! Dr. Michael Edwards is pleasant, caring and compassionate with me & all patients & staff. All doctors should aspire to emulate his abilities and consideration.
Thomas Pearce, MD – 279 E Main Street
- Dr. Thomas Pearce and staff always go the extra mile to provide any information or assistance necessary.
The Northeast PHO recognizes colleagues who provide a positive experience for our patients, help us keep care local and meet our quality targets.
This month’s winners are:
Regina Moormann, Danvers Family Doctors, was recognized for collaborating with the practice providers early this year to support quality improvement.
Michelle Murphy, Lahey Health Primary Care – Danvers Medical Associates received the Patient Experience award.“Michelle is excellent too…she always calls in a timely manner with answers to any of my questions – Very informative”
Please let us know if you would like to nominate a team member in your practice or another practice for the recognition program.
We will deliver gift cards to the winners each month, and they will be announced here in the newsletter.
Please be sure to look for the new winners in next month’s issue!
We will be publishing a special article starting in May honoring our colleagues helping the community during this time.
Please click here to share names of colleagues and let to let us know how they are helping our community during the Covid-19 crisis.