- Erinn Murphy, MD of Beth Israel Lahey Health Primary Care Family Medicine Associates, South Hamilton 15 Railroad Ave South Hamilton, MA 01982 Phone: 978-468-7381 Fax: 978-468-6020. Anticipated start date August 14, 2023.
- No Practice Changes/Updates this month.
SAVE THE DATE
Office Manager Meeting
Date: Wednesday, June 7th @ Noon
Topic: NEPHO Practice Colleagues Successful Tech/AI Experiences
Location: Teams Meeting
Date: Wednesday, June 28th, @ Noon
Speaker: Dr. Gabriel Merlin, Coastal Orthopedics
Topic: Touching Hands Da Nang Vietnam
Location: Teams Meeting
NEWS FROM NEPHO
MAY 2023 EDITION
IN THIS ISSUE:
2023 NECOMG ANNUAL MEETING
The NECoMG Annual Meeting will be held virtually via Zoom Meeting on June 15, 2023 at 7:00 a.m. Meeting login information, listed below, was sent to NECoMG Shareholder member emails with a link to the proxy/voting form. Please use the form to submit your response by June 14th. Click here to read the bios for this year’s speaker and Board of Directors candidates.
Click the link below to Join Zoom Meeting:
Meeting ID: 917 3963 6949
Or Join by phone:
Meeting ID: 917 3963 6949
BEVERLY HOSPITAL RECOGNIZED AS A TOP HOSPITAL
We are proud to share that Beverly Hospital has received an “A” Leapfrog Hospital Safety Grade 23 times in a row, one of only 20 hospitals in the country to be awarded an “A” in every Hospital Safety Grade cycle since 2012. This national distinction recognizes Beverly Hospital’s achievements in patient safety. To read more about this recognition, please click here.
REBRANDING LAHEY OUTPATIENT CLINIC DANVERS (LOCD)
As announced on Friday, May 5, 2023, LOCD will be rebranded to Beth Israel Lahey Health Care Center – Danvers. To view, download and print the notification, please click here.
POINT32HEALTH/HPHC CYBER SECURITY INCIDENT
On May 24, 2023 HPHC announced that their investigation into the incident revealed that members’ personal information and protected health information may have been copied and taken. The files involved may contain members’ names, mailing addresses, phone numbers, dates of birth, health insurance account information, Social Security numbers, and provider taxpayer identification numbers. Medical history, diagnoses, treatment, dates of service, and provider names, may also have been compromised. HPHC is not aware of any misuse of personal information or protected health information as a result of this incident. For more information, please visit: http://harvardpilgrim.org/data-security-incident.
Considering this incident, HPHC is providing all health plan members with immediate access to two (2) years of free credit monitoring and identity protection services through IDX. If you are enrolled in a HPHC insurance plan, you can enroll by visiting https://response.idx.us/HPHC and entering one of the following codes:
- Adult members: QE3U9P6XL
- Minor dependents: QE3JEO9MZ
You can also call (888) 220-5517 for assistance. IDX representatives are available between the hours of 9:00 a.m. to 9:00 p.m. EST, Monday through Friday.
It is also important that you know the following:
- User Information – If, for some reason, you are able to navigate to an HPHC webpage that asks you to enter your user information, you should not enter that information. Instead, you should reach out to the HPHC Member Services phone number on the back of your card. If you do not have your ID card available, please call (888) 333-4742 (TTY: 711).
- Access to Care – This outage does not impact your ability to receive care. If you need assistance with matters related to access to care, please call the HPHC Member Services phone number on the back of your ID card.
The Point32Health website is the best source of information and updates related to the system outage. Point32Health will update the page as information becomes available.
WELLSENSE MASSHEALTH ACO PHARMACY
WellSense MassHealth ACO Pharmacy Update: Process for Supply Chain Issues
The WellSense pharmacy team has shared the following process for providers if there is a supply access issue. In general, the provider would need to search for an alternative in-network pharmacy by using the pharmacy search tool. The pharmacy search tool is available for both ACO members and providers.
Click here to access the pharmacy search tool reference guide.
If the provider cannot find an in-network pharmacy with access to the medication, they should reach out to pharmacym mailbox. The pharmacym mailbox (email@example.com) is a resource for providers to reach out to for claims specific escalations, including supply issues.
When reaching out to the pharmacy mailbox, providers should include:
- Member info (name, DOB, WS ID #)
- Drug info (drug name and strength)
- Pharmacy info (pharmacy name)
- Time/Urgency information (e.g., refill due date)
- Example: I am looking for assistance with a prescription I sent to Accredo for Tadalafil 10 mg for patient Toi Story, DOB 2/2/2022, WS ID#123456789. Patient will be out of medication in two days.
WELLSENSE MASSHEALTH ACO UPDATES
Looking for PT/OT Services while caring for WellSense ACO patients?
The Provider Directory is posted online here: https://wellsense.providerlookuponlinesearch.com/
Users can select Insurance Plan: ‘WellSense BILH Performance Network ACO’
Search by: Specialty
Users will see a drop down to select the type of therapy they are looking for (e.g. OT/PT). Once selected all in-network providers will appear.
We understand there has been an influx of communications and meetings surrounding the WellSense MassHealth ACO which went live on April 1, 2023. In an effort to help keep resources consolidated, we have created a tab on our website dedicated to information we are able to share that we believe will be helpful at this time.
Check back frequently for additional resources!
Click here to view, download and print a document that will aid in navigating the MassHealth product lines, accompanied by this MassHealth Provider Bulletin that breaks down the ACO exclusivity. Please note: the cheat sheet refers to products that COULD be accepted, but not necessarily ARE accepted by your practice. To determine if your practice is participating in a specific contract through the Northeast PHO, please click here to refer to our Contract Participation Grid or reach out to Alycia.Messelaar@Lahey.org.
TEACHING SELF-COMPASSION IS ESSENTIAL TO TEENS’ MENTAL HEALTH
Please click here to read an article written by Dr. Elizabeth Humphreys, Pediatrician at Garden City Pediatrics.
BILHPN TEXTING CAMPAIGN
The BILHPN texting campaign for June will focus on eye exams for patients with diabetes. The text language is included below
[Practice Name] @Beth Israel Lahey Health: Everyone with diabetes is at risk for retinopathy, the leading cause of vision impairment and blindness among working-age adults. If you have not already done so, schedule your diabetic eye exam by calling one of these local eye care providers found here: [INSERT LINK]. If you need to update your records, please contact your PCP office at [PRACTICE PHONE]. To stop receiving messages, reply with ‘STOP’.
If you have any questions regarding the BILHPN texting campaigns please contact Laureen Viel at Laureen.Viel@Lahey.org.
Blue Cross Blue Shield of Massachusetts
We previously notified you that effective for dates of service on or after July 1, 2023, we would implement diagnosis-driven claim edits to reinforce our existing monitored anesthesia care (MAC) medical policy 154 guidelines. After careful review, we have decided to postpone our enforcement of this medical policy to January 1, 2024. For more information, click here.
Authorization Manager Tips for Assisted Reproductive Technology (ART) Providers
As a reminder, all providers will be required to submit initial authorization requests and inquiries electronically through Authorization Manager rather than by phone or fax starting June 1, 2023 for the commercial (HMO, PPO) and Federal Employee Program (FEP) members. Authorization Manager is the most efficient method to submit requests, and it’s available 24/7 at no additional cost via single sign-on through Provider Central. To view the complete notification, click here.
Medical Policy Update: Medicare Advantage Management
The policy has been updated as follows: Removed LCD L33622 and added LCD L39455 to MP #320; MP #320 Diagnosis and Treatment of Sacroiliac Joint Pain reinstated and added. Revised policy title for MP 482. To view the complete policy, click here.
Top Five Tips for Mastering Patient Risk Reporting
For value-based payment programs, accurately capturing hierarchical condition categories (HCC), is a must. These five tips can help safeguard the reporting process and help improve quality of care.
- Report and address active chronic conditions at least once annually, but the more the better. Patient risk scores reset annually, and many chronic conditions are HCC codes. Make sure to address them at least annually. Wellness visits are a prime time for this.
- Report secondary diagnoses with chronic conditions, even if not the primary reason for the visit. If a condition is addressed, then it should be reported.
- Report any complications in addition to condition. Underlying conditions with complications, e.g., diabetes with cataracts, generally impact risk scores more than uncomplicated conditions do.
- Always provide documentation. Undocumented conditions affect reimbursement and audit results— and can also impact patient outcomes.
- Take full advantage of diagnosis code specificity tools. Capturing the correct ICD-10 codes is essential to reflect the accuracy of a member’s health profile. IT’s imperative is to be specific with ICD-10 codes. Some electronic health records have diagnosis code calculators to assist providers in choosing the highest level of specificity via ICD-10 code.
For additional information and to view the article, click here and scroll to related title.
Return to Referral Requirements Post Federal Public Health Emergency
As the Public Health Emergency comes to an end, Fallon Health is preparing to return to PCP referral requirements for specialty care for Fallon Medicare Plus, Fallon Medicare Plus Central, and NaviCare—effective July 1, 2023. These referrals need to be submitted into our Proauth referral and authorization system. For additional information and to view the article, click here and scroll to related title.
Harvard Pilgrim Health Care
COVID-19 Coverage Updates
President Joe Biden has signed a bill that will officially end the federal COVID-19 Public Health Emergency (PHE) at the end of the day on May 11, 2023. As a result, Point32Health is returning to many pre-pandemic operations and policies and will be updating the Coronavirus (COVID-19) Updates for Providers page. To view the updates, click here.
GIC Product Updates Effective July
Effective July 1, 2023, Point32Health is updating the Commercial Group Insurance Commission (GIC) product offerings. For the 2023-2024 plan year, Point32 Health will offer two custom Commercial Harvard Pilgrim Health Care/GIC products in New England for active GIC or eligible municipal enrollees, retired GIC enrollees not eligible for Medicare, retired municipal teachers, and certain other government retirees. For additional information, click here.
Claims Editing Alignment
As part of the integration, Point32 Health are continuing to align the policies and claims editing processes across the legacy brands, Harvard Pilgrim Health Care and Tufts Health Plan. Effective for dates of service beginning July 1, 2023, all claims for both medical and behavioral health services, including those performed at community mental health centers, will be subject to claims edits and processed consistently across the claims platforms for the legacy brands. To view the notification, click here.
MassGeneral Brigham Health Plan
As of 4/1/23, in order to support the sub cap claims payment methodology for the Mass General Brigham ACO, our system was configured to require a valid attending provider be sent on all outpatient hospital claims (UB92 claim with a bill type 013). If claims are submitted without the appropriate attending provider on the Mass General Brigham ACO claims, these claims will be rejected back to the submitter. Additionally, this requirement is only in place for the Mass General Brigham ACO line of business.
With that being said, please resubmit any rejected Mass General Brigham ACO claims with the valid attending provider to Mass General Brigham Health Plan as soon as possible.
Please note, we have since turned the edit off for our Commercial lines of business. If you received a rejection for your commercial claims, we ask that you please resubmit the claim as initially submitted to Mass General Brigham Health Plan.
We apologize for any inconvenience. If you have any questions please feel free to contact firstname.lastname@example.org.
Medicare Promoting Interoperability Program Annual Call for Measures
The Centers for Medicare & Medicaid Services (CMS) is initiating its Annual Call for Measures to allow stakeholders to be involved in the evolution of Medicare Promoting Interoperability Program measures for eligible hospitals and critical access hospitals (CAHs). Proposals must be submitted by July 1, 2023 to be considered for future rulemaking. The Annual Call for Measures process allows eligible hospitals and CAHs, professional associations, medical societies, and other stakeholders, such as researchers and consumer groups, to identify and submit measures. Measure proposals will be accepted through July 1, 2023. For additional information, click here.
October 2023 Healthcare Common Procedure Coding System (HCPCS) Quarterly Update
The purpose of this Change Request (CR) is to remind the Medicare contractors that the quarterly update to the HCPCS file is available for them to download. The complete HCPCS file is updated and released quarterly to the Medicare contractors. The file contains existing, new, revised and discontinued HCPCS codes for the October 2023 quarter. Contractors must download the file via the CMS mainframe in September 2023. The recurring update notification applies to chapter 23, section 20 of the Medicare Claims Processing Manual. To view the transmittal, click here.
Tufts Health Plan
Providers enrolled as Pain Management/Anesthesiology are not being paid for office visits 99213 and 99214 due to a system glitch. This issue is being driven by a Tufts Health Plan change to align with Harvard Pilgrim Health Care policies on March 9, 2023. Despite HPHC policies allowing these claims for these types of providers, the system inadvertently has denied all claims. THP has outlined they will be issuing retro payments for the entire network of physicians who have been impacted by this error.
Payment Policy Update: Preventive Services
The policy has been updated as follows: Added codes 83020, 83021, 83030, 83033, 83051, 85660, Z00.110, Z00.111, Z00.121, Z00.129, and Z13.0 to the Metabolic/Hemoglobin Screening (Newborns) section, effective April 20, 2023, Code Z71.3 added to the Obesity Screening (Adults) Section, effective April 15, 2023, Code Z78.0 added to the Osteoporosis Screening section, effective April 15, 2023, Codes S4993 and S4989 were removed from the Preventive Services Policy effective May 5, 2023 , Code Z12.39 was added to the BRCA Genetic Testing section, effective May 5, 2023, Codes Z85.09, Z85.44, Z12.31 were added to the BRCA Genetic Testing section effective March, 20, 2023, code 87623 was added to the Cervical Cancer Screening Section, Code A4660 was added to the Blood Pressure Screening (Adult) section, effective May 5, 2023, code G0451 was removed from the Preventive Services Policy, Codes Z00.121 and Z00.129 were added to the Lipid Disorders in Adults section, effective April 15, 2023. To view the complete policy, click here.
For All Senior Patients: Prescription Advantage
Most of our senior patients have pharmacy coverage by a Medicare Part D plan or a Medicare Advantage plan. As you know, patients have up to a $500 deductible, just for prescriptions, and may be approaching the coverage (Donut Hole) gap where out-of-pocket expenses can be significant. Please see the 2023 Medicare Part D Prescription Drug Coverage Phase Tip Sheet for more information.
All senior patients should sign up for Prescription Advantage (PA), a Massachusetts state-sponsored secondary coverage prescription drug assistance program, for seniors and people with disabilities, regardless of prescription coverage or income. Call 1-800-243-4696 or www.prescriptionadvantagema.org
Some key points about Prescription Advantage:
- No enrollment fee for most seniors ($200 fee for higher income individuals/couples)
- PA supplements prescription drug benefits for medications covered by Medicare Part D or credible coverage plans based on income and out-of-pocket threshold met
- > 65 y.o., eligible for Medicare, and meets income guidelines
- < 65 y.o., works no more than 40 hrs./month and meets Mass Health’s Common Health disability/income guidelines
BILHPN Pharmacy Newsletters:
Please see BILHPN Pharmacy newsletters with current pharmacy related issues. Click here to access past issues*.
POPULATION HEALTH UPDATE
Cervical Cancer Screening and HPV Vaccination
HPV Vaccination: On Time Vaccination Rates (Claims through 3/31/23)
- HPV vaccination rates have increased 14% since 2022!
- Continue to provide confident recommendations for the 2 doses of Gardisil prior to the patient’s 13th birthday.
BCBS PPO – Immunizations for Adolescents : HPV 21.67 %
BCBS HMO – Immunizations for Adolescents : HPV 25.00 %
Tu Salud: Latino Health and Wellness Fair
Fenway Park- DELL/EMC Club
Sunday, June 11th, 2023
12:00pm – 5:00pm
- BILH sponsored event
- Family friendly, Latino health and wellness fair
- Games, activities, music, entertainment
- Ali Wiklund, FNP-BC and Dr. Reyes will be hosting a table
- Providing information on the importance of routine cervical cancer screening
- Providing information on the importance of on time HPV vaccination
For more information, please click here.
DIABETIC EYE EXAM CLINIC
NEPHO and Cape Ann Eye Specialists collaborated to hold a Saturday morning clinic in Gloucester for patients needing diabetic eye exams. Patients were also able to get free blood pressure checks and reminded of upcoming appointments. Pictured is the team who staffed the clinic: Liz Isaac, NEPHO; Jane Sheridan, eye technician; Mercy Njuguna, Office Manager; Dr. Weinstein-Zanger and Ali Wiklund, NEPHO.
Many thanks to Cape Ann Eye Specialists for a successful clinic!
Please click here to take a moment to read the Provider Spotlights!
Virtual Networking videos from NEPHO providers can be found here.
Please reach out to Alycia Messelaar at Alycia.Messlaar@Lahey.org if you are interested in being featured in a Virtual Networking video.
Please share this directory with your office by printing or showing them how to visit us online for an easy to use directory search tool.
Note: Primary care providers (PCPs) in the BILH Performance Network no longer need to submit an administrative referral to refer Blue Cross Blue Shield of MA, Harvard Pilgrim Health Care, or Tufts Health Plan members to a specialist in the BILH Performance Network. Please reach out to Alycia Messelaar at Alycia.Messelaar@Lahey.org regarding questions pertaining to providers within the BILHPN Network.
As a reminder, it is important to use the NEPHO Physician Directory when referring to a specialty physician.
Here are the key memos that have been sent out over the last month – JUST in case you missed it!
- 2023 Annual Meeting: Vote & Proxy Response Requested by June 14th
- Monthly BILH Pharmacy Newsletters
- Monthly BILHPN BMC WellSense MassHealth ACO Newsletter
- Monthly Beth Israel Lahey Health Performance Network CDI Newsletter
- HPHC Cybersecurity Updates
- Boston Children’s Hospital
- May 2023 Continuing Education Opportunities
- Updated Urgent & Emergent Access Guide
Please reach out to Alycia.Messelaar@Lahey.org for a specific communication that you are unable to find.
DEA Fraudulent Calls
BILHPN would like your staff and providers to be aware of recent reports of fraudulent calls made to BILH primary care practices by individuals misrepresenting themselves as agents with the Federal Drug Enforcement Administration. A recent warning to the public from the DEA has confirmed these bad actors are targeting physicians, providers, and the public, attempting to extort money and Personal Identifiable Information (PII). The caller may reference a provider’s NPI or state license number, in order to appear more credible and influence the provider or staff to disclose the requested information. DEA personnel will never initially contact providers by phone, nor request PII over the phone. Legitimate investigations by the DEA are initiated via an official letter or in person, not phone calls. Please share this information with your staff and providers, and ask them to report any such calls to your Integrity and Compliance department contact or the Northeast PHO.
See link to the DEA press release for additional information: DEA Press Release
As a best practice, when receiving calls requesting data such as this, it is important for staff to ask for a name, company, call back number and direct email and outline the call will be returned. This gives your practice the ability to confirm the call is not fraudulent, as well as track specific calls coming in.
As the Public Health Emergency (PHE) ended on May 11, 2023, the Northeast PHO wanted to share resources pertaining to TeleHealth.
- Massachusetts Medical Society – What you Need to Know about Telemedicine and Informed Consent https://www.massmed.org/telemedicine-informed-consent/
- HRSA Health Resources & Services – Telehealth policy changes after the COVID-19 public health emergency https://telehealth.hhs.gov/providers/policy-changes-during-the-covid-19-public-health-emergency/policy-changes-after-the-covid-19-public-health-emergency
- Center for Connected Health Policy – Massachusetts https://www.cchpca.org/massachusetts/
- Commonwealth of Massachusetts Board of Registration in Medicine – Telemedicine policy update https://www.mass.gov/doc/policy-20-01-policy-on-telemedicine-amended-october-6-2022/download
- Massachusetts Medical Society – TeleHealth and Virtual Care https://www.massmed.org/Practice-Support/Telehealth-and-Virtual-Care/Telehealth-and-Virtual-Care/
- Drug Enforcement Administration (DEA) https://www.nepho.org/drug-enforcement-administration-dea/
Please click here to request access to the May 24th Medical Service Conference, presented by Dr. Louis Tramontozzi, Dr. Joseph Peppe and Chad Brouillard, Esq.
REFERRAL MANAGEMENT UPDATE
As a reminder, providers with Ophthalmic Consultants of Boston (i.e., Drs. Tina Cleary, Mina Farahani, Ambika Hoguet, James Hung and Laura Voicu) are no longer participating in the Northeast PHO network. New patient appointments requiring referrals will not be approved.
Please refer to one of the following NEPHO eye care providers for your patients:
IOANNIS P. GLAVAS, MD
100 Cummings Ctr. Suite 106D, Beverly, MA
- Ioannis Glavas, MD – Oculoplastic Surgery*
GURLEY EYE CARE ASSOCIATES
195 School Street, Suite B, Manchester, MA
- Gregory Blaha, MD – Retinal*
- John Gurley, MD
- Emma Massicotte, MD
- Michael Piacentini, MD
LAHEY HOSPITAL AND MEDICAL CENTER DEPARTMENT OF OPHTHALMOLOGY
41 Mall Road, Burlington, MA
- Jeffrey Chang, MD – Retinal*
MICROSURGICAL EYE CONSULTANTS
31 Centennial Drive, Peabody, MA
- Yonwook “Justin” Kim, MD
- Daniel Luther, MD
- William Orenberg, MD
- Richard Rodman, MD
- Jeffrey Sorkin, MD – Pediatric*
- Andre Witkin, MD – Retinal*
- Yu “Peter” Zhao, MD – Retinal*
NORTH SUBURBAN EYE ASSOCIATES, P.C.
669 Main Street, Wakefield, MA
955 Main Street, Suite 108, Winchester, MA
- Kimberly Mooney-McNulty, MD
RETINA CARE INSTITUTE
900 Cummings Ctr., Suite 308V, Beverly, MA
- Shahrokh Khani, MD – Retinal*
SPECIALIZED PEDIATRIC EYE CARE
77 Herrick Street, Suite 102, Beverly, MA
- Danielle Ledoux, MD – Pediatric*
- O’ine McCabe, MD – Pediatric*
MATTHEW WEINSTEIN-ZANGER, MD
35 Middle Street, Gloucester, MA
- Matthew Weinstein-Zanger, MD
QUALITY DEPARTMENT UPDATES
Wednesday, May 17 was World Hypertension Day.
To help support our goals and initiatives regarding blood pressure, consider implementing some or all the following best practices:
- Take BP a 2nd time if greater than 139/89.
- Re-schedule anyone with a high BP for a BP check or follow up appointment before they leave the office.
- Try to take the blood pressure at the end of the rooming process.
- Before taking the BP, ask the patient to close their eyes, imagine a beautiful place, and take 3 deep breaths. Take their blood pressure when they open their eyes.
Many practices across NEPHO already incorporate some or all these best practices. If you have a best practice you would like to share, let us know!
BILHPN ACUITY TRAINING FOR EPIC PROVIDERS
Below is a list of dates for BILHPN Acuity Training for Epic users and a link to the recording of the September 12, 2022 Session. Click on each date to register.
Provider Acuity Training Series with CME Credit
Click here to request access to view the Recording for the September 12th Provider Acuity Training Series Session.
Arcadia Acuity Trainings
CLINICAL DOCUMENTATION IMPROVEMENT
OPTUM NEWSLETTER – May – Focus on: Arthritis (rheumatoid, osteo and psoriatic)
Please click here to view the 2023 Optum webinar schedule.
Facts About Coverage Post PHE
Here are some highlights of what is changing on May 11, 2023, (or later) for telehealth services billed under Medicare Part B:
- Virtual check-in codes (G2012, G2010, G2252) and remote patient monitoring codes will only be allowed for established patients after the PHE ends.
- Medicare will continue to pay for audio-only telephone services billed with CPT® codes 99441-99443 through Dec. 31, 2024, when appropriate and all required elements in the code descriptions are met. The payment parity to CPT® codes 99212-99214 is also extended through Dec. 31, 2024.
- Behavioral and mental health services (CPT® 90785-90840) are now permanently added to the Medicare Telehealth Services List and may be provided using audio-only equipment through Dec. 31, 2024.
- All other services on the Medicare Telehealth Services list, unless otherwise indicated, require audio-video equipment permitting two-way, real-time interactive communication. CMS will update the list for 2024 using standard protocols.
- Incident-to services via virtual supervision will no longer be allowed after Dec. 31, 2023.
- When the PHE ends, CMS will continue to allow for a total deferral to state law regarding licensure requirements for billing Medicare for services provided outside of their state of enrollment. State laws may override this freedom, however.
- Practitioners must resume reporting their home address on the Medicare enrollment beginning Jan. 1, 2024.
- All telehealth platforms must be HIPAA compliant starting the day after the end of the PHE (May 12). Smart phone video options such as FaceTime and Skype will no longer be an option for telehealth after the PHE ends, per the Office of Civil Rights.
- Place of service (POS) codes will continue to be used based on where the patient would have been seen had they been seen in person. However, POS 02 Patient not in their home when telehealth services are rendered or POS 10 Patient in their home when telehealth services are rendered may be reported, as appropriate. Reporting these specific POS codes will result in facility reimbursement.
- Modifier 95 Synchronous telemedicine service rendered via real-time interactive audio and video telecommunications system will continue to be used for audio and video services for Medicare telehealth through 2024.
- Modifier 93 Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system must be used, as of Jan. 1, 2023, for all audio-only services. Many commercial payers have instructed providers to append this modifier to services listed in Appendix T of CPT® 2023.
Remember that this guidance applies to Medicare Part B only. Make sure to check other payers’ policies to ensure compliance.
Please reach out to Jessica Bryan at Jessica.M.Bryan@Lahey.org with questions or concerns regarding this clinical documentation tip or any other coding guidance.
PATIENT EXPERIENCE COMMENTS
Beth Israel Lahey Health Primary and Specialty Care, Beverly – 30 Tozer Road Suite 203
- I recently changed my PCP to Dr. David Driscoll & am very grateful I did. He was so patient & thorough during the visit. He took the time to review tests I had previously done & answered all questions I had.
- The staff were knowledgeable & helpful. Dr. Deborah Shih is always a pleasure to visit with.
Beth Israel Lahey Health Primary Care, Beverly – 100 Cummings Center
- Dr. Pierre Ezzi – Everything was very good. I have been a patient in this office for years & have been very happy all of them!
Beth Israel Lahey Health Primary Care, Beverly – 900 Cummings Center
- Dr. Daniel McCullough – the BEST! Anything wrong, he’s the fixer.
Beth Israel Lahey Health Primary Care, Danvers – 5 Federal Street
- Dr. Brent Fryling is a very good doctor! He takes time to talk & explain what is going on.
Beth Israel Lahey Health Primary Care, Gloucester – 298 Washington Street 4th Floor
- I couldn’t ask for a more professional, caring, knowledgeable physicians! Dr. Victor Carabba is truly a superior human!
- I consider myself very lucky to have had Dr. Karen Damico recommended to me by 2 nurses who worked at Addison Gilbert Hospital. She is an excellent, caring and thorough physician.
Blackburn Primary Care, Gloucester – 1 Blackburn Drive
- Dr. Jay Isaac is very ‘present’ and interactive. He listens to my concerns and provides relevant medical suggestions and advice. I feel confident in his assessment of my medical journey.
- Dr. Jay Isaac is the best doctor I’ve had the pleasure of being with as well as my family. He is caring, kind knowledgeable and goes above and beyond for his patients.
Brian Orr Pediatrics, Gloucester – 1 Blackburn Drive
- Dr. Brian Orr and his team are so helpful and understanding. He gave a great recommendation/referral and that doctor reached out to us the next day with very wise advice.
Cape Ann Medical Center, Gloucester – 1 Blackburn Drive
- Always professional and respectful. Dr. Janet Doran’s experience is highly respected by me as she utilizes her knowledge in a positive way.
- Dr. Shawn Pawson is a tremendous asset to the CAMC. He is professional as well as very caring. I am very fortunate to have him as my primary caregiver!
Danvers Family Doctors, Danvers – 140 Commonwealth Avenue
- The staff is always helpful and friendly. They accommodate your needs in a timely manner. Dr. Subroto Bhattacharya is so knowledgeable and patient, never making you feel rushed.
EMTAR Healthcare, Inc., South Hamilton – 205 Willow Street
- Dr. Michael Edwards – Always treated with respect. They all make you feel very comfortable and at ease. Love this place
Essex County Primary Care, South Hamilton – 42 Asbury Street
- Dr. Nicholas Avgerinos – Very good visit – Spent time – No rushed – Answered all questions.
Garden City Pediatrics, Beverly – 83 Herrick Street
- We have always & will always recommend Dr. John Dean & Garden City to our friends & family.
- Dr. Suzanne Graves has ALWAYS been there, available and supportive
- We continue to be happy with Dr. Eric Sleeper and the entire Garden City Ped. Staff – thank you all!
North Shore Pediatrics, Danvers – 480 Maple Street
- North Shore Pediatrics and Dr. David Danis are an absolute FAVORITE. We cannot speak highly enough of Dr. Danis!!
- We absolutely love Dr. Lance Goodman. We have had nothing but positive experiences with this office.
Thomas Pearce, MD, Gloucester – 279 East Main Street
- Dr. Thomas Pearce is an exceptional doctor and care giver who always takes the time to really understand his patients! I appreciate his expertise and care!
Thompson Medical Associates, Gloucester – 9 F Dr. Osman Babson Road
- I have always been satisfied every time I have spoken to staff and Dr. Candace Thompson and Amy. They make you feel so comfortable. They take great interest in helping you in any way they can.
The Northeast PHO recognizes colleagues who provide a positive experience for our patients, help us keep care local, meet our quality targets and support their colleagues.
This month’s winners are:
Susan Jeannotte, Essex County OB/GYN, was recognized for outstanding year-long support and collaboration with the NEPHO Population Health Team and proactively outreaching to patients to meet quality measures. She was nominated for the Teamwork Award by Lisa Cartledge. Susan is shown above (right) with Robin Stewart (left).
Annie Sartorius (left) and Paula Lutz (right), BILH Primary and Specialty Care, Beverly, shown above with Dr. Deborah Shih (middle), were recognized for the patient experience comment which read “Paula the MA and Annie the RN were fantastic as always!! Kind, caring, and personable!!”
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!