April 2014

Updates

**PHC has Moved** The Pueblo Health Care office has moved. We are now located at 425 W. 15

Beaumont/Yaklich House. The phone and fax numbers remain the same.

ParkCare Plus/RCI Effective 3/1/2014, Emdeon will no longer be

serviced by Smart Data Solutions instead of Emdeon.

Smart Data’s EDI support phone number at

MultiPlan MultiPlan currently has some physicians aligned with both the PHC Group contract, as well as individual contracts

physician’s intent is to only be aligned with PHC and not an individual contrac

Unfortunately, since these are direct agreements, PHC is unable to terminate on the physician’s behalf

additional information.

PHC 2014 Notebooks The updated PHC Contracting Notebook inserts have been delivered.

comments please let us know. There is a correction for

apologize for the confusion.

ICD-9 to ICD-10 crosswalksPHC has access to .pdf documents that crosswalk from ICD

are interested in a copy, please contact PHC. The following specialties are available:

Cardiothoracic, Dermatology, Emergency, Family Practice

lower and upper, Otolaryngology, Pediatrics

Office Manager Roundtables/ICDIn preparation for the transition to ICD-10, PHC will be hosting

presented by the ICD-10 Coalition. The webinars are from 12

invites which will indicate the location of the meeting. We will schedule the meeting until 1:30 pm to allow time for

discussion.

***PHC has created an Office Manager group email list. It is a great way

beneficial to your office. If you currently do not receive emails from us and

let us know.***

Your Pueblo Health Care Staff:Ann Bellah, Executive Director (

Sandra Proud, Provider Relations/Member Services (

400 W. 16

Editors: Sandra Proud and Ann Bellah

The Pueblo Health Care office has moved. We are now located at 425 W. 15th

St. (corner of 15

phone and fax numbers remain the same.

Effective 3/1/2014, Emdeon will no longer be RCI’s vendor for EDI claims. RCI will keep the same payer ID, but it will be

serviced by Smart Data Solutions instead of Emdeon. If you have questions or are having issues with EDI claims

at 855-297-4436.

physicians aligned with both the PHC Group contract, as well as individual contracts

intent is to only be aligned with PHC and not an individual contract, the individual contract

Unfortunately, since these are direct agreements, PHC is unable to terminate on the physician’s behalf

The updated PHC Contracting Notebook inserts have been delivered. If you did not receive one or have questions or

There is a correction for RMHP. Timely filing should reflect 120

10 crosswalks PHC has access to .pdf documents that crosswalk from ICD-9 to ICD-10 of top 50 codes for 15 different specialties. If you

contact PHC. The following specialties are available: Anesthesia,

Family Practice, Gastro, General Surgery, Internal Medicine

Pediatrics, Urology.

Office Manager Roundtables/ICD-10 Webinars and Email list PHC will be hosting group meetings for most of the ICD

10 Coalition. The webinars are from 12-1pm every third Tuesday of the month. Watch for your

location of the meeting. We will schedule the meeting until 1:30 pm to allow time for

group email list. It is a great way for us to send information

currently do not receive emails from us and would like to be included on the list, please

Your Pueblo Health Care Staff: Ann Bellah, Executive Director (ann_bellah@parkviewmc.com)

Phone: 584-4371

Sandra Proud, Provider Relations/Member Services (sandra_proud@parkviewmc.com

Phone: 584-4642

400 W. 16th St. Pueblo, CO 81003

Main Phone: 584-4806

Fax: 584-4038

Editors: Sandra Proud and Ann Bellah

St. (corner of 15th

and Greenwood) in the

will keep the same payer ID, but it will be

If you have questions or are having issues with EDI claims, call

physicians aligned with both the PHC Group contract, as well as individual contracts. If the

, the individual contract should be termed.

Unfortunately, since these are direct agreements, PHC is unable to terminate on the physician’s behalf. Contact Ann for

If you did not receive one or have questions or

imely filing should reflect 120 days, not 180 days. We

10 of top 50 codes for 15 different specialties. If you

Anesthesia, Behavioral, Cardiology,

Internal Medicine, OBGYN, Ortho-

Email list most of the ICD-10 webinars

day of the month. Watch for your

location of the meeting. We will schedule the meeting until 1:30 pm to allow time for

to send information that we feel may be

be included on the list, please

sandra_proud@parkviewmc.com)

Educational In-ServicesPueblo Health Care recently offered the following in

PHC Annual Report/ICD Complete Practice Resources, presented two different sessions on

ICD

focused on

transition

negative) and the importance of proper documentat

session “Achieving

administrators, physicians and staff

free, successful ICD

available for both

20 Certified

sessions.

Colorado HealthOp/ParkCare Plus/PMC Wellness WorksHealthOp representatives, Freda Montoya and

HealthOp Plans, Providers, ID Cards, Claims addresses, Payor ID numbers and

resources. Jeanne Garman, PMC Benefits Administrator

Stephanie Arellano, PMC Employee Wellness Co

to easily assess ergonomics and prevention st

ICD-10 Implementation (February 27National ICD-10 Program Director, presented From “ICD

Do-10”. He gave an ICD-10 Overview including Myth Busters,

Implementation and UHC’s partnership commitment through the

transition. Six Certified Coders received CEU credits for atte

this presentation.

Work Flow Improvements of Performance Improvement, introduced process improvement principles,

identified eight different kinds of waste and explained

reduce waste in the office. He gave the attendees a new prospective on

daily tasks,

at work and at home.

Upcoming In-services: April 10 – ICD-10-CM Coding Extravaganza

June 24 – Liability Issues w/EMR’s (COPIC/CME)

July 10 – HIPAA Update (Doctor’s CO/CME)

August 5 – CMS Update

Services Pueblo Health Care recently offered the following in-services:

PHC Annual Report/ICD-10 (January 9Complete Practice Resources, presented two different sessions on

ICD-10. The morning session “ICD-10 Starts with Physicians”

focused on engaging physicians and staff in tackling the ICD

transition by educating on the realities of ICD-

negative) and the importance of proper documentat

session “Achieving ICD-10 Success” was designed for practice

administrators, physicians and staff and focused on having a

free, successful ICD-10 implementation . CME and CEU

available for both sessions. 22 Physicians received

20 Certified Coders received CEU credits for attending one or both

sessions.

/ParkCare Plus/PMC Wellness Works (February Freda Montoya and Judy VanCleave, presented an overview of the Colorado

Op Plans, Providers, ID Cards, Claims addresses, Payor ID numbers and additional

resources. Jeanne Garman, PMC Benefits Administrator, provided a ParkCare Plus plan update.

llano, PMC Employee Wellness Coordinator, presented the importance of ergonomics, how

to easily assess ergonomics and prevention strategies for ergonomic injuries in the office.

February 27) Aaron Saap, MPS, UHC

10 Program Director, presented From “ICD-10?” To “I Can

10 Overview including Myth Busters,

partnership commitment through the

Certified Coders received CEU credits for attending

Work Flow Improvements (March 20) Bryan Eckhart, PMC of Performance Improvement, introduced process improvement principles,

identified eight different kinds of waste and explained

reduce waste in the office. He gave the attendees a new prospective on

daily tasks, ways to identify waste in all forms and how to reduce waste

at work and at home.

CM Coding Extravaganza

Liability Issues w/EMR’s (COPIC/CME)

HIPAA Update (Doctor’s CO/CME)

**** REMINDER ****

It is important if you sign up to attend a PHC

sponsored in-service that you show up. If you have

responded but cannot attend or if you would like

information from an in-service that you did not

attend please let us know.

January 9) Denny Flint, CEO,

Complete Practice Resources, presented two different sessions on

10 Starts with Physicians”

staff in tackling the ICD-10

-10 (positive and

negative) and the importance of proper documentation. The noon

designed for practice

and focused on having a stress-

CME and CEU credits were

ons. 22 Physicians received CME’s credits and

edits for attending one or both

February 20) Colorado

overview of the Colorado

additional helpful

provided a ParkCare Plus plan update.

rdinator, presented the importance of ergonomics, how

rategies for ergonomic injuries in the office.

Bryan Eckhart, PMC Director

of Performance Improvement, introduced process improvement principles,

identified eight different kinds of waste and explained simple ways to

reduce waste in the office. He gave the attendees a new prospective on

ways to identify waste in all forms and how to reduce waste

**** REMINDER ****

It is important if you sign up to attend a PHC

service that you show up. If you have

responded but cannot attend or if you would like

service that you did not

Membership Additions Pueblo Health Care’s membership total is currently at 2

our network:

Dr. William Jennings (Pueblo Women’s Center, LLC)

Please welcome this physician to the community and to the Pueblo Health Care Network.

Membership Changes

Dr. Puls and Dr. Mann moved from Jerry Murphy offic

Dr. Wilson has moved from SCC Urgent Care

If your office is planning on having any demographic changes, please provide PHC with this new

information. For your convenience, we have placed a demographic change form on our website. We

will notify all PHC Health Plan P

remittances and correspondence are delivered to the proper address. We will request an updated W9 and CMS 1500

(HCFA) reflecting these changes, as some plans require us to submit these forms with the change req

are planning on having a physician join your practice, please notify us as soon as possible so we can send out new PHC

member information, along with a Pueblo Health Care

www.pueblohealthcare.com Don’t forget our website. The calendar displays all scheduled in

updated to include many helpful links such as

more.

Messenger Model PHC is an Independent Practice Association that operates

Messenger model. PHC does not negotiate rates but does provide contract

language support. PHC’s role is to act as a messenger between

and physician practices.

“Working with Physicians,

Mission: The mission of Pueblo Health Care, Inc. is to

provide our physician partners the highest level of service

and support in terms of physician contracting, appropriate

educational in-services and administrative support for the

Pueblo Market Area. Understanding that maintaining

physician contracts is an on-going process, all efforts under

the model in which we conduct operations will be focused on

communication with our physician partners.

ership total is currently at 270. We are excited to announce the following

William Jennings (Pueblo Women’s Center, LLC)

to the community and to the Pueblo Health Care Network.

Dr. Puls and Dr. Mann moved from Jerry Murphy office to 1316 N. Grand.

Dr. Wilson has moved from SCC Urgent Care on Ivywood Lane to SCC Family Practice at 3676 Parker Blvd.

REMINDER!! If your office is planning on having any demographic changes, please provide PHC with this new

information. For your convenience, we have placed a demographic change form on our website. We

all PHC Health Plan Partners of these changes on your behalf. This will help ensure that

remittances and correspondence are delivered to the proper address. We will request an updated W9 and CMS 1500

(HCFA) reflecting these changes, as some plans require us to submit these forms with the change req

are planning on having a physician join your practice, please notify us as soon as possible so we can send out new PHC

Pueblo Health Care application.

Don’t forget our website. The calendar displays all scheduled in-services and meetings. The resources tab has been

updated to include many helpful links such as ICD-10 Coalition, Health Plans, AAPC, Colorado Medical Society and many

PHC is an Independent Practice Association that operates according to the

model. PHC does not negotiate rates but does provide contract

ct as a messenger between health plans

“Working with Physicians,

for Physicians!”

The mission of Pueblo Health Care, Inc. is to

provide our physician partners the highest level of service

and support in terms of physician contracting, appropriate

services and administrative support for the

Pueblo Market Area. Understanding that maintaining

going process, all efforts under

the model in which we conduct operations will be focused on

physician partners.

Vision: Our vision is to exceed the

expectations of our physician partners in

the areas of communication and education,

as it relates to Physician Relations, Employer

Relations and Payor Relations.

. We are excited to announce the following recent addition to

to SCC Family Practice at 3676 Parker Blvd.

If your office is planning on having any demographic changes, please provide PHC with this new

information. For your convenience, we have placed a demographic change form on our website. We

on your behalf. This will help ensure that

remittances and correspondence are delivered to the proper address. We will request an updated W9 and CMS 1500

(HCFA) reflecting these changes, as some plans require us to submit these forms with the change request. Also, if you

are planning on having a physician join your practice, please notify us as soon as possible so we can send out new PHC

services and meetings. The resources tab has been

lans, AAPC, Colorado Medical Society and many

Our vision is to exceed the

expectations of our physician partners in

the areas of communication and education,

as it relates to Physician Relations, Employer

Relations and Payor Relations.