Many of us have just returned from the MGMA National Conference in San Francisco. The conference is a l w a y s refreshing, engaging, and educational, and it is valuable to see what is most pressing on the national scene that we in Indiana can take away. The discussions primarily revolved around MACRA...how to best deal with the intricacies of the final rule and which pieces pertain to our own individual practices. ACI, MIPS, APM, QPP, ACO’s… Please understand that if your practice services Medicare patients, you HAVE to help your staff and practitioners maneuver through this maze! These changes will cost/ make your practice money over the next several years, starting at 4% (+-) in 2019 and increasing to 9% (+-) by 2022. This will be gauged off what your practice does starting in 2017! So it is real, it is here, and it must be dealt with! To learn more, IMGMA is holding a webinar on the impact of MACRA on December 6. There are always resources through our website, www.IMGMA.net, plus information through our national organization, www.MGMA.com. The MGMA “community” is an excellent way to post questions and stay in touch with practice managers that are walking in our same shoes. You'll find questions/answers and dialog around very pertinent and timely issues. Now on to the elections. WOW…very interesting results and one that will make an impact more than likely on the Affordable Care Act. President-elect Trump campaigned on its demise if he were elected. Congress has tried on many occasions to repeal it themselves. So it will be interesting to see how quickly they will approach this, but don’t confuse the ACA with MACRA…no connection. Ninety-one percent of Congress (484 members) voted for the approval of MACRA. MACRA is here to stay for the foreseeable future. So let me say again, it is real, it is here, and it must be dealt with! As IMGMA looks forward to helping the practices in the state navigate through MACRA and many other issues, we continue to look for improvements in the ways we can be of assistance. In that vein, your Board of Directors and its committee chairs met in Indianapolis last month to meet and discuss our overall impact and how to improve it. Our committees consist of Legislative (Chair-Steve Freeland), Membership continued on page 2 10014 Deering Street Fishers IN 46037 Phone: 317.371.4354 Fax: 317.872.1432 www.imgma.net [email protected] In This Issue: ACMPE Corner 2 .............................. New IMGMA Member 2 ................... Overview of MACRA QPP 4 .............. SecAon 1557 7 ................................. Spotlight Member 8 ......................... MACRA EducaAon 9 ......................... Ransomware ProtecAon 10 .............. Indiana CoreMMIS 11 ...................... Third Party Payer Days 11 ................ Open LeQer from Medicaid 12 ......... Business Partner Links 12 ................. IMGMA Officers, Board of Directors, and CommiQee Chairs 13 ................. Message from the President December 2016 Jim BuQerfield On the Calendar: • Dec. 6, 2016: WEBINAR: MACRA - How Your Practice Can be Successful in 2017 & Beyond (see page 9) • Feb. 16, 2017: CONFERENCE: Conquering MACRA: What You Need to Know to be Successful, Marriott, Indianapolis North (see page 9) • Feb. 22, 2017: Third Party Payer Day, Ritz Charles, Carmel (see page 11) • March 7, 2017: Third Party Payer Day, St. Mary’s Medical Center, 3700 Washington Ave., Evansville (see page 11) • April 13, 2017: Third Party Payer Day, Grand Wayne Convention Center, Ft. Wayne (see page 11) • April 27-28, 2017: Indiana/Illinois MGMA Annual Conference At the DoubleTree by Hilton Chicago – Oak Brook Save the Date: April 27-28, 2017 2017 Annual Conference Year 2 of our Home and Away arrangement with the Illinois MGMA Chapter
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Manyof ushavejust re turnedfrom the MGMAN a t i o n a lConference inSanFrancisco.Theconference i sa l w a y sr e f r e s h i n g ,engaging, andeducational, andit is valuable tos e e w h a t i smost pressingon the nationalscene that we in Indiana can takeaway. The discussions primarilyrevolved around MACRA...how to bestdealwiththeintricaciesofthefinalruleand which pieces pertain to our ownindividual practices. ACI, MIPS, APM,QPP, ACO’s… Please understand that ifyour practice services Medicarepatients, you HAVE to help your staffand practitioners maneuver throughthis maze! These changes will cost/make your practice money over thenext several years, starting at 4% (+-)in 2019 and increasing to 9% (+-) by2022.Thiswillbegaugedoffwhatyourpractice does starting in 2017! So it isreal, it is here, and it must be dealtwith!To learnmore, IMGMA isholdingawebinar on the impact ofMACRAonDecember 6 . There are a lwaysresources through our website ,www.IMGMA.net, plus informationthrough our national organization,
w w w . M G M A . c o m . T h e M G M A“community” isanexcellentway topostquestionsandstayintouchwithpracticemanagers that are walking in our sameshoes. You'll find questions/answersand dialog around very pertinent andtimelyissues.Now on to the elections. WOW…veryinteresting results and one that willmakean impactmore than likelyon theAffordable Care Act. President-electTrump campaigned on its demise if hewere elected. Congress has tried onmany occasions to repeal it themselves.So it will be interesting to see howquicklytheywillapproachthis,butdon’tconfuse the ACA with MACRA…noconnection. Ninety-one percent ofCongress (484 members) voted for theapproval of MACRA. MACRA is here tostayfortheforeseeablefuture.Soletmesayagain,itisreal,itishere,anditmustbedealtwith!As IMGMA looks forward to helping thepractices in the state navigate throughMACRA and many other issues, wecontinuetolookforimprovementsintheways we can be of assistance. In thatvein, your Board of Directors and itscommittee chairs met in Indianapolislast month to meet and discuss ouroverall impact and how to improve it.Our committees consist of Legislative(Chair-SteveFreeland),Membership
continuedonpage2
10014DeeringStreetFishersIN46037Phone:317.371.4354Fax:[email protected]
InThisIssue:ACMPECorner 2..............................
NewIMGMAMember 2...................
OverviewofMACRAQPP 4..............
SecAon1557 7.................................
SpotlightMember 8.........................
MACRAEducaAon 9.........................
RansomwareProtecAon 10..............
IndianaCoreMMIS 11......................
ThirdPartyPayerDays 11................
OpenLeQerfromMedicaid 12.........
BusinessPartnerLinks 12.................
IMGMAOfficers,BoardofDirectors,andCommiQeeChairs 13.................
MessagefromthePresidentDecember2016
JimBuQerfield
OntheCalendar:• Dec.6,2016:WEBINAR:
MACRA-HowYourPracticeCanbeSuccessfulin2017&Beyond(seepage9)
• Feb.16,2017:CONFERENCE:ConqueringMACRA:WhatYouNeedtoKnowtobeSuccessful,Marriott,IndianapolisNorth(seepage9)
• Feb.22,2017:ThirdPartyPayerDay,RitzCharles,Carmel(seepage11)
• March7,2017:ThirdPartyPayerDay,St.Mary’sMedicalCenter,3700WashingtonAve.,Evansville(seepage11)
• April13,2017:ThirdPartyPayerDay,GrandWayneConventionCenter,Ft.Wayne(seepage11)
• April27-28,2017:Indiana/IllinoisMGMAAnnualConference
AttheDoubleTreebyHiltonChicago–OakBrook
SavetheDate:April27-28,2017
2017AnnualConference
Year2ofourHomeandAwayarrangementwiththeIllinoisMGMAChapter
(Chair-Herschal Jacquay), Education (Chair-SarahBrain), Communication (Chair-Todd Stallings), andBusiness Partners (Chair-Richard Altman). I want tothank each of these Chairs and their committees fortheir time and their commitment to engaging themembershipinrelevantways.Theyarealsolookingforactiveparticipationfromourmembership,so ifyouareinterested in any of these areas, please contact usthroughourwebsiteformoreinformation.EachofthesecommitteeshelpstheBoardreachyou,ourmembers,sothatyoufeelapartofthisgreatassociation.Wewanttobeengagedandengaging.Letusbearesource.Pleaseplanonattendingouroutreachevents,webinars,andourSpring2017Conference.Let’sWINthistogether!!
byJimBuQerfieldCEO,
EvansvilleSurgicalAssociates
December2016Page2
ACMPECornerMGMAwillofferthefollowingexamdatesfor2016and2017.
2017EXAMDATESExamWindow RegistrationMarch11–25 Jan.30–Feb.10,2017June10–24 April24–May5,2017September9–23 July24–August4,2017December2–16 October23–November3,2017Examsitescanbefoundonline.Registrationinformationislocatedonlineathttp://www.mgma.com/education-certification/education-resources/register-for-the-acmpe-exams.
President’sMessage…con8nuedfrompage1
MarySAnesCroweHorwathAccountant,TaxSeniorManagerSouthBendMelodyWarfelWindroseHealthNetworkPracQceAdministratorIndianapolis
EmilyFisherFairhavenObstetrics&GynecologyPracQceAdministratorGoshen
Students:OmarAhmedMaQRelano
NewMembertoIMGMA-Welcome!
December2016Page3
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FinaldetailsoftheMACRAQualityPaymentProgram(QPP)for the 2017 reporting year were released in October bythe Centers for Medicare and Medicaid Services (CMS).Whilemuchoftheproposedrulewasincludedintheminaldraft, CMS made a few provisions especially for smallpracticesandforeligibleproviderswhoaren’tquitereadytodiveinfor2017.TheMedicareAccessandCHIPReauthorizationActof2015was passed by Congress last year to abandon the mlawedSustainable Growth Rate formula and create a newpayment growth structure for the Medicare program.MACRAimplementeda .5percentannualrateincreaseforMedicare Payments through 2019, after which paymentswouldbeadjustedeitherpositivelyornegativelybasedonproviders’performancesthroughthetwo-prongedQualityPayment Program, which includes the Merit-BasedIncentive Payment System (MIPS) and AdvancedAlternativePaymentModels(APM).MIPS replaces and combines several different qualityprograms established by CMS over the years, includingMeaningful Use, the Physician Quality Reporting System,andtheValue-BasedPaymentModimier to incentivizehighquality,lowcostservices,alongwithcertimiedEHRuse.Who’sInvolvedEligibleprovidersfortheQPPincludephysicians,physicianassistants, nurse practitioners, clinical nurse specialists,andcertimiedregisterednurseanesthetists.Undertheminalrule,anyproviderwhohas less than$30,000 inMedicarePart B charges or fewer than 100 Medicare patients peryearwouldbeexemptfromprogram.AccordingtoDr.PatrickConway,deputyadministrator forinnovationquality,CMSCMO,thislow-thresholdexemptioncould represent as many as 380,000, or 32.5 percent of,Medicare clinicians. Another 200,000 providers, orapproximately 14.4 percent, are not among the eligibletypes of clinicians and also will not be required toparticipate.That leaves about 600,000 clinicians who will have todecidehowtoparticipateintheQPPforthe2017reportingyear. CMS est imates up to 120,000 c l inic ians(approximately 5-8 percent of all clinicians billing underthe Medicare Part B) will participate in Advanced APMs,andanother480,000orsowillparticipateinMIPS.Althoughmany very small practices will be exempt fromthe QPP program, CMS has earmarked $20 million eachyearformiveyearstotrainandeducateMedicarecliniciansin small practices of 15 clinicians or less and providersworkinginunderservedareas.WhenDoWeStartThemirstQPPreportingperiodbeginsJanuary1,2017,andthe mirstpositiveornegativepaymentadjustmentswillbe
applied beginning January 1, 2019. Performance data forthe2017reportingyearisdueMarch31,2018.What’sAtStakeEligibleproviderswhochoosenottoparticipateinanywaywill receive an automatic 4 percent negative paymentadjustment in 2019. Payment adjustments graduallyincreaseover theyears to5percent in2020,7percent in2021,and9percentin2022.Providerswhodoparticipatealsoaresubjecttothesamenegativepaymentadjustmentsiftheyarefoundtoprovidepoorquality,highcostservicesthatdonotrelyoncertimiedEHRuse.Providerswhodotheopposite,whoprovidehighquality, lowcostserviceusingcertimied EHR technology, have the potential to earnpositivepayment adjustments of 4, 5, 7, and9percent inthesameyears.Like the Value-Based PaymentModimier program,MIPS isbudget neutral, which means any positive paymentadjustments are paid out of money CMS retains throughthenegativepaymentadjustments.Also,CMShassetasidean additional $500 million to reward exceptionalperformers in the MIPS program each year of the mirst 6yearsoftheprogram.For2017,exceptionalperformersarethosewhoearnaminalscoreof70orhigherona100-pointscale.HowtoParticipateThe mirst year of the QPP is a transitional year. Providerscan choose one of fourways to participate in 2017,whatCMSiscalling“PickYourPace”:
• “Test”theprogrambysubmittingaminimumamountofdata – one quality measure, for example – to ensurephysicians’ systems are working and prepared forbroaderparticipationinthenextyears.
• Submit 90 days of 2017 data, which would allowpractices to submit for their mirst performance periodanytimebetweenJanuary1andOctober2,2017,avoida negative payment adjustment, and still qualify for asmallpositivepaymentadjustment.
• Submita full yearof2017datawhichcould result inapositive payment adjustment and insulate against apaymentadjustment.
• Join an Advanced APM, which involves more risk, butoffers providers who receive 25 percent of Medicarepayments or see 20 percent of Medicare patientsthroughanAdvancedAPMtheability toearnup toa5percentincentivepaymentin2019.
In addition to the 2017 programmodimications, CMS alsohas indicated that additional transitional provisions mayextendintothe2018reportingperiodaswell.
con8nuedonpage5
December2016Page4
OverviewofMACRAQualityPaymentProgramFinalRule
December2016Page5
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CHOICE WING TO WING. COAST TO COAST.
INMGMA 2016.indd 1 5/17/16 11:28 AM
MIPSProviderswhochoose theMIPSoptionwillberequiredtosubmit data in only three of four eventual categories,includingthefollowing:
• Quality–60percentofminalscore:reportupto6qualitymeasures,includinganoutcomemeasure.
• Clinical Improvement Activities – 15 percent of minalscore: attest that you completed up to 4 improvementactivities.
• AdvancingCare Information–25percentof minal score:fulmillthemiverequiredmeasures,includingSecurityRiskAnalysis; e-Prescribing; Provide Patient Access; SendSummary of Care; Request/Accept Summary of Care.Choosetosubmitupto9measuresforadditionalcredit.
Beginning in 2018, CMS also will include a costperformancecategory in theMIPSprogram.By2022, costwill count for30percentof the minal score,pullingweightfromthequalitycategory.ProviderswhoshareacommonTaxIdentimicationNumbercanreportMIPSasagroupregardlessoftheirspecialtyorpracticesite.GroupsmustregisterbyJune30,2017,totakeadvantageofthisoption.MACRAwilleventuallyallowsoloand small practices of no more than 10 clinicians to join
“virtual groups” and combine their MIPS reporting,althoughthisoptionisnotavailablein2017.AdvancedAPMProviderswhoparticipateinanadvancedAPMcanearna5percentlumpsumincentivepaymenteachyearfrom2019through2024andavoidMIPSreportingrequirementsandpaymentadjustments.
• ComprehensiveESRDCare(CEC)–Two-SidedRisk• ComprehensivePrimaryCarePlus(CPC+)• NextGenerationACOModel• SharedSavingsProgram–Track2• SharedSavingsProgram–Track3• OncologyCareModel(OCM)–Two-SidedRiskFor more information about the MACRA QPP, review theExecutiveSummaryor theentireFinalRule.CMSalsohasdeveloped a Quality Payment Program website to helpproviders explore their options and plan theirparticipation.
byCIPROMS,Inc.Afull-servicemedicalbillingcompany
Reprintedfromthewww.ciproms.comblogUsedwithpermission.
MACRAQPPFinalRule…con8nuedfrompage4
December2016Page6
Page7 December2016
At Katz, Sapper & Miller, we help physician groups, hospitals and health systems thrive. From consulting to tax and accounting, fair market assessments to valuation services, our Healthcare Resources Group has become a trusted partner for an evolving industry. We focus on protecting your interests so you can focus on delivering the highest level of care.
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StartingOctober17,2016,coveredentitiesundertheAffordableCareAct(ACA)of 2010 will be requiredt o p o s t N o t i c e s o fNondiscrimination andTa g l i n e s t h a t a l e r tindividuals with limitedEnglish promiciency to the availability of languageassistance services. Those Taglines must be posted in atleast the top 15 languages spoken by individuals withlimitedEnglishpromiciencyinthestate.TheserequirementsweremandatedunderSection1557ofthe ACA, also known as the nondiscrimination provision,andwere included in a rule minalized earlier this year bythe Department of Health and Human Services’ Ofmice ofCivil Rights (HHS OCR). Broadly, Section 1557 prohibitsdiscrimination in healthcare of individuals based on therace,color,nationalorigin,age,disability,orsex,includingdiscrimination based on pregnancy, gender identity andsex stereotyping. Previously, civil rights laws enforced byHHS OCR broadly barred discrimination based only onrace,color,nationalorigin,disability,orage.
Covered entities include any health program or activitywhich received funding fromHHS, anyhealthprogramoractivity thatHHS itself administers, andHealth InsuranceMarketplaces and all plans offered by issuers thatparticipateinthoseMarketplaces.TheHHSOCRhascompiledalistofthetop15languagesineach state and made those available on their website.Additionally,HHSOCRhasprovidedsampledocumentsofaN o t i c e o f N ond i s c r im i n a t i o n , S t a t emen t o fNondiscrimination,andTaglinesavailablefordownloadin64differentlanguagesandintwomileformats.For more information, review the Section 1557 of thePatientProtectionandAffordableCareActwebpageattheHHSOCRsite.
byCIPROMS,Inc.Afull-servicemedicalbillingcompany
Reprintedfromthewww.ciproms.comblogUsedwithpermission.
SecAon1557:NewNondiscriminaAonandLanguageAccessNoAficaAonRequirements
Page8 December2016
IndianaMGMA:HowlonghaveyoubeenanIndianaMGMABusinessPartner?
Kraig:Justbecameone!
IndianaMGMA:Whatisyourbusinessandwhatdoyoudo?
Kraig:Weprovideproductsandservicestothemedicalindustrythatincludethefollowing:
• ChronicCareManagementservices• Tele-Medicinesolution• Award-winning“cloud-based”ElectronicHealthRecords
• PopulationHealthsolutions• RevenueCycleManagement• EducationalWebinars
IndianaMGMA:Whatarethe3topreasonscompaniesuseyourservice?
Kraig:Productqualityandeaseofuse;customerserviceandsupport;andaffordability
IndianaMGMA:Whatisarecentsuccessstoryyouhavefromworkingwithamedicalpracticeclient?
Kraig:AninternalmedicinepracticeinLasVegas,Nev.,implementedourfully-integratedsystem(Scheduling/Billing/EMR)andsawtheirrevenuesalmostdoublesincetheyhadallinformationinonelocation.Oursystemstartedonthebillingside,soeverythingisgearedaroundreimbursement.
IndianaMGMA:Tellusaboutyourhobbies/interests.
Kraig:SpendingtimewithmywifeJodiandourfourdogs.Ialsoenjoyweightlifting,golfandboating.
Contact:KraigVondraniSALUSHealthcare785-477-1626kraigvondran@promitablemd.comwww.isalushealthcare.com
GettoknowyourIndianaMGMABusinessPartner!ThisMonth’sSpotlightPartner:KraigVondran,iSALUSHealthcare
Page9 December2016
WEBINAR
IMGMA Presents: MACRA - How Your Practice Can beSuccessfulin2017&BeyondJoinusasiSALUSHealthcareguidesusthroughMACRAtounderstand why it was created, how the two paymenttracks affect your practice, what the exact reportingrequirementsarefor2017,andhowyourpracticecanearnmoneyduringtheperformanceyear.We’llalsoshowyouhowtomindthequalitymeasuresthatmake the most sense for your ofmice and answer yourquestions during our Q&A time. Make sure your staffregisters today to be ready for a successful start to theQualityPaymentProgram.COST:FreeWHEN:Tuesday,December6,2016,at12pmor5pmESTREGISTRATIONREQUIRED:https://attendee.gotowebinar.com/rt/7004020289342917380?source=Website
CONFERENCE
Conquering MACRA:WhatYouNeedtoKnowtobeSuccessfulTheGreatLakesPracticeTransformationNetwork(GLPTN) will host thise v e n t d e v o t e d t ou n d e r s t a n d i n gimportant elements oftheMedicareAccessandCHIP ReauthorizationAct of 2015 (MACRA).Through two distinctlearning tracks, attendeespreparing for MACRA’s Merit-based Incentive PaymentSystem (MIPS) and its Advanced Alternative PaymentModel (APM) will leave with greater knowledge of theMACRA minal rule and strategies to be competitive in thetransition to value-based reimbursement. A keynotespeaker from the American Medical Association will befollowed by breakout sessions facilitated by local andregionalexperts.Theconferencewillwrapupwithapaneldiscussiononstrategiestoreducehealthcarecosts.COST:$99WHEN:Thursday,February16,2017,from9amto4:15pmWHERE:Marriott,IndianapolisNorth,3645RiverCrossingParkway,IndianapolisIN46240REGISTRATION REQUIRED: www.conf.purdue.edu/MACRApart
SOCIALMEDIASURVEY
Takeour IMGMAMACRA/MIPSSurveyon the IMGMAhasFacebookpage.We’dliketoknowwhatyouthink.Visit us at https://www.facebook.com/IndianaMGMA/ orgo to Facebook and search for IndianaMGMA. Take oursurvey,andwhileyouarethere,pleaseLIKEourpage.IMGMAisalsoonTwitteras@IndianaMGMA,andwehostan IMGMA LinkedIn Group. Search for IMGMA from yourLinkedInPromile.
HaveQuesAonsaboutMACRAforYourPracAce?CheckOutTheseUpcomingOpportuniAes
Page10 December2016
AscyberaSacksandransomwareincreasinglythreatenhealthinformaQonprivacyandthe
integrityandavailabilityofEHRdata,theSecretaryofHHS,Sylvia
M.BurwellisappealingtohealthcarecompaniestoensurerobustsecuritycompliancetocombatransomwareaSacks.
Lastsummer,SecretaryBurwellsentaleSertoCEOsurgingthem
topaycloseraSenQontocybersecurity,especiallythethreatofransomware.Ithas
beenreproducedbelow.ShealsodirectedthemtotheDepartment
ofJusQce’stechnicalguidancedocumentcalled“HowtoProtect
YourNetworksfromRansomware.”
YourMoneyorYourPHI:NewGuidanceonRansomware
Page11 December2016
2017ThirdPartyPayerDaysJoinusforourannualThirdPartyPayerDays.Invited
payerswillhavedisplaytableswithaddiQonalinformaQon,andrepresentaQveswillbeavailabletoanswerquesQonsanddiscussproblemsyoumaybe
experiencingatyourpracQce.
JoinusatanyofthefollowinglocaQonsthroughoutIndiana:
February 22, 2017 Ritz Charles,
Carmel
March 7, 2017 St. Mary’s Medical Center
3700 Washington Ave., Evansville
April 13, 2017 Grand Wayne Convention Center,
Fort Wayne
Cost for IMGMA and IN-HFMA Members: $99-firstperson
$79-eachaddiAonalpersonfromthesamepracAce.
Cost for Non-Members:$160—firstperson(Feeincludes
IMGMAmembership—$125value)$79-eachaddiAonalperson
fromsamepracAce.
Register Today at IMGMA.net
sponsored jointly by:JoinaCommiQee!IMGMAencouragesyourparticipationonacommittee!Pleasecontactthe
[email protected],oron-lineatwww.imgma.netformoreinformationon
howyoucangetinvolved!
The Indiana Health CoveragePrograms (IHCP) is replacingi t s cur ren t i n format ionp r o c e s s i n g s y s t e m ,IndianaAIM, with the newCoreMMIS, or Core MedicaidManagement InformationSystem. CoreMMIS will be amore modern system thatmoreaccuratelyandefmicientlya d j u d i c a t e s c l a i m s i nalignment with IHCP coverage policies and nationalbillingguidelines.AlongwithCoreMMIS,anewproviderinterfacecalledtheProvider Healthcare Portal (Portal) will replace WebinterChange.ProviderHealthcarePortalRegistrationProviderswill need to create a unique, secure Provideraccount for each IHCP-enrolled service location toconductbusinesswiththeIHCPwhenthenewCoreMMISsystemisimplemented.Adesignatedrepresentativemustbe assigned to create the Provider account. Thisrepresentative will have full access to all informationrelated to the service location and will also assign andmanageallotherstaffwithPortalaccessforthatservicelocation.SeeCoreMMISBT201661formore informationand for links to the web-based training on theregistration process. Authorized representatives anddelegates can access the Portal to register a secureaccount.ProviderCommunicationsCoreMMIS bulletins are regularly posted to the IndianaCoreMMIS web page to communicate important systemdetails, includingtransitiondates,aswellasinformationabouthowandwhentoregisterforthePortal.Providersalso can sign up to receive email notimications ofCo reMMIS bu l l e t i n s and a l l IHCP p rov ide rcommunications.
IndianaMedicaid’sNewCoreMMIS
Page12 December2016
withgratefulappreciationtoourbusinesspartners...PLATINUMBUSINESSPARTNERSSomersetHealthCareTeam
GOLDBUSINESSPARTNERSAlliedHealthGroupiSALUSHealthcareKatz,Sapper&MillerMedProGroupMMIC
SILVERBUSINESSPARTNERSCCPAPurchasingPartnersCIPROMSEliteServices,Inc.GLACollectionCompany,Inc.GRMDocumentManagementIdealProteinofAmerica,Inc.IMCCreditServicesMKMarchitecture+designNationalBankofIndianapolisOldNationalBankORSPCISGOLDPNCBankProAssuranceCompanies
BRONZEBUSINESSPARTNERSAlliedCollectionServicesCenterforDiagnosticImagingCoverysFavoriteHealthcareStafmingForrestShererInsuranceHomeServicesUnlimitedISMAInsuranceAgencyProfessionalOfmiceServicesScrubs&Beyond/LIFEUniformTeleVoxTheMedicalFoundationTransworldSystems
DearMedicaidProviderCommunity,I am writing to update you on the upcomingimplementationof thenewprocessingsystem for IndianaMedicaid, “CoreMMIS,” which stands for Core MedicaidManagement Information System. We are just under onemonthfromtheimplementationdateofDecember5,whenCoreMMIS will replace Indiana Medicaid’s longtimeprocessingsystem,IndianaAIM.CoreMMISwillbeamodernizedsystemthatwillprovideusgreater accuracy and efmiciency in processing claims forservices that align with coverage policies and nationalbilling guidelines. It will also deliver a new providerinterface called the Provider Healthcare Portal. This newportal will afford your teams greater functionality withcapabilitieslikeonlineproviderenrollmentandtheabilityto upload supporting documents for electronic claim andpriorauthorizationsubmissions. Thenewsystemwillbemoreresponsive toproviderneedsandcanaccommodatechanges inpolicy faster andmoreaccurately. WebelievethissystemwillimprovetheproviderexperienceandmakedoingbusinesswithIndianaMedicaideasier.Hereat IndianaMedicaid,our teamhasbeenworking formany months in preparation for this upcomingimplementation and we have full conmidence that, alongwithournetworkproviders,ourstateMedicaidsystemwillbereadytoserveour1.4millionmembersbetterthroughthis enhanced technology. As with any system transition,weknowtherewillbesomehiccupsintheearlydays,butwearepreparedtohelp.
• Our communications and provider relations initiativesareinfullswing.Awebsitededicatedtothetransitionisactiveandbeingupdatedcontinuously.
• From the above site, your authorized representativesand delegates can access the new Portal to register asrequired to use the system. I encourage you and yourappropriatestafftoregisterontheportalnow.Thiswillensure you are prepared to continue using onlinefunctionalityonDecember5andthereafter.
• You can mind a repositoryof theproviderbulletins thathavebeenissuedrelatedtotheCoreMMIStransition.
As we approach December 5, and at any time after theimplementation, we want to hear from you. If you areencounteringanydifmicultyorhearinganyconcerns,pleasebe sure to direct them to us. We have set up a specialmailbox to receive concerns after go-live that you [email protected],youcansend your general questions to [email protected] or to the provider relations mield consultant foryour area. Please also feel free to share this letter withothers inyourworkplaceornetwork that are likely tobeaffectedbythetransitiontoCoreMMIS.Welookforwardtopartnering with our provider community to make this asuccessfultransition.
Sincerely,
JoeMoserMedicaidDirectorStateofIndiana
senttotheprovidercommunityonNovember11,2016
OpenLeQertoMedicaidProvidersonCoreMMIS
Page13
PresidentJimButtermieldCEO,EvansvilleSurgicalAssociates
PresidentElect&MembershipCommitteeLiaisonPhilEllisDirectorofMemberEngagement&Development,IRHA
TreasurerJeffLawrenceController,CancerCareGroup,PC
PastPresidentJocelynForehand,CMPECEO,SouthsideOBGYN
DirectorCarmenGarringerManagerPracticeOperations,St.VincentSportsPerformance
DirectorMikeJonesCEO,AssociatedSurgeonsandPhysicians
DirectorBridgidThomas,RNPracticeAdministrator,IndianaHealthSouthernIndianaPhysiciansBedford
Director&LegislativeCommitteeChairSteveFreelandCEO,CancerCareGroup,PC
IMGMAAdministrator&ACMPERepAngelaStevenson,FACMPEDirectorofOperationsHIPAAComplianceOfUicer,IndianaHandtoShoulderCenter
MembershipCommitteeChairHerschalJacquayExecutiveDirector,JWMNeurology
EducationCommitteeChairSarahBrainBillingManager,HancockPhysicianNetwork
CommunicationsCommitteeChairToddStallings,FACHEAdministrator,HomeServicesUnlimited
BusinessPartnerCommitteeChairRichardAltmanGLACollectionCo.
IMGMAOfficers,BoardofDirectors,andCommiQeeChairs
December2016
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