News You Can Use and Important Updates
May 2017
A new way to get in touch with Beacon Health Network Management, a need to re-contract, and hiking trails you may want to check out this summer. These updates and more in your May Network Newsletter!

 A New Way to Contact Beacon Health Network Management...

We are streamlining our process in order to respond to you quicker. All you need to do is email BeaconNetMan@emhs.org or call us at 207-973-9799 and our team is at your service!
  
Going forward we'd appreciate you using these updated contacts when submitting forms on new providers, provider changes, or other business regarding services to the EMHS Employee Medical Plan (currently administered through Geisinger).
  
To make it easier we've also updated the forms on  BeaconHealth.ME to correspond with the new information. ( http://beaconhealth.me/Contracted-Provider-Network/Credentialing-Forms.aspx ).
  
Thank you for your attention to this detail - it will ensure we can continue to provide excellent customer service!  
 










 
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PS: We miss our administrative assistant Karen Eldridge too. She's gone on too support another Maine business. We wish her good health and happiness.



Looking Ahead to 2018 - Health Plan RE-Contracting

Beacon Health is replacing all contracts for providers, practices, hospitals, and other organizations like PHOs or ACOs that serve our EMHS Employee Medical Plan.
  
New contracts will be coming to you in the next few weeks, please be on the lookout. These contracts have the same terms as your existing contracts and just need to be updated and ready to go for 2018 open enrollment.
  
We certainly would appreciate a fast turn-around on getting the contracts back. It will allow Beacon Health to update and validate our database for the Plan's next open enrollment.
  
If you have any questions, please do not hesitate to contact us:
BeaconNetMan@emhs.org or 207- 973-9799
  
Thank you in advance for helping us with this administrative process and for being a trusted healthcare provider to the members of the EMHS Employee Medical Plan!  
 
Acronyms of the Month
Decode the  healthcare acronyms below... the answers are at the end of the newsletter
  • COBRA    ______________________________________________________
  • DFRR       ______________________________________________________
  • EHR         ______________________________________________________
  • HGP        _______________________________________________________
  • OPPS      _______________________________________________________

 

 

Credentialing Tip: Is Your PECOS Up to Date?

Beacon Health is encouraging all our partners to make every effort to keep your provider information up-to-date using Medicare's online enrollment management system, Provider Enrollment, Chain and Ownership System (PECOS)
  
Medicare uses this system to align patients with providers participating in Accountable Care Organizations, like Next Generation and Medicare Shared Savings Programs. It is critical that PECOS is updated in a timely manner and the information mirrors what Beacon Health is submitting for your providers in order to maximize the benefit of the care delivery model we are building.
  
PECOS allows providers to securely review, update and submit applications and information currently on file. Providers should upload all required supporting documentation and electronically sign the certification statement.

Here's a useful tool we found from Medicare. It allows you to check and revalidate due dates for your entire list of provides, suppliers, or group practice members.

Wellness Tip of the Month!
  
Hi all! With the warmer days of spring and summer right around the corner it's a great time to dust off your sneakers and get outside!

Maine has so much to offer from hiking and walking trails, beaches and waterfalls. If you're looking for some new adventures here's a website you might want to check out.

 Plenty of fun ways to enjoy Maine, friends and family, and get healthy!


Happy Wellness Friends!


Acronyms of the Month
Decode the  healthcare acronyms below... the answers are at the end of the newsletter
 
  • COBRA - Consolidated Omnibus Budget Reconciliation Act: A law that gives individuals and their families the right to choose to continue group coverage for up to 18 months under certain circumstances (e.g., loss of job, reduction in number of hours worked). Individuals choosing this option are typically required to pay the full costs of coverage.
  • DFRR - Disclosure of Financial Relationships ReportA report designed to collect information concerning the ownership and investment interests and compensation arrangements between hospitals and physicians. CMS proposed to send the DFRR to 500 hospitals to provide sufficient information to determine compliance and assist in any future rule making concerning the reporting requirements and other physician self-referral provisions. In 2010, CMS delayed implementation of the DFRR and instead focused on implementation of section 6001 of the Affordable Care Act, which includes disclosure requirements relevant to physician-owned hospitals for purposes of complying with the rural provider and whole-hospital ownership exceptions. The information submitted by hospitals on CMS' website is published yearly.
  • EHR
a):  Evidenced-based Hospital Referral: The practice of referring patients to hospitals that have a proven track record in producing high-quality outcomes in a give procedure or diagnosis. When outcomes data are missing (as often is the case), EHR involves referring patients to high-volume centers for those select procedures and diagnoses (e.g., CABH surgery) where there is a proven correlation between high volume and high quality.
b):  Electronic Health Record: An electronic version of a patient's medical history, that is maintained by the provider over time, and may include all of the key administrative clinical data relevant to that persons care under a particular provider, including demographics, progress notes, problems, medications, vital signs, past medical history, immunizations, laboratory data , and radiology reports. The EHR automates access to information and as the potential to streamline the clinician's workflow. the EHR also has the ability to support other care-related activities directly or indirectly through various interfaces, including evidence-based support, quality management, and outcomes reporting.
  • HPG - Human Genome Project: DNR, A national effort sponsored by the National Institutes of Health and the Department of Energy to create an ordered set of DNA segments and to develop new computational methods for analyzing genetic map and DNA sequencing data. the project ended in 2003 with the completion of the human genetic sequence. An important feature of the project was the federal government's transfer of technology to the private sector through licensing technologies to private companies and awarding grants for innovative research. the project continues to catalyze the multibillion -dollar US biotechnology industry and foster the development of new medical applications.  
  • OPPS - Outpatient Prospective Payment System:  A system developed by the Centers for Medicare and Medicaid Services (CMS) to pay for most outpatient services at hospitals or community health centers under Medicare Part B.
     
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