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Assure Your Claims are Accepted and Paid as Version 5010 Enforcement Discretion Ends June 30
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The HIPAA 5010 electronic transaction standard was to go in effect January 1, 2012. However, CMS provided an enforcement discretion period through the end of June to give providers and clearinghouses additional time to complete testing and for vendors to complete software installation.
The enforcement discretion period will end June 30. Claims submitted using the replaced Version 4010 format are subject to be rejected. While it is likely your organization, clearinghouse and you have successfully tested and migrated to Version 5010 we want to make sure you are aware of the June 30 end date to Version 5010 enforcement discretion.
Additional information regarding Version 5010 can be found here.
Version 5010 is necessary to support the transmission of claims using ICD 10. Implementation of ICD 10 has been delayed from October 2013 to October 2014 and additional information can be found here.
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ICD-9 Webinar to be Held Wednesday June 27, 3PM EST
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A webinar on the guidelines to ICD -9 coding will be held on Wednesday June 27, 3 PM EST. This webinar will help you understand the guidelines to specific ICD - 9 coding. This will support your documentation of medical necessity, of services rendered and claim submission.
Accurate and specific ICD-9 coding also supports mapping to Hierarchical Condition Categories (HCC) codes and scoring that is used for payment/shared savings systems such as Independence at Home, Medicare Advantage Plans and others that are emerging in the market. Dial in information will be provided prior to the webinar. The webinar will be repeated and PowerPoint slides posted to the Academy site.
Click here to register.
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June 30 Deadline for E-Prescribing Hardship Exemption Request
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June 30, 2012 is also the last day to submit a hardship exemption request, or report at least 10 instances of e-prescribing on claims to CMS to avoid the 1.5 percent reduction on all Medicare claims in 2013. The available hardship categories are;
- Inability to electronically prescribe due to state, or federal law, or local law or regulation
- The eligible professional prescribes fewer than 100 prescriptions during a 6- month payment adjustment reporting period
- The eligible professional practices in a rural area without sufficient high-speed Internet access (G8642)
- The eligible professional practices in an area without sufficient available pharmacies for electronic prescribing (G8643)
Hardship exemption requests must be submitted annually and by June 30 to claim an exemption request to avoid next year's penalty. Additional information about thee-Prescribing incentive program and the hardship exemption process can be found on the CMS site here.
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IAH Expansion Efforts Underway - How You Can Help and Action if Your Program Was Not Selected
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IAH Expansion Efforts Underway
CMS officials have acknowledged the difficulty in initial practice selection due to the high number (130) of programs that applied as well as the statutory cap of 10,000 beneficiaries. CMS followed the criteria in the posted application and specifications in selecting the initial IAH practices. CMS is also to announce the approved consortia practices in June. The Academy is involved in efforts to expand IAH. You can help by donating to the Homecare Medicine Action Fund.
What to Do if You Applied and Were Not Selected - Here is What to do Now
1) Provide us by E-Mail as soon as possible for your practice;
(a) Years of experience providing home-based primary care,
(b) Number of IAH eligible beneficiaries in current practice, and
(c) Number of IAH eligible beneficiaries you could treat within the next year in addition to the number in (b).
We will use this critical information in the effort to encourage an increase in the number of eligible beneficiaries.
2) Contact your Representatives and Senators and let them know that their Medicare constituents are suffering without timely needed care and Medicare funds are not being used effectively because the 10,000 beneficiary cap is preventing needed medical care from being provided and keeping the resultant savings from being achieved. |
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Academy IAH Learning Collaborative Next Meeting via June 19 Call
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The kick-off meeting of the Academy grant funded learning collaborative took place on May 2 prior to the Annual Meeting in Seattle. The next meeting of the Learning Collaborative will be on through a June 19 call focusing on top concerns of practices as they begin service to eligible beneficiaries under the Demonstration.
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Support Your Field Through Participation on Education Committee
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A strategic goal of the Academy was to establish an Education Committee. This committee is now in place under the chairmanship of Dr. Ed Ratner. The charge of the Education Committee is to promote competencies related to home care medicine among members and other professionals through live, print and electronic educational interventions. Support your Academy and field by participating on the Education Committee. Please click here to let us know that you are interested in serving on the Education Committee and subcommittees.
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Please contact Gary Swartz, JD, MPA at 410-679-5857 or Gary.Swartz@aahcp.org to discuss these or any other practice management issues or questions. |
Since 1988, the American Academy of Home Care Physicians has served the needs of thousands of physicians and related professionals, agencies and organizations interested in improving care of patients in the home.
Academy Board member volunteers and members work to reduce barriers to providing home care medicine and to enhance practice education. Notable successes include: fostering increased reimbursement, sponsoring multiple educational and scientific seminars, and providing the practice community with a variety of helpful publications.
Academy members include home care physicians - physicians who make house calls, care for homebound patients, act as home health agency medical directors, or who refer patients to home care agencies. They also include nurse practitioners, physician assistants, home health agencies, hospital systems and consultants interested in the field.
Members come from all across the United States. We also have some international members. The Academy welcomes student affiliates and corporate sponsor-members.
Constance F. Row, LFACHE
Executive Director |
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Readmissions Reduction
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Many of you have been approached by or wish to approach hospitals to offer the support of your housecalls program to their effort to reduce readmissions. You have asked us for a basic briefing document you could take with you, something that would explain how house calls can help, and give some concrete examples of benefits.
An interested group met at the Annual Meeting to give the background needed and to describe their programs.Click here for a Policy Brief giving the argument and their examples. Consider this an Annual Meeting gift that we hope will keep on giving! And many thanks to those who participated!
Constance Row, LFACHE
Executive Director
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Medical Management of the Home Care Patient - Updated and Available for Your Use!
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The Academy is pleased to announce an updated and expanded Medical Management of the Home Care Patient (MMHCP) is Now Available. This important publication for care of your patients and operating a home care medicine practice is updated with the most current and relevant material. This book is applicable to the practice and patients of all Academy members including physicians, nurse practitioners and physician assistants. Leaders of your Academy in conjunction with the AMA authored the MMHCP. Order you copy here.
This 4th edition, like the field of home care medicine, has grown across many aspects of care, organization and regulation and covers the changing landscape from care of special populations, relationships with community based long term care supportive services through skilled nursing and therapy services to the latest in acute hospital in the home programs.
Specific topics include:
- The basis for care of the home care medicine patient.
- Care transitions and the importance of care transitions in reducing hospital readmissions.
- Legal, compliance and ethical issues that arise or are present in practice of home care medicine.
- The Veterans Administration's Home Based Primary Care Program.
- Special home care medicine populations from neonatal through hospice and end of life care.
- A caregiver self-assessment tool.
- A comprehensive glossary.
- Listing of national, state and local resources.
- Case studies, tables, figures and easy-to-read text.
- A continuing medical education component for physicians interested in obtaining AMA PRA Category 1 Credits™
The MMHCP is a care delivery complement to the expanded Field Guide to Home Care Medicine and both beginning and growing practices will want to have both references.
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Looking for a Change? Use the AACHP's Career Center
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As a member of the AAHCP you are entitled to use the AAHCP Career Center to post and search for job openings in the field of Home Care Medicine. Click here to view the current postings.
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Are you taking advantage of all your member benefits? | | |
Being a member of the AAHCP comes with a number of members only benefits. We hope that you have taken advantage of all your membership has to offer. If not, click here to see what you are missing and how to make the most of your membership with us! |
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Practice Management and Technical Assistance Services | |
Access your Academy's "Practice Management and Technical Assistance Services" to obtain answers to your practice management questions. Listen to recent feedback:
"Thank you for talking to me today -- I learned a lot"
--Mary Ann Crumlish, PA-C
Comfort Care Medical Group
Jacksonville, FL
" The Academy has great resources."
"The fact that you called shows you care"
--Lyn O'Brien, PhD, ANP/GNP-BC
The Geriatric Center for Home Health Care
Franklin, MA
"Thanks again to the AAHCP for channeling our concerns and offering guidance and advocacy."
--Andrew Lyons, MD
Medical House Calls
New York, NY
The Academy's Practice Management and Technical Assistance Services are led by Gary Swartz, JD, MPA Associate Executive Director of the AAHCP who brings his extensive practice management service to your immediate aide.
Click here for more information. |
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Start Benchmarking Your Practice/Program Against Home Care Medicine Guidelines | |
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Unsure about whether your program meets "best practice" standards as a clinical practice? Find out now by buying Recommended Clinical Practice Guidelines for Quality Home Care Medicine.
This important document representing the collective wisdom of Academy experts with over 100 years of experience in the field will give you the guidance you need so you'll see where you are and where you need to go.
Guidelines can be bought as part of the Home Care Medicine Field Guide, click here to subscribe.
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