Note: New Content Noted with Asterisks*** and Highlighted
Dear KHF Providers and Practice Administrators,
We have several updates to share regarding payor updates, programs and upcoming events. There is a lot of information, and we want to make sure we are keeping our membership informed. We recommend reading through this communication in its entirety and please reach out to us with any questions you may have!
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COVID & RSV Update
Some KHF practices have begun administering the new COVID vaccine and the RSV monoclonal antibody. So far, they don’t have information about payment for these immunizations by the commercial insurance companies. We will update KHF practices in the next few weeks as these claims are processed and we can determine if they are being paid appropriately.
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The Tridemic: Flu, RSV and COVID- Social Media Posts
The CDC recommends a flu shot for every child six months of age and older. Also, there is an updated COVID vaccine to protect everyone against the latest strain of COVID, and the CDC has advised all eligible family members to receive one.
A new immunization called Beyfortus will be available in October to protect babies and other children against RSV(Respiratory Syncytial Virus).
Click here to view the PDF file.
Please visit the Member section of KidsHealthFirst.com for additional resources.
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Checklist for Planning and Implementing a Flu Vaccination Clinic
The AAP released a planning checklist for practices to prepare for setting up flu vaccine clinics in their office.
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Pfizer to allow 100% returns on COVID vaccines for young children
September 29, 2023- Pfizer has revised its policies to allow 100% returns on vials of its updated COVID-19 vaccine for young children beginning Oct. 1, a move the AAP says will benefit pediatricians and families.
Read more here.
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AAP Fall Respiratory Virus Webinar Series Announced:
The AAP is excited to announce the launch of a webinar series to prepare clinicians for the fall respiratory season. The Webinar series will cover a range of topics from clinical updates to practical tips/tricks for implementation. Pediatricians, family physicians, practice managers, pediatric support staff, and others are encouraged to join.
Pre-registration is required.
Prevention of RSV in Children - Clinical Updates
Tuesday, October 10th, from 6:00 – 7:00PM CT
Presenters: Jefferson Jones, MD, MPH (CDC), Mary T. Caserta, MD, FAAP
Moderator: Sean O’Leary, MD, MPH, FAAP
Topics will include clinical data on nirsevimab and maternal RSV vaccines, CDC guidance, AAP recommendations, among other relevant topics.
Register here.
Nirsevimab Implementation Strategies in Outpatient Pediatric Practices
Tuesday, October 17th, from 7:00 – 8:00PM CT
Topics will include purchasing, coding and payment, office processes, documentation, and more.
Register here.
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Educational Webinars: Pfizer RSV Vaccine - A New Maternal Indication
We understand that there are a lot of questions about the RSV vaccine. For babies there is an immunization from Sanofi called Beyfortus, and KHF has created a toolkit for practices to utilize that will be released soon. At the same time, Pfizer has the Maternal RSV Vaccine to be given to pregnant women. Below is information from Pfizer that we wanted to share.
Pfizer’s Vaccines US Medical Affairs team is providing brief educational webinars entitled Pfizer RSV Vaccine - A New Maternal Indication. These live sessions will be conducted on Tuesdays, Wednesdays, and Thursdays starting October 3, 2023. Additional live sessions may be added, so check the website for the latest schedule. On demand content will be available soon.
Session topics include:
- RSV burden of disease in infants
- Mechanism of Maternal Immunization
- ACIP Recommendations and Clinical Considerations
- Clinical Trial Data: Safety and Efficacy
- Question and answer session.
Click on the following link for the live schedule and other educational resources:
RSV Vaccine Educational Webinars led by Pfizer Vaccines US Medical Affairs
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CDC recommends new vaccine during pregnancy to help protect babies against severe respiratory syncytial virus (RSV) illness after birth.
On September 22, 2023, the CDC recommended a new vaccine called AbrysvoTM produced by Pfizer (bivalent RSVpreF vaccine) to help reduce severe illness in babies for the first six months of life. Results indicated a reduction in hospitalization for babies by 57 percent. The CDC recommended “seasonal administration of one dose of RSV vaccine” during weeks 32 through 36 of pregnancy.
To learn more, click here.
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Q&A for Parents- RSV
KHF has created a new Q & A for Parents addressing commonly asked questions regarding RSV. Please feel free to copy the information to share with parents or share on your website.
See the latest Q&A for parents on the KHF intranet here.
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AAP Resources:
Below is a list of helpful resources for practices:
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FDA Notice: Recall on 4.2% Sodium Bicarbonate Injection, USP and 1% and 2% Lidocaine HCl Injection, USP by Hospira Products***
October 2, 2023- Hospira, a Pfizer company, is recalling Lot Numbers GJ5007, 42290DK, and GH6567 of 4.2% Sodium Bicarbonate Injection, USP, 5 mEq/10mL vial; 1% Lidocaine HCl Injection, USP, 50 mg/5mL vial; and 2% Lidocaine HCl Injection, USP, 100 mg/5mL vial due to the potential for presence of glass particulate matter.
To read more click here.
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FDA Provides Updated Recommendations for Certain O&M Halyard Surgical N95 Respirators, Surgical Masks, and Pediatric Face Masks***
September 29, 2023- The FDA is providing an update to consumers, health care providers, and facilities about certain surgical N95 respirators and masks manufactured by O&M Halyard. This update includes the current recommendations for these products.
Click here to read more and to view FDA recommendations.
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GPPMA Listserve Q &A: New Hire Reporting***
Question: I currently report my new hires to Georgia New Hire Reporting site. My question is does anyone also report to E-Verify to report new hires as well?
Answer: According to Kids Health First PEO Adams Keegan-
The GA New Hire Reporting is:
- mandatory for all employers;
- is wholly separate from E-Verify and must be done on the GA run website.
If you use a PEO or a Payroll company – you should check with them to see if they do it on your behalf.
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KHF Question of the Day- Transcutaneous Bilirubin Meter***
Questions:
- Do you use a Transcutaneous Bilirubin Meter in your office?
- If yes, what instrument do you use?
- If yes, have you had issues with the reliability of the reading or other issues?
To view results click here.
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AAP Clinical Practice Guidelines for Obesity- Live Training October 10th
TCCN is excited to host this educational webinar scheduled for Tuesday, October 10, 6:30-8:00 pm, on the new AAP guidelines for obesity, with a special focus on patients with diabetes.
Attendance at this webinar is an additional opportunity to fulfill the TCCN practice education requirement. As a bonus, those participating in real time will receive 1.5 CME credits.
You can register via the TCCN communication sent earlier this week, or REGISTER HERE
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TCCN Asthma Flu Recall Lists
Asthma Flu Recall lists were distributed through secure emails to practices last week. Please use this list as a tool to help you start recall efforts early for the upcoming flu season.
If you have any questions about your Flu recall list, please reach out to Laura Baldwin at laura.baldwin@tccn-choa.org.
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Webinar Replay Available: TCCN Antibiotic Stewardship Webinar: Prescribing Guideline
This lunchtime series presents the new Georgia Pediatric Antibiotic Stewardship website, gpas-online.org, designed to help you in your busy practices with guidelines and a new antibiogram visualization tool.
If you missed it, click here to watch:
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In Office CPR Recredentialing Training***
Kids Health First has an agreement with a BLS CPR trainer who can come to your office and complete your physician and staff CPR recredentialing.
We are pleased to announce an agreement with Doug and Deanna Morris of No Stress Training. Here is their biography and their offering for Kids Health First practices.
Program Details:
- Come to your practice or you can send people to their Fayetteville location.
- You schedule the training time directly with them for your convenience.
- $45 per person for a 2 year BLS recredentialing.
- They will prorate training for anyone who is currently credentialed that you want to get on your training schedule.
- This agreement runs January 2023- February 2025
Please note that each office should complete a HIPAA Confidentiality Agreement with the company and your practice.
Call No Stress Training directly to schedule your sessions and please identify your practice as a Kids Health First practice. Slots are already being filled for 1st quarter 2024!
Doug and Deanna Morris
No Stress Training
www.nostresstraining.com
nostresstraining@outlook.com
(770) 519-2283
(770) 519-2284
If you have additional questions, please feel free to contact Donna Scowden at dscowden@khfirst.com
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TCCN OSHA Webinar Replay***
The replay for the 2023 TCCN OSHA webinar held earlier this month is now available to view.
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Click here to view the presentation.
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Click here to view the slides.
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Click here to view the included Bloodborne Pathogens Test
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CME Opportunity for Kids Health First Providers
Click here to learn more and register for a free, online, Pediatric-specific course that satisfies the DEA requirement mandated by the MATE Act.
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PeachState
Georgia Pathways to Coverage Program
Georgia residents can apply for the program starting on July 1, 2023, with coverage starting the 1st of the month after approval is given.
Included is the introduction flier, FAQ and example ID card.
Virtual Credit Card
Beginning 7/1/2023 providers not enrolled in EFT will receive claim payment through the Virtual Credit Care (VCC). Please click here to read more.
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Aetna
Aetna CPT 96160 Error
Aetna implemented a claim processing edit on 4/30/2023 causing CPT 96160 to deny in error. This edit was removed on 7/7/2023.
Aetna confirmed a project will be completed to reprocess CPT 96160. All claims within the date span of 4/30/2023-7/7/2023 will be reprocessed. There is no ETA on the project completion at this time, but KHF will continue to track this issue until it is resolved.
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Anthem
Requests for Additional Information are now digital
Use your Attachments Dashboard to access notifications about documents needed to process your claim. Starting in June (2023) Anthem Blue Cross and Blue Shield began sending notifications to you through your Attachments Dashboard on Availity.com, when medical records, itemized bills, or other documents are required to process Commercial members claims.
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Georgia Medicaid
Medicaid Unwinding Toolkit Resources
Beginning April 1, 2023, all Georgia Medicaid and PeachCare for Kids® members will undergo an eligibility review. For more information, please visit https://staycovered.ga.gov or https://dhs.georgia.gov/medicaid-unwinding.
Georgia Medicaid Provider Revalidation
Provider revalidation has also been voluntary due to the PHE. However, in 2023 the revalidation will become mandatory.
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DCH to post Member Redetermination Date on GAMMIS
GAMMIS will now be including a member’s date of redetermination within the information posted when checking a member’s eligibility.
As shown in this screenshot, within the section Member ID Information the field titled, “Redetermination Date” is listed under the field titled “Gender” in the second column in the right-hand portion of the screen.
As a reminder, a screen shot noting the child’s eligibility on the date of service will ensure payment of services provided. Additionally, practice staff can also alert families of their child’s redetermination date.
This flyer and coloring sheet from Stay Informed, Stay Covered can help explain this process to families.
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Georgia Department of Community Health Shares Additional Coverage Options for Medicaid/PeachCare for Kids® Members as Redetermination Process Continues
As Georgia processes its first full batch of Medicaid/PeachCare for Kids® eligibility redeterminations in three years, the Georgia Department of Community Health (DCH) is re-sharing options for Medicaid members to maintain, regain, and explore other options for healthcare coverage.
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Members who are no longer eligible for Medicaid or PeachCare for Kids® can see if they are eligible for coverage through the Georgia Pathways to Coverage program, which launched July 1, 2023 by applying at gateway.ga.gov.
Click here to download the full press release.
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TCCN Roundup:
The TCCN Roundup is designed to be a twice weekly information hub for all things TCCN.
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Please to check out the latest issue
- Please note that the link above only accounts for some TCCN updates. In order to view the full TCCN Newsletter with your contracted payor updates please check your TCCN inbox!
TCCN Quality Steps Newsletter
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