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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CDC Recommends Updated COVID-19 Vaccine for Fall/Winter Virus Season***
On September 12, 2023 the CDC recommended that everyone 6 months and older receive the new updated COVID-19 vaccine for the upcoming virus season. The vaccines should be available later this week.
Click here to learn more.
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KHF Question of the Day- Prescribing Wegovy***
Question: Have you started prescribing Wegovy (semaglutide) to patients 12+
who meet the criteria of initial BMI at 95 percentile or greater?
Please click here to view survey results!
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CDC Health Alert Advisory: Increased Respiratory Syncytial Virus (RSV) Activity in Parts of the Southeastern United States
The CDC reported on Tuesday, September 3 that there was increased RSV activity in parts of the southeast during the last few weeks potentially signaling an early start to the RSV season.
Click here to read more.
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Q&A for Parents- RSV
KHF has created Q & A for Parents addressing commonly asked questions regarding RSV, symptoms to watch for, and how parents can help their children if they are diagnosed with RSV. Please feel free to copy the information to share with parents or share on your website.
See the latest Q&A on the KHF intranet here.
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RSVP Today! TCCN September 21st OSHA Training
The Children's Care Network invites you to its annual FREE OSHA Training. This training session will be held on Thursday, September 21st at 10:00 AM.
As a reminder, each staff member that attends the training session will be certified to return to your practice and hold a formal OSHA training session for your staff.
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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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Georgia Smoke-free Air Act***
As of July 1, 2023, the Georgia Smoke-free Air Act also applies to electronic smoking devices that create aerosol or vapor and the use of any oral smoking device for the purposes of circumventing the state’s prohibition on smoking.
This Legal Update from Vxtra provides details.
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Recommended CME for Kids Health First Providers
The DEA recently announced that physicians renewing their DEA license from late June onward will need to demonstrate that they have completed 8 hours of training in opioid prescribing and treatment of opioid use disorder. This training is mandated by the MATE Act.
KHF has identified a free, online, Pediatric-specific course that satisfies the DEA requirement. This course has been vetted by Dr. Lori Desoutter, KHF’s Medical Director.
Please click here to learn more and register for the class.
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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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