Alaska Medical Assistance Newsletter

A Monthly Newsletter for Alaska Medical Assistance Providers March 2012 Xerox 1835 S. Bragaw St., Suite 200 ACS is Now Xerox Anchorage, AK 99508-3469 Affiliated Computer Services Transitions to Xerox Web Address http://medicaidalaska.com Brand Two years ago Xerox acquired Affiliated Computer Services (ACS), Alaska Medicaid's Phone Numbers fiscal agent. On Wednesday, January 25, 2012, Xerox officially retired the ACS name 907.644.6800 800.770.5650 (toll-free) from most of Xerox’s service businesses – including Government Healthcare Solutions. All communication will now bear the Xerox name and logo. Fraud and Abuse Hotline 907.644.5975 or This change does not require any action by you, the provider. Please continue to use 800.256.0930 (toll-free) the same addresses for mailing your claims or correspondences; the same phone numbers for inquiries and faxes; and the same website, http://medicaidalaska.com, for Recipient Services information on Alaska Medicaid billing and training. 907.644.6800, option 6 800.780.9972, option 2 (toll-free) If you have any questions regarding this transition, please call Provider Inquiry at 907.644.6800, option 1, or 800.770.5650, options 1, 1 (in-state toll free). Provider Inquiry 907.644.6800, option 1 800.770.5650, option 1, 1 (toll-free) VacTrAK Helps Ensure Timely and New Provider Enrollment Portal Appropriate Immunizations http://enroll.medicaidalaska.com Fax Numbers A Letter to Providers from PA...... 907.644.8131 Drs. Ward Hurlburt, State Director of Public Health, PA: Travel, MRI, ...... 907.644.5982 PA Mental Health ...... 866.653.1435 and Joe McLaughlin, State Epidemiologist SUR...... 907.644.8128 EPS...... 907.644.9845 Dear Colleague: Finance ...... 907.644.8120 The purpose of this letter is to encourage your practice to enroll in VacTrAK, Alaska’s Training ...... 907.644.9845 Attachments/RTD ...... 907.644.8122 immunization information system (IIS). The state of Alaska is seeking to increase or ...... 907.644.8123 provider enrollment in this system, which will help ensure that children in our state Enrollment ...... 907.646.4273 receive timely and appropriate immunizations. According to the US Centers for Disease Provider Inquiry...... 907.644.8126 Control and Prevention, in 2010, Alaska ranked 42nd in the nation among the states with respect to immunization coverage rates for infants and young children. We can In this issue and should do much better! A tool such as VacTrAK has been an important resource for ACS is Now Xerox ...... 1 increasing immunization coverage rates in other states like Wisconsin and Mississippi VacTrAK Helps Ensure Timely and Appropriate Immunizations ...... 1 that lead the national coverage ranking list. Another benefit to patients is that Translation and Interpretation Services...... 2 statewide IISs help ensure timely immunization for children if families move or change New Precertification Requirements providers. According to the US Centers for Disease Control and Prevention, over 20% For 2012...... 2 Upcoming Holiday...... 2 of US children see more than one healthcare provider by their second birthday. Spring Training for Providers...... 3 WebEx Training...... 3 In addition to benefiting your patients, there are numerous benefits to you in utilizing RBRVS-Based Fee Schedules Now Available.. 3 VacTrAK. The following is a list of some of these benefits: Health Care Corner...... 3 Update Coming to Preferred Drug List ...... 3 • Obtaining consolidated patient immunization records New Federal Medicaid Website Available ...... 3 Alaska Medicaid Introduces RSS Feeds ...... 4 • Viewing automatically generated vaccine forecasts Claim Rejection Error Corrected...... 4 Ask Medicaid ...... 5 (Continued on p 2) Diagnosis Code Now Required on Claims for All Provider Types...... 5 1 A Monthly Newsletter for Alaska Medical Assistance Providers March 2012 (Continued from p 1) • Generating reminder/recall notices Translation and New • Managing vaccine inventory and Interpretation Precertification meeting state requirements for VFC enrolled providers Services Requirements For • Improving accuracy of immunization records Federal Mandates for 2012 • Reducing paperwork Providers The 2012 Alaska Medicaid Select Title VI of the Civil Rights Act of 1964 Diagnoses and Procedures • Producing official immunization and federal regulations implementing Precertification List is now available on records Title VI prohibit exclusion of individuals the Qualis Health website at • Accessing provider-specific on the grounds of race, color, or national http://www.qualishealth.org (under immunization completion rates at any origin from participation in programs that Healthcare Professionals select Alaska time receive federal funding. As recipients of Medicaid – Division of Health Care federal funding through Medicaid Services, then under Announcements click Currently, there are over 130 Alaska payments which are, in part, federally on Select Diagnoses/Procedures organizations/facilities participating in funded, enrolled providers may not Precertification List). You may go directly VacTrAK, representing hundreds of employ practices that have a to the 2012 precertification list at individual health care providers across the discriminatory impact on individuals. http://www.qualishealth.org/sites/default state. As of February 16, 2012 there were /files/AK-Medicaid-Precert-List.pdf. 508,320 persons listed in VacTrAK that Medicaid-enrolled providers are obligated had two or more vaccines on-record. to provide access to health care services, Please review the new 2012 list as including language interpreting services, changes have occurred. Enrollment is easy, quick, and free − when needed, for patients who have just go to our website to download the Limited English Proficiency (LEP). enrollment application at: https://vactrak.alaska.gov/iweb. For more The U.S. Department of Health and information please call the Alaska Human Services has published a Immunization Program at 907-269-0312. document that includes a four-factor analysis that guides providers through If your practice is not already enrolled in the process of determining the extent of VacTrAK, we need your help. The more their obligation to offer LEP services, and effectively we can pull together as a development of a plan to meet the needs statewide public health/health care of the LEP population. This document, provider team, the greater our impact will “Guidance to Federal Financial Assistance be on raising the health status bar in Recipients Regarding Title VI Prohibition Alaska! Against National Origin Discrimination Upcoming Sincerely, Affecting Limited English Proficient Persons”, is available in Volume 68, Holiday Number 153 of the Federal Register, published Friday, August 8, 2003, and State of Alaska Closure Ward B. Hurlburt, MD, MPH available at The state’s offices will be closed in honor Director Division of Public Health and http://www.gpo.gov/fdsys/pkg/FR-2003- of Seward’s Day on March 26, 2012. Chief Medical Officer, DHSS 08-08/pdf/03-20179.pdf.

Joe McLaughlin, MD, MPH State Epidemiologist and Chief Section of Epidemiology, DHSS

2 A Monthly Newsletter for Alaska Medical Assistance Providers March 2012

In addition, you can attend from the Spring Training comfort and convenience of your own office! Health Care for Providers Check the Xerox website at Corner April Training Dates in http://medicaidalaska.com under Training >Schedule to view a list of topics A study released by the Alaska Section Seward and Nome that will be presented at these WebEx of Epidemiology said that 9,000 It’s not just for baseball teams. On-site sessions, and register today. Alaskans were hospitalized due to falls education will be offered in two locations from ’05-’09. The highest rates were for providers. April 3 through 5 will see RBRVS-Based Fee among seniors, especially Natives and classes offered in Seward, and in Nome those in the northern part of the state. the dates are April 10 through 12. There are many simple preventative Schedules Now measures to reduce the chances of a fall. These courses will prepare you and your For more information, see the fall injury- staff to accurately bill for services Available prevention page at reimbursed by Medicaid, Denali KidCare, and CAMA. Classes will include Effective January 1, 2012 http://www.cdc.gov/HomeandRecreatio introductory courses such as Recipient Resource Based Relative Value Scale- fee nalSafety/Falls/index.html Eligibility, Claims Management, Prior schedules for services provided on and after December 1, 2011 are now Authorizations, Guidelines for Record Keeping, Tribal courses, a Tribal Specific available at http://medicaidalaska.com Workshop, and Advanced Provider (select Providers > Lookups > Fee Workshops. Register online at Schedule, accept the CPT copyright Update Coming http://medicaidalaska.com. agreement, then select the appropriate provider type fee schedule). to Preferred Drug To view the complete 2012 Provider Training Calendar, please visit the Xerox If you are unable to access your fee website at http://medicaidalaska.com. schedule online, you may request a copy List From the main menu select “Training” by calling the Xerox Provider Inquiry Unit A new Alaska Medicaid Preferred Drug List then “Schedule”. To register for a training at 907.644.6800 or 800.770.5650 (toll- will be effective on March 8, 2012. The class, select “Training” then free in Alaska). revised Preferred Drug List is currently available online at “Registration.” For more information You may also request the fee schedule in http://hss.state.ak.us/dhcs/PDL/default.html. about provider training, please contact writing by fax to 907.644.8126 or the Xerox Training Department at 907.644.8127, or by mail to Please contact Chad Hope, Pharm.D. at 907.644.6800 or 800.770.5650 (in-state, 907.334.2654 with any questions. toll free). Xerox, Provider Inquiry Unit PO Box 240808 Anchorage, AK 99524. New Federal Written requests should include the Medicaid Website WebEx Training provider name, mailing address, NPI or Get Connected! Medicaid ID, number of copies requested, Available No training sessions in your area? Prefer and preferred medium (paper or CD). not to travel to attend training? Medicaid.gov Goes Live The Center for Medicaid and CHIP If you have internet access and phone Services (CMCS) is pleased to announce service, WebEx may be your solution. the initial launch of http://medicaid.gov, Xerox is offering WebEx training April 17 the first Federal government website through 19, 2012. devoted to the policies - and the people - WebEx training sessions offer the same of Medicaid and the Children’s Health material and are presented by the same Insurance Program (CHIP). This website is trainers as our on-site training sessions. the culmination of efforts at the Center Participants enjoy the same opportunity for Medicaid and CHIP Services to for Q&A with the trainer and interactivity revitalize and reorient the information with their fellow attendees as they would the Federal government makes available at on-site training. about these programs. (Continued on p 4)

3 A Monthly Newsletter for Alaska Medical Assistance Providers March 2012

Continued from p 3) programs, including Microsoft Outlook, allow you to receive RSS feeds right in As part of CMCS’ commitment to Alaska Medicaid your inbox. transparency and information sharing, http://medicaid.gov brings to the Introduces RSS A number of feed readers can be found forefront the items that states, the health Feeds at the following links: policy community and other stakeholders Feed readers for your computer: have said they care about most, Innovating and including: federal policy guidance, lists of http://www.dmoz.org/Computers/Softwar pending and approved waivers, highlights Improving e/Internet/Clients/Web of our Affordable Care Act Communication with http://email.about.com/od/rssreaderswin/ implementation efforts, State-specific tp/windows_free.html program information and data, and Medicaid Providers improved search capabilities. We are proud to announce the Alaska Feed readers for your mobile phone: Additionally, the CMS.gov website has Medicaid RSS Feed for HIPAA 5010 http://www.feed-readers.com/mobile-rss- been modified and improved. Here’s what updates. readers.html you’ll find on the new CMS and Medicaid Now, providers can get up-to-date To use Microsoft Outlook to read RSS, sites: announcements instantly using their follow the instructions found here: favorite feed reader, email, or even • A significantly improved search http://office.microsoft.com/en- engine that gets you to the mobile phone. Updates in the feed could us/outlook-help/subscribe-to-an-rss-feed- information you’re looking for, fast. include everything from policy changes, HA010355679.aspx important Medicaid-related news, and • More in-depth information about Other popular web-based email sites such provider training opportunities. what CMS is doing to implement the as Yahoo!, Google, and MSN also offer Affordable Care Act and other new The benefit to providers is two-fold: it feed readers, so consult your email initiatives, and details about how you eliminates the need to constantly check support for instructions. can apply for new programs. our webpage for updates and streamlines Alaska Medicaid does not endorse or • Up-to-date, real-time updates that our communication with you; simply guarantee any particular RSS feed reader reflect important developments and subscribe to our feed to stay informed. initiatives happening with CMS or aggregator. programs. What is RSS? • Medicaid program information that’s Really Simple Syndication, commonly Claim Rejection readily available, easy to find, and abbreviated as RSS, is a standardized easy to use - and CMCS will be format for delivering new or updated continually looking for ways to Error Corrected enhance your experience on this site. content from a website. Claims for Speech • Easy-to-access links to RSS quickly delivers news and updates http://healthcare.gov, which will straight to a user’s inbox or news reader. Language Treatment continue to be the primary site for Many news-related sites, weblogs and Affected consumer information. other online publishers syndicate their Providers who submitted electronic claims content as an RSS Feed. Current Medicare and Medicaid with CPT code 92508 between 1/1/2012 information people rely on now will Subscribing to the HIPAA 5010 RSS will and 1/31/2012 received a negative 999 continue to be available as CMS is ensure your office is in the loop on recent rejection message containing the launching an archive version of each CMS policy changes, updates, or training explanation of “EXPECTED VALUE OF website so that historic information can opportunities we have added ZERO FOR PQRI PROCEDURE CODES.” On remain online without adding clutter to RSS also protects your privacy; we do not 1/31/2012, Alaska Medicaid corrected our primary sites. collect your personal information, and the electronic claims processing system to you need not create an account with us remove this error. to read the Alaska Medicaid RSS Feed. Any claims containing CPT code 92508 Xerox does not track the RSS Feeds you submitted between 1/1/2012 and read and those you do not. 1/31/2012 that received a negative 999 rejection message must be resubmitted. Finding a Media to read Please check your remittance advice to RSS ensure all resubmitted claims were If you have never subscribed to an RSS received and processed properly. feed before, you will need to use a “feed reader” or “aggregator.” Many email 4 A Monthly Newsletter for Alaska Medical Assistance Providers March 2012

A: Effective January 1, 2012 and in For more information, please refer to the January 6, 2012 Ask Medicaid accordance with HIPAA 5010 Q: All of our recent claims requirements, all providers must announcement, New Billing Provider enter a physical address for the Address Requirements for HIPAA have been rejected billing (servicing) address when 5010 Transactions, available at because we didn’t use a submitting claims electronically. http://medicaidalaska.com (on the physical address on our Claims submitted without a physical menu bar select HIPAA 5010, then billing address will be rejected. 5010 Companion Guides). claims. We have always Submitting the physical address will Questions? Contact Xerox at used our PO Box on not affect where you receive your 907.644.6800 (option 1 for Provider claims – that is where we claims payments and RA. They will Inquiry, option 3 for the Electronic receive our clinic’s mail. continue to be mailed to the Pay-To Media Coordinator), or in-state toll-free address in your provider at 800.770.5650 (option 1, 1 for Is this a new file.Resubmit your claim with a Provider Inquiry, Option 1, 4 for the requirement? How do we physical address, and don’t forget Electronic Media Coordinator). to include your ZIP+4, which is also get paid for these required. claims?

Diagnosis Code Now Required on Claims for All Provider Types Effective January 1, 2012 All HIPAA-compliant electronic claims submitted on and after January 1, 2012 must conform to the new federal HIPAA 5010 standards. One of the changes impacting providers is that electronic Medicaid claims will not be paid if submitted without a diagnosis code. Some provider types may not have access to a Medicaid recipient’s medical records. To ensure HIPAA 5010 compliance for those provider types, default diagnosis codes have been assigned for use on certain Medicaid claims. For Payerpath users of these provider types, enter the code in field 21 and omit the decimal. The default diagnosis codes (ICD-9) for each of these provider types are as follows:

Provider Type Provider Description ICD-9 Code ICD-9 Description

83 Taxi V63.0 Residence remote from hospital or other health care facility 88 Pre-maternal Home V22.2 Pregnancy state, incidental 88 Hotel/Motel with Restaurant V63.0 Residence remote from hospital or other health care facility 89 Hotel/Motel without Restaurant V63.0 Residence remote from hospital or other health care facility 46 Home and Community Based Agency (HCB) 780.99 Other general symptoms 47 Residential Supported Living Arrangements V60.6 Person living in residential institution 48 Environmental Modifications V60.1 Inadequate housing 95 Personal Care Agency 799.9 Other unknown and unspecified cause Table 1: Default Diagnosis Codes (ICD-9) by Provider Type A mandatory diagnosis code is just one of the changes resulting from HIPAA 5010. Additional information is available at http://medicaidalaska.com. Select the HIPAA 5010 tab. If, after reviewing these resources you still have questions, knowledgeable HIPAA 5010 support is available by email at [email protected] or by telephone at 907.644.6831 or 855.226.9391 (toll-free).

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