Vaccines for Flu Season

Transcription

1 Get New Patients in to See the Doctor Page 4 Online Tools to Help Patients Page 5 New Culture and Language Program Page 7 Volume 24 Winter 2016 Summer 2012 Vaccines for Flu Season In September, IEHP sent your office a list of new flu vaccines to help you provide the best preventive care for your patients. The CDC recommends injectable influenza vaccines (including inactivated influenza vaccines and recombinant influenza vaccines) during The nasal spray flu vaccine (live attenuated influenza vaccine or LAIV) should not be used during Both trivalent (three-component) and quadrivalent (four-component) flu vaccines will be available. You can find details and immunization recommendations on the CDC s website at The CDC continues to recommend routine flu vaccination for everyone 6 months old or older who does not have contraindications. Children 6 months old to 8 years of age who received two or more doses of trivalent or quadrivalent influenza vaccine anytime before July 1, 2016 will only need one dose of flu vaccine. If only one dose of flu vaccine was received previously, then two doses are recommended. Continued on page 2...

2 Continued from page 1... Vaccines for Flu Season Reimbursement: Help Patients Manage Asthma or Diabetes Do you have Asthma? Join the BREATHE Program for a fresh approach to self care! You ll get the latest in lifestyle ideas to help you live an active life with asthma. Here are just some of the helpful topics and tools you can look forward to every month Creating an asthma-friendly home Reducing asthma triggers at home, recipes for creating your own cleaning products, the best indoor and outdoor plants, and more. How to get the most from your Doctor visits Knowing what to do before, during, and after your visits! Understanding your medicines how and when to use them. Colds and Flu how to protect yourself, and what to do on sick days. Asthma and Exercise don t let asthma stop you from living an active life. VFC (Vaccine for Children) eligible children who are ages 6 months through 18 years. IEHP will reimburse Providers the cost of the vaccine for IEHP Medi-Cal patients (over 18 years old) and Medicare DualChoice Cal MediConnect Members (IEHP Direct Members) by line of business (Medi-Cal/Medicare Rate). Submit completed CMS 1500 claim forms with the correct CPT code to: IEHP Claims Dept. P.O. Box 4349 Rancho Cucamonga, CA Visit and click for Providers then Flu Updates to learn more. You ll find the September 29, 2016 letter. Do you have Diabetes? Join the BREATHE Program Today! (See back for details) Don t miss out on this FREE Join the JOURNEY Program for a fresh approach to self care! at-home program! You ll get the latest in lifestyle ideas to keep you healthy for a long and active life. Here are just some of the helpful topics and tools you can look forward to every month Meal planning made easy, and tips to enjoy eating out PLUS, a collection of delicious recipes (Sloppy Joes in your first packet!) How to buy the best foods for less, every day of the year! Getting the most from your Doctor visits knowing what to ask. Understanding your medicines how they work for you. How to protect yourself from problems diabetes can cause. Join the JOURNEY Program Today! (See back for details) Don t miss out on this FREE at-home program! For details on using online tools to manage services for IEHP patients with asthma or diabetes (and earning P4P incentives), see page 5. Remind your IEHP patients that they will receive an invitation to participate in the Breathe or Journey program if diagnosed with asthma or diabetes. These programs are designed to help them learn, in the comfort of their own homes, how to manage their conditions better. It's easy to join! All they have to do is complete a registration survey and return it to IEHP. They will then receive educational packets, 1 per month for 7 months, that will help them: Understand that they have the power to improve their health and quality of life through commitment to self-care; Be confident in their ability to make good decisions and healthy choices; and Actively engage in maintaining and improving their health by knowing how to access the care they need. If you have IEHP patients diagnosed with asthma or diabetes who have not received a Registration Packet, please advise them to request one by calling IEHP Member Services at the number shown on their IEHP Member Card. 2

3 New Arrival! 2017 Policy and Procedure Manuals IEHP has provided your office with updated Provider Manuals on compact disc (CD). IEHP is required by state and federal regulators to maintain an Acknowledgement of Receipt (AOR) for each of our Providers. If you haven t already, please sign the AOR included with the CD and return it to IEHP by fax, or mail (as stated on the form) on or before Jan. 6, The CD contains the following: 1 Policy and Procedure Manuals (effective Jan. 2017) Medi-Cal IEHP DualChoice Cal MediConnect Plan (Medicare Medicaid Plan) 2 Summary of Effected Changes 3 IEHP Code of Business Conduct and Ethics 4 Model of Care (MOC) Training 5 General Compliance and Fraud, Waste and Abuse (FWA) Training 6 Cultural & Linguistics (C&L) Training Return Your AOR Today 5 for a Chance to Win Providers who submit their completed 2017 AOR form to IEHP on or before Jan. 6, 2017 will be eligible to win one of ten $50 gift cards. AOR forms must be completely and correctly filled out, and they must be ed to providerservices@iehp.org in order to qualify for the drawing. Don t wait! your AOR now for a chance to win! The AOR form can be found under "Updates" on the homepage of our secure Provider Portal. Log in at 3

4 Get New Patients in for Their Initial Health Assessment Newly enrolled IEHP patients must receive an Initial Health Assessment (IHA): Within 60 days of enrollment for patients age 18 months and under. Within 120 days of enrollment for patients over 18 months of age. Here are some ways IEHP is committed to helping you get IEHP patients the care they need starting with their very first visit to your office. 1 IEHP Global Quality P4P Program Offers up to $7,500 in IHA Incentives. In addition to IEHP P4P program incentives, this program provides qualified IEHP Physicians (with at least 500 IEHP patients) up to $7,500 for meeting annual goals in each of 10 quality measures (up to $75,000). One of those selected quality measures is for Initial Health Assessment (IHA), which means getting 50% of your IEHP patients in for their IHA. That s a $7,500 bonus for meeting this goal! Incentive Quality Measure Goal Rate $7,500 Initial Health Assessment 50% For full Global Quality P4P Program details and guides to help you reach your goals, visit IEHP s secure Provider Portal or call the Provider Relations Team. 2 IEHP s Monthly Member Rosters Identify All Newly Enrolled IEHP Members Due for an IHA. Visit IEHP s secure Provider Portal at select Eligibility and Rosters and then click on Initial Health Assessments. Call patients on the list and set up an IHA. Be sure to follow up and confirm with patients prior to their appointments. Tip! Develop and Mail a Welcome Packet Mail to new IEHP patients on your monthly roster list. Provide information about your practice. Encourage IEHP patients to call you to schedule an appointment. 4

5 Use Online Tools to Ensure Better Care IEHP supports you in providing quality care, and we can help you with managing preventive services. For example, you can offer more targeted care to IEHP patients with asthma or diabetes using selected online tools. You ll find these tools on the IEHP Provider Portal: 1 Rosters Click on the Rosters tab to gather information the Doctor needs to provide quality care and service to the IEHP patient. To find out if the patient with asthma is on medicine or needs it Go to Rosters > Health Management > Asthma To see if the patient with Diabetes had certain tests (HbA1c/Neph test/eye test) Go to Rosters > Preventive Care > Diabetes Care 2 3 P4P Select this tab for details on incentives up to $7,500 in the Global Quality P4P program. And under the original P4P program, your office can earn additional incentives (e.g., Check if patients on your Roster had HbA1c testing. Your practice can earn $25 per test up to 4 payments per IEHP patient per year). Referral to health classes If an IEHP patient would like to attend a class near her/his home in Diabetes Self Management or Family Asthma, fill out a form online in the IEHP Provider Portal. New IEHP Provider Portal Feature If you have changes to your address or other information on Doctor Search, you can now update this information directly in the Provider Portal. Just log in to your account and go to Doctor Search. Click edit to make corrections. Don t forget to save them! 5

6 IEHP Scrub of the Month Darinee Hathaitham is an Office Manager for Dr. Vilaivin Tarin s office in Corona, where she has worked for almost 35 years! In that time, Darinee has developed a reputation for taking her job very seriously. Nominate a co-worker Darinee Hathaitham She is honest, trustworthy and responsible, Dr. Tarin told IEHP. Not only does Darinee keep me informed of all important changes, she treats our patients and staff with kindness. Dr. Tarin also praised Darinee s meticulousness when it comes to billing. She makes my life so much easier, Dr. Tarin said. I don t even need to check her work. When she s not working, Darinee, who is happily married with two daughters, is an excellent cook especially Thai food. We are proud to name Darinee Hathaitham the IEHP Scrub of the Month. Do you work with a winner? A hard worker who brightens your office with kindness, inspiring your team to do its best? Tell us why: Write your reason why you think this person should be Scrub of the Month. Keep it under 500 words. If you give us the best reason, we ll give you and your co-worker a $50 Target gift card. Send your name, office location and work phone number. Fax, mail or your entry: Fax: (909) On the cover sheet, write ScrubTalk - Scrub of the Month Nomination. Mail: IEHP ScrubTalk - Scrub of the Month Nomination P.O. Box 1800 Rancho Cucamonga, CA providerservices@iehp.org Q. A. ASK Susie As an office manager for a PCP, I want to ensure that my staff uses IEHP s Provider Portal to get our assigned IEHP Members in for all their preventive care. What should we focus on to get the most we can out of it? The best strategy is to focus on rosters. They tell you so much about the Members assigned to you. We have rosters such as: CCS: gives detail about your Members with CCS cases Early Start Initial Health Assessment (See page 4) 24-Hour Nurse Advice Line: tells you which Members called our Nurse Advice Line and gives details of their concerns. Preventive Care: provides information on what services are due for your assigned Members, including: Breast Cancer and Cervical Cancer Screening Childhood Immunizations Diabetes Care DualChoice Annual Visit Well Care Visits Yellow Card completion Each roster contains the Members' eligibility and contact info, so you can reach out to Members and get them in for the preventive care they need. Ask Susie about IEHP procedures or programs: Call (909) Fax to Ask Susie at (909) providerservices@iehp.org 6

7 Cultural Corner Understanding Your Patients' Culture & Language Your office likely sees an increasingly diverse patient population that may present cultural, language and health literacy barriers. At IEHP, we realize that Providers are in an optimal position to improve health outcomes for culturally diverse patients. That s why we created the Cultural & Linguistics (C&L) program. What is C&L and how can it help Providers? C&L is part of IEHP s Independent Living & Diversity Services Dept. The program was created to identify and remove barriers patients encounter in getting needed care. FREE C&L services to support your practice: Interpreter services If your patients have limited English proficiency, call IEHP to arrange for a FREE face-to-face interpreter or one via telephone. Materials in Spanish IEHP creates informational materials in Spanish and provides language assistance via telephone in a variety of languages. Materials written in plain language, without medical jargon Materials available in alternate formats IEHP provides large print, Braille, e-text and audio. Cultural Sensitivity training IEHP offers educational programs to enhance understanding (e.g., how your patients' culture, gender identification, and other cultural or language aspects influence their approach to healthcare). Sign language interpretation assistance For your IEHP patients who are deaf or hard of hearing. 7

8 P.O Box 1800 Rancho Cucamonga, CA Staff Newsletter 2016 Inland Empire Health Plan. All Rights Reserved. MDS Tips for a More Peaceful Holiday Season Tip #1: Be organized Before you do anything, sit down with a calendar and plan, plan, plan! Make lists, set reminders, and create realistic deadlines you can meet. Tip #2: Find time to exercise Exercise first thing in the morning. This makes you more likely to engage in healthy behavior the rest of the day. Sneak in exercise when you can. For example, take a walk after a meal with a family member while everyone relaxes. Extend your exercise routine by 15 minutes, and you can counteract some of the holiday snacks and help lower stress. Tip #3 Involve your family If you re hosting, ask family and friends to borrow some of their decorations for your events. You could save time, money and stress. They may even offer to help you set them up. Say yes when people offer to help. Especially children. Kids love to help, so let them. You ll save time and energy, which could help reduce stress. Moving Yo ur Office? Please give the IEHP Provider Relations Team (and your IPA) a 60-day notice. Member notification is required by State agencies. Your IEHP patients will be notified, so they can keep receiving their medical care. Questions? Ideas? Reach Your Provider Relations Team at (909) Fax: (909)