Posts Categorized: Featured

VFC Program Information

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The 2014 VFC enrollment documents are now available at the link below.  The VFC program will not be sending these document by U.S. mail. 

Attached to this email, you will find important Information regarding the 2014 re-enrollment process. Once you have read the attached information, please click on the following link to be taken to the Arizona Department of Health Services, VFC 2014 Enrollment webpage to access re-enrollment documents http://azdhs.gov/phs/immunization/documents/vaccines-for-children/2014-az-vfc-provider-enrollment-information.pdf.  Please read the attached document carefully before beginning the processIt includes information on the following topics:

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AHCCCS Transition to DRG- Based Payment Effective October 1, 2014

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To further AHCCCS’ goals of enhancing quality of member care and promoting efficient delivery of services, effective October 1, 2014 AHCCCS will transition from the twenty year old tiered per diem inpatient reimbursement system to an APR-DRG payment system. Payments under the APR-DRG methodology will be consistent with efficiency, economy, and quality of care. An APR-DRG payment system will offer many opportunities to improve member safety and health outcomes as well as improve program efficiency–in contrast to the tiered per diem methodology which promotes a quantity-based delivery model.

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Process Update Related to YOUR Claim Medicare Coordination of Benefit Claim Submissions

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Bridgeway Health Solutions (Bridgeway) has been working to implement new technology in our claims organization to improve the processing of claims requiring submission of Medicare EOB’s (Coordination of Benefit documentation) for claims processed for the Centene Medicare Advantage Programs.

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Physical Therapy Benefit

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NEW OUTPATIENT PHYSICAL THERAPY BENEFIT FOR ADULT AHCCCS MEMBERS STARTING

MARCH 1, 2014

Beginning March 1, 2014, the AHCCCS Program will add a new outpatient physical therapy benefit for adult members 21 years of age or older.  This new benefit will cover 15 outpatient physical therapy visits when they are needed to keep a level of function or help get to a level of function.  Currently, all AHCCCS adult members can receive 15 outpatient physical therapy visits to restore a level of function, but not to keep or get to a level of function.  This new outpatient physical therapy benefit will start March 1, 2014.  The outpatient physical therapy visits are covered during each benefit year.

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Flu Widespread in Arizona

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After a steady increase in flu cases this year, Arizona flu activity hit widespread this week; widespread is the highest category possible. Influenza has been reported in all 15 counties. Most of the circulating flu is the 2009 H1N1 virus. Doctor and hospital visits for flu have increased over the last few weeks around the state.

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