Bridgeway Health Solutions

SKILLED NURSING FACILITIES – URGENT ALERT

mcobb — Fri, 10 May 2013 16:51:58 +0000

Urgent Claims Notification for Skilled Nursing Facilities

Bridgeway has identified a payment issue with a small percentage of SNF claims that were processed on the check run for May 7, 2013 that has resulted in zero-dollar claim payments. Bridgeway has corrected the issue and is currently in the process of appropriately reprocessing the claims to pay at the correct amount. If you have any questions on this issue please contact the Bridgeway claims department at 866-475-3129.

June Update

mcobb — Mon, 06 May 2013 17:55:47 +0000

JUNE MEMBER ADVISORY COUNCIL MEETINGS

Don’t forget to add our upcoming Member Advisory Council Meetings to your June calendar! Make your reservations early by calling Maria Cobb @ 866-475-3129 ext. 26824 or email mcobb@centene.com. Lunch is provided so an RSVP is necessary.

MARICOPA – JUNE 10, 2013 ABIL 5025 E. Washington Street Phoenix, AZ 85034 11:30 am – 1:00 pm

PINAL/GILA – JUNE 12, 2013 Eva’s 2033 N. Pinal Ave. Casa Grande, AZ 85122 11:30 am – 1:00 pm

GRAHAM/GREENLEE/COCHISE – June 6, 2013 Fairfield Inn, 3855 El Mercado Loop Sierra Vista, AZ 85635 11:30 am – 1:00 pm

Changes to Your Claims Submission

mcobb — Wed, 01 May 2013 21:57:42 +0000

We have implemented new technology to improve the optical character recognition (OCR) of claims forms. Beginning April 1, 2013, we no longer accept handwritten red forms or black or copied claims forms. From now on, the only acceptable claim forms will be those printed in Flint OCR Red, J6983, (or exact match) ink.

Paper claims received by the plan are scanned using Optical Character Recognition (OCR) technology. This scanning technology allows for the data contents contained on the form to be read while the actual form fields, headings, and lines remain invisible to the scanner. Photocopies cannot be scanned and are no longer accepted.

Although a copy of the CMS-1500 and CMS-1450 form can be downloaded, copies of the form cannot be used for submission of claims, since a copy may not accurately replicate the scale and OCR color of the form. This change will improve quality and service, while also reducing cost and the potential for fraud and abuse. If you have any questions or concerns, please call us at (866)475-3129 and ask for “The Rep of The Day.” We are available to come to you and provide training so that you can use the EDI online system for claims. Our staff can be at your location within one business day of the request.

SKILLED NURSING FACILITIES – URGENT ALERT!

mcobb — Wed, 01 May 2013 21:38:25 +0000

Urgent Claims Notification for Skilled Nursing Facilities: Bridgeway has identified a payment issue with a small percentage of SNF claims that were processed on the check run for April 29, 2013 that has resulted in zero-dollar claim payments. Bridgeway has corrected the issue and is currently in the process of appropriately reprocessing the claims to pay at the correct amount. If you have any questions on this issue please contact the Bridgeway claims department at 1-866-475-3129. Thank you.

Emdeon Payer Code Change

mcobb — Wed, 24 Apr 2013 16:49:50 +0000

Please take note that the Bridgeway Payer ID Code for Emdeon has been changed. The new Payer Code is 68069.

Agency with Choice

mcobb — Thu, 18 Apr 2013 18:34:04 +0000

Agency with Choice is a new member-directed option that will be available to home-based ALTCS members beginning on January 1, 2013. Under the Agency with Choice option, the provider agency and the member enter into a co-employment relationship and share employer-based responsibilities for the paid caregiver. The provider agency maintains the authority to hire and fire the caregiver and provide or arrange for the required minimum standardized training for the caregiver. The member, or their individual representative, may choose to assume one or more of the following employer-based responsibilities:

Recruit and select caregivers, including specifying the qualifications of the caregiver over and above the standard qualifications required by AHCCCS
Dismiss caregivers
Manage caregivers, including determining duties and schedules
Supervise caregivers
Training caregivers, including identifying special training needs

Please click here to be directed to more information about the Agency of Choice collaboration and resources that pertain to it’s developement.

AZ Fall Prevention Coalition Survey

mcobb — Tue, 16 Apr 2013 22:01:14 +0000

The AZFPC Evaluation Committee would like to invite you to complete the attached survey. They are seeking to gather vital information from the older adults in our community regarding their awareness of falls as a health concern, behaviors related to fall prevention, and so forth. We would greatly appreciate your help so we can further work together to reduce fall risk and occurrence in the state of Arizona.

Announcing Collaboration between Bridgeway and Jackson White

mcobb — Wed, 10 Apr 2013 18:02:37 +0000

Jackson White is a reputable organization within Arizona that is committed to helping seniors and their family members prepare for and understand ALTCS. They provide online web tools as well as personalized one-on-one consultations at no cost to Arizonans in need. Bridgeway is now collaborating with Jackson White to assist in delivering information and helpful tools to seniors and people with disabilities who are seeking guidance in putting their affairs in order with advance directives, living wills, and various power of attorney documents.

For those interested in learning more about ALTCS, visit the MY ALTCS PAGE on the Jackson White website.

If you are interested in the many resource documents such as powers of attorney and living wills, visit the RESOURCE page on the Jackson White website.

Enhanced Rates for Primary Care Services

mcobb — Wed, 20 Mar 2013 17:42:56 +0000

Section 1202 of the Affordable Care Act requires that Medicaid reimburse designated primary care providers who provide primary care services and vaccine administration services at rates that are not less than the Medicare fee schedule in effect for 2013 and 2014, or, if greater, at the payment rates that would result from applying the 2009 Medicare physician fee schedule conversion factor to the 2013 or 2014 Medicare payment rates. These reimbursement requirements apply to dates of service between January 1, 2013 and December 31, 2014. To receive the enhanced payment, CMS requires that physicians meeting one of the required criteria provide a “self-attestation” to AHCCCS verifying that they qualify for the enhanced payment through either the requisite Board certification or the 60% CPT code requirement. This means that before AHCCCS or its Contractors can provide an enhanced payment, the physician must submit an Attestation form.

Physicians filing the required Attestation on or before April 30, 2013 will be paid the enhanced fee retroactively for dates of service from January 1, 2013 forward for all primary care eligible services. Physicians filing the required Attestation on or after May 1, 2013 will be paid the enhanced fee on a going forward basis from the time the successful Attestation is received.

The Primary Care Provider Attestation Form for AHCCCS registered providers is available on line. Prior to the completion of the form, please review the information in the memo carefully. Links to the memo, the Attestation page, and general information are provided below:

Primary Care Provider Enhanced Fee Attestation page

Primary Care Provider Enhanced Fee Attestation memo 2/19/13

http://www.azahcccs.gov/commercial/ProviderBilling/rates/PCSrates.aspx

New Transportation Vendor Effective April 1, 2013

mcobb — Wed, 13 Mar 2013 16:18:23 +0000

Bridgeway Health Solutions has a new transportation vendor!

Effective April 1, 2013 Total Transit will be our new transportation vendor for Bridgeway members.

To schedule non-emergent transportation the member or the member’s representative can continue to call Bridgeway’s Member Services Department (numbers are located on the right)

*NEW* you can call Total Transit directly at 1- 877-986-7420

If members have approval for ongoing transportation needs (like for dialysis) they will continue to receive transportation as scheduled.

If members want to check or change their transportation arrangements, the member can call Member Services or Total Transit.

There is no change in member transportation benefits.

If you have questions please call Member Services Department Monday through Friday 8:00AM to 5:00PM.

Thank you.

Bridgeway Health Solutions

Member Services Department