Latest news

Affirmant Health Partners October 2016 Newsletter

October 25, 2016

Please read the attached newsletter from Affirmant Health Partners, our state-wide clinically integrated network.  These newsletters will available monthly, and will serve to provide the most up to date information on our network.

Payor Conference Reference Tools

October 20, 2016

Thanks to all who spent the afternoon with us yesterday at the annual Lakeland Care Network Payor Conference. We hope it was a valuable day for you and your office or department.  Attached are presentations for your reference.

(Aetna's presentation and handouts will be attached in a separate news article as we are limited to 10 attachments per article.)

All Medicaid Plans Now Require Enrollment in CHAMPS

October 7, 2016

Meridian Health and McLaren Health Plan have also confirmed with Lakeland Care that physicans who see any Medicaid, or even simply refer Medicaid patients to Lakeland for any services, MUST ENROLL and ATTEST to their information within the CHAMPS System.  Please note that enrolling in CHAMPS does not require you to be a Medicaid FFS Provider.

Here's how you enroll in CHAMPS:

1.            Go to www.michigan.gov/mdhhs

2.            Click on “Doing Business with MDHHS” Icon (top of page)

Clarification on ASR Letter Regarding HAP

October 7, 2016

The letters from ASR that were sent to all of the Lakeland Care Network physicians, were sent in error.  Unfortunately, it’s created confusion, so here's a little clarity on the whole thing.

HAP is a network in the Detroit area and is expanding in the east and into northern Michigan. HAP bought ASR about 5 years ago and they are currently marketing their expansion into Northern Michigan. These letters were intended for the physicians in the eastern and northern Michigan expansion areas.

Payors Exiting Exchange/Marketplace for 2017

September 18, 2016

United Healthcare has announced that they will no longer be participating in the individual insurance marketplace for 2017 for both Michigan and Indiana, as well as 24 other states.  This will leave only Blue Cross Blue Shield and Priority Heath as options for Michigan residents looking to sign up for insurance on the exchange.  For Indiana residents, PHP of Northern Indiana has also opted to exit the Indiana individual marketplace as well as its Individual Product line for 2017.

UHC Community Plan Requires CHAMPS Enrollment

September 16, 2016

In case you haven't heard, UnitedHealthcare Community Plan (Medicaid) is now requiring all new providers to be enrolled in CHAMPS, due to State policy changes. They warn that failure to enroll could cause unnecessary delays in payment. This applies to both rendering and ordering/referring providers that are servicing Medicaid members.  As they receive rosters from Lakeland Care, they will validate each new provider to ensure they are enrolled in CHAMPS.  If the provider is not found in CHAMPS, Lakeland Care will notify your office.

New Presurgery Planning Clinic - Informational Breakfast Meeting

September 16, 2016

There will be an information session and breakfast for the Office/Practice managers, nurses, and staff of any surgery offices in Niles, Watervliet, and St. Joseph regarding the new surgical optimization clinic called "Presurgery Planning."  The presentation will be on Thursday, September 22, from 0700 - 0800 in the Upton Conference room 5 (SJ) and will be videoconferenced to the the Small Dining Room in Niles. Breakfast will be served in both locations.

LMOA 2016-17 Season Begins Soon

August 10, 2016

Here's a sneak peek at the first program that the Lakeland Medical Office Association will bring to you for our 2016-2017 season!

Come and learn from Medicare what they want in your documentation, because we all know if the documentation isn't there, you can risk losing a lot of money.

We encourage you to bring your physician(s) for this presentation, so block their calendars—and yours—and we'll see you at our season kickoff meeting on Wednesday, September 28th!

Cigna Network News July 2016

August 3, 2016

Cigna's  newest edition of Network News for July 2016 includes these topics:

A New Look. Better Service at CignaforHCP.com on page 3

Introducing the new Care Allies on page 7

Cigna ranks #1 on 2016 PayerView Report  on page 8

Taking action to fight the opioid epidemic on page 19

These highlights and more are found in the attached newsletter.

Priority Health - Adding NDC Codes to Claims

August 1, 2016

As of October 1, Priority Health will require the inclusion of National Drug Codes (NDC) on claims for services that include drugs. This aligns Priority Health’s billing requirements with many national payers.

Claims submitted on or after Oct. 1, 2016 without the NDC codes will be rejected. This applies to all Priority Health plans, and applies to all drugs on the claim (even if the drug is not a covered benefit).

More information:

Quality and Care Management: Speak for Yourself - Plan Your Care

July 20, 2016

“Speak for Yourself - Plan Your Care” is an advance care planning initiative through, Lakeland Health, Caring Circle, and the Southwestern Michigan Community. It involves a systematic approach to advance care planning. We are encouraging people, at any age, to have a designated decision maker, and identify their end-of-life wishes. The focus of the “Speak for Yourself - Plan Your Care” pilot is to have meaningful discussions with patients who are seriously ill and frail. Certified facilitators are located within the following pilot sites:

AM BEST RATING UPGRADE

June 2, 2016

AM Best recently upgraded MPIE’s financial strength rating from to B++ stable (Good) to A- (Excellent) positive. The rating actions reflect MPIE’s strong risk-adjusted capitalization, historically profitable operating results, stable loss reserving trends and its expertise in Michigan’s medical professional liability market. Additionally, supportive rating factors include an expansion of MPIE’s enterprise risk management programs and underwriting performance that compares favorably with its peer companies.

New Group for Heritage Consultants

April 26, 2016

Lakeland Care has added a new employer group, Kruger Plastics Products, as an employer direct contract who uses Heritage Consultants as their payor.  Kruger Plastics employees’ access to the Lakeland Care Network began January 1, 2016.  Please verify they are presenting their new ID card showing Heritage Consultants, since this group has used United Health Care and Preferred Benefit Administrators over the past couple of years.

Allergy Relief for Seasonal Sufferers: Lifestyle interventions and medications to manage allergies

April 6, 2016

It's that time of year when allergy sufferers start to experience increased sneezing, a runny nose, itchy eyes, or a scratchy throat, due to high grass and tree pollen counts. Seasonal allergies, also sometimes called "hay fever," affect millions of people each year. Symptoms can be minor, or they can be more disruptive such as chronic sinus infections, or breathing difficulty associated with asthma.

If you suffer from seasonal allergies, lifestyle interventions and medications can provide relief. Here's what you need to know about living with seasonal allergies.

 

Niles Community Schools Changes Payor

February 29, 2016

As of 12/1/15, Niles Community Schools has changed their insurance payor. The school system has switched from Preferred Benefit Administrators to BCBS. Please check for new ID cards from your patients.

On the Job, What You Eat Affects How You Work

February 8, 2016

Why should you think twice before opting for a lunchtime cheeseburger?

What you eat can significantly affect your work performance, but we rarely give our digestive decisions any thought, consultant Ron Friedman writes in the Harvard Business Review.

Many of us intuitively know that high-carb meals can lead to a "sugar high" (and then crash), and that high-fat diets can cause us to become tired quickly after eating. But Friedman notes that we do not always make smart decisions when it comes to how we refuel our bodies at lunch.

LMOA February Luncheon Invitation

February 3, 2016

The Lakeland Medical Office Association (LMOA) invites you to attend our February luncheon and meeting.

PROGRAM:         How to Measure Success

We all want measures. We all want to make data-informed decisions and grow our organization.  But, how do we measure success?  How do we know where to start?  We should start at the beginning.  Mission, Vision and Values define our organization and how we measure success.

Secure Health Care Messaging App Available

January 29, 2016

TigerText is widely used as a secure health care messaging app which allows users to safely exchange non-emergent PHI with colleagues.  TigerText messages are encryped and set to self-destruct after a preset period of time, which ensures maximum corporate data security.  The app also complies with HIPAA, SOX, and other regulations.  Visit the app store on your mobile device to download. For questions, contact the help desk at Lakeland.

After Hour Surgery Reminder

January 29, 2016

 For ALL after-hour surgeries, please us the dedicated surgery line to call in a surgery team.

  • Calling from outside Lakeland, dial (269) 982-2566
  • Calling from in-house, dial extension 2566

By using this dedicated line, you bypass the automated greeting and avoid being placed in a queue where your call is answered in the order it was received.   The dedicated surgery line is answered immediately by an operator who will assist you by calling in the surgery on-call team.