News

While many worried that the U.S. transition to ICD-10 was going to be the coding world’s equivalent to the apocalypse, I am happy to report that the transition has been about as “apocalyptic” as the Y2K panic was back in 2000.

Are you looking for some help with the conversion of ICD-9 to ICD-10 codes and vice versa? 
The American Association of Professional Coders (AAPC), the nation's largest medical coding training and certification association for medical coders, has created this link to help you.  

ICD-10 will affect diagnosis and inpatient procedure coding for everyone covered by the Health Insurance Portability and Accountability Act (HIPAA), not just those who submit Medicare or Medicaid claims.  Health care providers, payers, clearinghouses, and billing services must be prepared to comply with the transition to ICD-10 by October 1, 2015.Lakeland has been preparing for the October 1, 2015 deadline and we are confident that this will be a smooth transition.  All orders submitted to Lakeland for processing wil

Effective 8/15/15, Commercial Travelers will be the new claims payor for any Andrews University student that has the school-sponsored student insurance.  The previous payor, ASRM, will process claims with dates of service up to and including 8/14/15.  Only a handful of ID cards have been printed since Commercial Travelers is waiting for the final download of participating students from Andrews.  Until then, here is some information to help you to provide care and send in claims for those students:

The Lakeland Care Contracting Committee announced this week that, despite rumors to the contrary, the Lakeland Care network will continue to contract with United HealthCare for their COMMUNITY PLAN Medicaid product.  There has been no interruption in this contract and those patients who have Community Plan will be able to continue to see those Lakeland Care providers that have chosen to accept this plan.  

Priority Health, Humana, Blue Cross Blue Shield of Michigan, United HealthCare and Health Alliance Plan (HAP) have combined resources as a consortium of payers offering ICD-10 information to the provider community. Their goal is to show that transitioning to ICD-10 does not have to be overly costly or burdensome. They will use one voice and work together to aid physicians and other health care providers in the transition to ICD-10.

The Payers Collaboration is planning a series of hour-long webinars by specialty on Thursdays at noon Eastern time.

President Obama made the ICD-10 delay official on April 1, 2014. ICD-10 implementation was scheduled to take place October 1, 2014, however that date has been delayed for at least one year. CMS has yet to make an official statement on the issue.

Stay tuned to lakelandcare.com for updates.

Michigan will be expanding the Medicaid program in 2014. The new program, called the Healthy Michigan Plan, is part of the Affordable Care Act and will extend health care benefits to over 320,000 Michigan residents this spring.

The Berrien Health Plan estimates that 100% of their current Plan A members and 90% of the Plan B members will be eligible for the new Healthy Michigan Plan.

Lakeland Care has signed a contract with Cigna effective January 1, 2014. This PHO agreement includes both the Lakeland HealthCare system facilities as well as all of the Lakeland Care physicians. If your office currently holds a contract with Cigna, this new PHO contract will automatically super cede your existing contract.

On Wednesday, December 18, 2013, Lakeland Care is hosting a breakfast meeting at the Vineland Center from 8:00 – 10:00 a.m. for practice managers and staff to attend a presentation by Cigna on this new contract.

Effective 8/15/12, the Andrews University Student Insurance Plan that used to be through Bollinger has changed. Currently, their plan is being underwritten by American Fidelity Assurance Company and their claims administrator is John T. Riley Insurance Agency, PO Box 356, West Boylston, MA  01583.

For online claims and EOB information, please visit www.johntriley.com.

Those MI-HIP patients who have rolled over to the new federal Pre-existing Condition Insurance Plan, have a new address for their claims.

When you click on the link below, look down toward the middle of the page for "Schedule". Here they have posted their April - June schedule as well as their August - October schedule.

http://www.helendevoschildrens.org/lakeland

Please note that Pediatric Neurology is currently not able to rotate through the St. Joseph clinic. They are in the process of recruiting another physician.  Once they are fully staffed, they will again be able to have office hours in the St. Joseph clinic.

You can receive Marty's weekly VISION emails simply by contacting him and asking to be put on his "weeklies" list. Also, you could join his LinkedIN group and see the weeklies that way also. His most recent 'weekly' is below.

Easy is NOT equal to Simple

“I have never in my life envied a human being who led an easy life. I have envied a great many people who led difficult lives and led them well.” ― Theodore Roosevelt

OK, it’s time to remind you that there isn’t any easy way to do the right things, the right way. When you come to the fork in the road and one sign says EASY and the other says HARD. Rarely is the EASY path the right one. It’s just the way it is. Sorry.

Their new ID cards for 2013 were inadvertantly printed with an "LCI" rather than the full rectangular Lakeland Care logo.  Our logo, as you are aware, indicates that you, as participating Lakeland Care physician offices, participate with the patient's insurance and would be considered IN NETWORK for claims processing.

So, in summary, you are a participating physician for Vail Rubber employees, even if the ID card they bring in shows "LCI".  They will have the corrected cards shortly.

If you have any questions, please feel free to call Monica Roney at 269-927-5207.

The Lakeland Care PHO expects to have the contract with CIGNA completed by the end of March or early April.  The contract that the committee is working on would, for the first time, include the physicians along with the hospital.  

If the proposed Lakeland Care PHO contract is accepted, the new contract would supercede any existing contracts that our physicians may currently hold with CIGNA.

Reimbursement Advocate Alert for November 15, 2012 from the Michigan State Medical Society

Announcing Lakeland Care COMET — Continuing Online Medical Education and Training. Your online source for obtaining CME credit and tracking your CME credits.

Physicians have access to videos from the 2012 Weekly CME Program and lectures from Graduate Medical Education. New videos are added weekly. Physicians have received a personalized email from “admin@lakelandcare.com” with instructions on how to access COMET and set their password.

For claim payments from United Health Care, please be advised that this new contract's fee schedule is based off of the 2010 Medicare base rates, so they may not match the 2011 base rates used for the current Lakeland Care fee schedule.

For claim payments from Priority Health, please be advised that this new contract's fee schedule is based off of the current year Medicare base rate, per the contract language.  This means their fees are based on the 2012 rates.

Please be advised that as a participating Lakeland Care provider, you DO participate with this insurance, through our agreement with Cofinity.

The ID card will show MiHIP, the Cofinity logo, but no Lakeland Care logo.  You ARE PARTICIPATING and will be paid at the Lakeland Care fee schedule when you care for MiHIP patients.

 The plan is administered by PHP of Lansing.