April 2005 Medicare Bulletin - Idaho Insert
Posted April 4, 2005
Download a PDF copy
of this issue 
Table of Contents
- Idaho HealthCare Conference 2005
- Idaho Health Professional Shortage Areas (HPSAs)
- Idaho Mental Health Professional Shortage Areas
- Idaho Policy Updates
TopIdaho HealthCare Conference 2005
Blue Cross of Idaho, CIGNA Government Services, Department of Health and Welfare/Medicaid, EDS, Idaho State Insurance fund, Regence Blue Shield of Idaho, and TriWest Healthcare Alliance invite you to attend their annual Idaho Health Care Conference.
To kick off our 12th annual conference, we are introducing a tropical theme.
The conference will include exhibitor fairs and be held in six locations. Participants are encouraged to visit with the exhibitors during breaks and at lunch. Registration is free for all Idaho health care providers. Multiple sessions will allow you to attend individual presentations by all participants, if you choose.
AGENDA
BOISE
Wednesday, May 4, 2005
8:00 a.m. to 4:15 p.m.
Boise Centre On-The-Grove, 850 Front Street, Boise, ID
Parking Map Located Inside
Please pre-register by: April 20, 2005
CLARKSTON, WA
Tuesday, May 10, 2005
8:00 a.m. to 4:15p.m.
Quality Inn, 700 Port Drive, Clarkston, WA
Please pre-register by: April 26, 2005
POST FALLS
Wednesday May 11, 2005
8:00 am. to 4:15 p.m.
Templins Resort, 414 E. First Avenue, Post Falls, ID
Please pre-register by: April 27, 2005
IDAHO FALLS
Tuesday, May 24, 2005
8:00 a.m. to 4:15 p.m.
Shilo Inn, 780 Lindsey Boulevard, Idaho Falls, ID
Please pre-register by: May 10, 2005
POCATELLO
Wednesday, May 25, 2005
8:00 a.m. to 4:15 p.m.
Idaho State University Pond Student Bldg. # 14, 1065 S. 8th St., Pocatello, ID
Please pre-register by: May 11, 2005
BURLEY
Thursday May 26, 2005
8:00 a.m. to 4:15 p.m.
Burley convention Center, 800 North Overland Avenue, Burley, ID
Please pre-register by: May 12, 2005
Registration starts at 8:00 a.m., classes begin at 8:30 a.m.
CONFERENCES
8:00 - 8:30 a.m. Registration
8:30 - 9:30 a.m.
Blue Cross of Idaho (Facility, Physician & Other HealthCare Provider Review)
CIGNA Government Services (2005 Medicare Updates)
Idaho State Insurance Fund (Workers’ Compensation)
EDS (Life of a Claim)
Regence Blue Shield of Idaho (EDI, HIPAA Transactions and Regence Online Services)
9:30 - 10:00 a.m. Break
10:00 - 11:00 a.m.
Blue Cross of Idaho www.bcidaho.com (ePlan, EDI and HIPAA)
CIGNA Government Services (2005 Overview of Medial Review)
EDS (Provider Resources)
Idaho State Insurance Fund (Workers’ Compensation)
Regence Blue Shield of Idaho (Provider Servcies)
11:00 - 11:30 a.m. Break
11:30 - 12:30 p.m.
Blue Cross of Idaho (Facility, Physician & Other Health Care Provider Review or True Blue ® - Medicare Advantage for locations in Boise, Post Falls, Pocatello and Burley)
CIGNA Government Services (2005 Medicare Updates)
DHW/Medicaid (Health Connections - 101)
EDS (Most Preventable Denials)
Regence BlueShield of Idaho (EDI, HIPAA Transactions and Regence Online Services)
12:30 - 1:45 p.m. Lunch (on your own)
1:45 - 2:45 p.m.
Blue Cross of Idaho www.bcidaho.com (ePlan, EDI and HIPAA)
CIGNA Government Services (Medicare Basics)
EDS (Life of a Claim)
DHW/Medicaid (Health Connections - Advanced Discussion)
TriWest Healthcare Alliance (TRICARE West Region Changes)
2:45 - 3:15 p.m. Break
3:15 - 4:15 p.m.
Blue Cross of Idaho (Facility, Physician & Other Health Care Provider Review)
Centers for Medicare & Medicaid Services (CMS)
(Overview of Medicare Prescription Drug, Most current Products, Q&A)
EDS (Most Preventable Denials)
Regence BlueShield of Idaho (Provider Services)
TriWest Healthcare Alliance (TRICARE West Region Changes)
Description of Payor Sessions
Blue Cross of Idaho
Facility, Physician & Other Health Care Provider Review
This session will address Blue Cross of Idaho billing requirements, procedures and policies, contracting reimbursement, and BlueCard®.
True Blue® - Medicare Advantage
This session will address True Blue-Medicare Advantage policies, procedures and benefit updates (this session only available in Boise, Post Falls, Pocatello, and Burley: 11:30 a.m. - 12:30p.m.)
www.bcidaho.com , eplan, EDI and HIPAA
This session will address Web site changes, ePlan capabilities, maximizing Blue Cross of Idaho’s EDI Clearinghouse,
and HIPAA status.
CIGNA Government Services
2005 Medicare Updates
Learn the latest news and regulations that may affect your business and gain knowledge of where to obtain current Medicare information, such as the CIGNA Government Services Web site and other resources. This class will be offered twice
during the day.
2005 Overview of Medical Review
This class will inform Idaho providers on the benefits and results of probe reviews conducted by CIGNA Government Services’s Medicare Review department and how the CERT process works.
Medicare Basics
If you are new to Medicare billing or just need a refresher course, this is the class you don’t want to miss! This class is an interactive session that will teach you how to complete a CMS 1500 form and what fields are required by Medicare (a sample CMS-1500 form will be provided.)
Centers for Medicare & Medicaid Services (CMS)
News from CMS
This workshop will give you an overview of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA). We will also show you the most current products offered by CMS and how to order them from our Web
site. Time will also be allotted for a Q&A session.
Department of Health and Welfare (DHW/Medicaid)
Healthy Connections - 101
This class will explain enrollment, referrals (Including 3-way), exemptions and billing issues.
Healthy Connections - Advanced Discussion
This is an open discussion on how to deal with difficult patients, how Healthy Connections can help you, and billing the Medicaid client time will be allotted for a Q&A session.
EDS
Life of a Claim
This class will explore the life cycle of a claim upon its arrival at EDS until it appears on your Idaho Medicaid Remittance Advice (RA).
Provider Resources
This session will cover the resources available to providers: Idaho Medicaid Provider Resources CD (PES), MedicAide Newsletter, Idaho Department of Health and Welfare Web site, Small Provider Billing Unit (SPBU), Provider Service Representative (PSR), Provider Relations Consultant (PRC), MAVIS and POS devices.
Most Preventable Denials
Review of denials that are easily prevented. Instruction will include tips that demonstrate how to avoid these denials.
Idaho State Insurance Fund
Workers’ Compensation
This educational class will provide the latest information on our imaging procedure for medical bills, records, NOI’s and more. Learn what documentation is required for your bill to easily flow through the process. Time will be allotted for Q&A session.
Regence Blueshield of Idaho
Provider Services
This session will focus on common billing issues. Other topics of discussion will include systems updates, product updates, physician and other health care professionals contracting issues, and the Regence Group. In order to assure that individual questions are answered, time will be allotted for a Q&A session.
EDI, HIPAA Transactions and Regence Online Services
Maximize HIPAA and the Web! In addition to electronic claims, we will discuss how you can utilize the 27 x transactions for eligibility, claims status, referrals and preauthorizations. We will provide HIPAA required updates on NIP, security and Medicare crossover/complementary claims for Regence Blueshield if Idaho. We will also review the advantages of using our Regence online system (ROS) for health care professionals, including new features and the ability to view, print and save your imaged paper vouchers online.
TRIWEST Healthcare Alliance
TRICARE West Region Changes
This session will focus on the new West Region changes, new claims processor and new authorization processes. Other topics of discussion will include claims processing and referrals and authorizations.
Parking Facility Information
- City Centre Garage: On the corner of 9th & Front streets, entrance on 9thStreet.
Hours 6:30 a.m. - 11:00 p.m. Monday through Friday. - Eastman Garage: Surrounded by 9th, Main, 8th and Idaho Streets-entrances on Main and Idaho Streets.
Hours: 6:30 a.m. - 10:00 p.m. Monday through Friday - Capitol Terrace Garage: Surrounded by 8th, Main, Capitol, and Idaho Streets-entrances on Main and Idaho Streets.
Hours: Open 24 hours a day. - Ninth Street Garage: (Limited Parking) Below the Wells Fargo Bank Center on the corner of 9th and Main Streets-entrance on 9th Street.
Hours 6:30 a.m. - 5:30 p.m. Monday through Friday - monthly parking and block customers only. (Wells Fargo Center and Grove Court Plaza) - Grove Street Garage: (Limited Daytime Parking) Behind the Statehouse Inn, on the corner of 10th and Front Streets-entrance on 10th Street.
Hours: 24-hour access and coin box system. Attendant available Monday through Friday from 6:30 a.m. -
6:30 p.m. - Boulevard Garage: (Limited Parking) Under the Grove Hotel, surrounded by Front Street, Capitol Boulevard and the Grove Plaza-entrance on Capitol (mid-block),
Hours: 6:30 a.m. - 2:30- a.m. Monday through Saturday.
Idaho Policy Updates
The Idaho LCD Draft Policies listed below are on the CIGNA Web site open for comment.
- Draft - Epidural Injections
- Draft - B12 Injection
- Draft - DoxorubicinHCI Liposome Injection
- Draft - Folic Acid, Serum
- Draft - Fundus Photography
- Draft - Nerve Blocks/paravertebral Nerve Blocks
- Draft - Paravertebral Facet Joint Nerve Block
- Draft - LCD Pelvic Echography
- Draft - Vitamin B-12 Cyanocobalamin Chemistry Test
- Draft - LCD Zoledronic Acid (Zometa)
Mental Health Professional Shortage Areas
Designated Geographic Areas
Effective July 1, 2004
Idaho
| County | Area Name/Parts | Rural/Urban |
| Ada | Mental Hlth Region IV Ada |
Rural |
| Adams | Catchment Area # 3 Adams |
Rural |
| Bannock | Mental Hlth Region VI Bannock |
Rural |
| Bear Lake | Mental Hlth Region VI Bear Lake |
Rural |
| Benewah | Mental Hlth Region I Benewah |
Urban |
| Bingham | Mental Hlth Region VI Bingham |
Rural |
| Blaine | Mental Hlth Region V Blaine |
Rural |
| Boise | Mental Hlth Region IV Boise |
Rural |
| Bonner | Mental Hlth Region I Bonner |
Urban |
| Bonneville | Mental Hlth Region VII Bonneville |
Rural |
| Boundary | Mental Hlth Region I Boundary |
Urban |
| Butte | Mental Hlth Region VII Butte |
Rural |
| Camas | Mental Hlth Region V Camas |
Rural |
| Canyon | Catchment Area # 3 Canyon |
Rural |
| Caribou | Mental Hlth Region VI Caribou |
Rural |
| Cassia | Mental Hlth Region V Cassia |
Rural |
| Clark | Mental Hlth Region VII Clark |
Rural |
| Clearwater | Mental Hlth Region II Clearwater |
Rural |
| Custer | Mental Hlth Region VII Custer |
Rural |
| Elmore | Mental Hlth Region IV Elmore |
Rural |
| Franklin | Mental Hlth Region VI Franklin |
Rural |
| Fremont | Mental Hlth Region VII Fremont |
Rural |
| Gem | Catchment Area # 3 Gem |
Rural |
| Gooding | Mental Hlth Region V Gooding |
Rural |
| Idaho | Mental Hlth Region II Idaho |
Rural |
| Jefferson | Mental Hlth Region VII Jefferson |
Rural |
| Jerome | Mental Hlth Region V Jerome |
Rural |
| Kootenai | Mental Hlth Region I Kootenai |
Urban |
| Latah | Mental Hlth Region II Latah |
Rural |
| Lemhi | Mental Hlth Region VII Lemhi |
Rural |
| Lewis | Mental Hlth Region II Lewis |
Rural |
| Lincoln | Mental Hlth Region V Lincoln |
Rural |
| Madison | Mental Hlth Region VII Madison |
Rural |
| Minidoka | Mental Hlth Region V Minidoka |
Rural |
| Nez Perce | Mental Hlth Region II Nez Perce |
Rural |
| Oneida | Mental Hlth REgion VI Oneida |
Rural |
| Owyhee | Catchment Area #3 Owyhee |
Rural |
| Payette | Catchment Area # 3 Payette |
Rural |
| Power | Mental Hlth Region VI Power |
Rural |
| Shoshone | Mental Hlth Region I Shoshone |
Urban |
| Teton | Mental Hlth Region VII Teton |
Rural |
| Twin Falls | Mental Hlth Region V Twin Falls |
Rural |
| Valley | Mental Hlth Region IV Valley |
Rural |
| Washington | Catchment Area # 3 Washington |
Rural |
Idaho Health Professional Shortage Areas (HPSAs)
Designated Geographic Areas
|
1Classified as HPSA, effective 3/1/02
2 No longer classified as HPSA, effective 3/1/02
3 No longer classified as HPSA, effective 9/1/03
4 Classified as HPSA, effective 9/1/03
5 Classified as HPSA, effective 5/1/04
