2006-02 ID Insert

March 2006 Medicare Bulletin - Idaho Insert

Posted March 3, 2006

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13th Annual Idaho Health Care Conference 2006
Echography, Retroperitoneal LCD - Revision
Idaho Health Professional Shortage Areas (HPSAs)
Idaho Mental Health Professional Shortage Areas

Echography, Retroperitoneal LCD - Revision

The LCD for Echography, retroperitoneal has been revised for Idaho. 250.40-250.43 have been added to the policy for ICD-9's that support medical necessity. To view the policy in its entirety, please refer to the LCD for your specific state.

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13th Annual Idaho Health Care Conference 2006

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.

Be one of the ‘lucky' ones to attend our 13th annual conference. The theme for the 2006 conference is ‘CASINO'.

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 3, 2006 from 8 a.m. to 4:15 p.m.
Boise State University, 1910 University Drive, Boise ID
Parking Map Located Inside
Please pre-register by: April 19, 2006

CLARKSTON, WA
Tuesday, May 9, 2006 from 8 a.m. to 4:15 p.m.
Quality Inn, 700 Port Drive, Clarkston WA
Please pre-register by: April 25, 2006

COEUR D' ALENE
Wednesday, May 10, 2006 from 8 a.m. to 4:15 p.m.
Coeur d'Alene Casino, U.S. Highway 95, Worley, ID
Map Located Inside
Please pre-register by: April 26, 2006

IDAHO FALLS
Tuesday, May 23, 2006 from 8 a.m. to 4:15 p.m.
Shilo Inn, 780 Lindsey Boulevard, Idaho Falls, ID
Please pre-register by: May 9, 2006

POCATELLO
Wednesday, May 24, 2006 from 8 a.m. to 4:15 p.m.
Holiday Inn, 1399 Bench Road, Pocatello, ID
Please pre-register by: May 10, 2006

TWINS FALLS
Thursday May 25, 2006 from 8 a.m. to 4:15 p.m.
Red Lion Inn, 1357 Twin Lakes Road, Twin Falls, ID
Please pre-register by: May 11, 2006

Registration starts at 8 a.m., classes begin at 8:30 a.m.

Conference Agenda

8 - 8:30 a.m.	Registration
8:30 - 9:30 a.m.	Blue Cross of Idaho (Facility, Physician & Other Health Care Provider Review) CIGNA Government Services (2006 Medicare Part B Updates) Idaho State Insurance Fund (Workers' Compensation) EDS (Medicaid Billing Tips) Regence BlueShield of Idaho (EDI, HIPAA Transactions and Regence Online Services)
9:30 - 10 a.m.	Break
10 - 11:00 a.m.	Blue Cross of Idaho (www.bcidaho. com, New DOC System, & BlueCard® Eligibility) CIGNA Government Services (Comprehensive Error Rate Testing) EDS (Provider Forum) Idaho State Insurance Fund (Workers' Compensation) Regence BlueShield of Idaho (Provider Services)
12:30 - 1:45 p.m.	Lunch (on your own)
1:45 - 2:45 p.m.	Blue Cross of Idaho (Contracting/ Credentialing 101) CIGNA Goverment Services (Medicare Basics) EDS (Medicaid Billing Tips) DHW/Medicaid (Healthy Connections Basics for New Medicaid Provider's Office Staff) TriWest Healthcare Alliance (TRICARE Updates)
2:45 - 3:15 p.m.	Break
3:15 - 4:15 p.m.	Blue Cross of Idaho (Electronic Data Interchange (EDI) 101) EDS (Provider Electronic Solutions (PES)) Regence BlueShield of Idaho (Provider Services) TriWest Healthcare Alliance (TRICARE West Region Changes)

Description of Payer Sessions

Blue Cross of Idaho

Contracting/Credentialing 101
This class will explain contract rate development, effective dates, annual updates and amendments, requirements for Traditional, PPO, Medicare Advantage and Commercial Managed Care contracts and credentialing criteria for all provider types.

Electronic Data Interchange (EDI) 101
Learn the latest on the EDI clearinghouse information, 835 electronic remits, electronic payments and NationalProvider Indicator (NPI) update.

Facility, Physician & Other Health Care Provider Review
This session will address Blue Cross of Idaho billing requirements, procedures and policies, reimbursement, andBlueCard®.

Medicare AdvantageSM-True Blue® and Secure BlueSM
This session will address True Blue and Secure Blue policies, procedures, and benefit updates including
Part D.

www.bcidaho.com, New DOC System, & BlueCard Eligibility®
This session will address Web site changes, online registration, BlueCard Eligibility, Point-of Service-Managed Care allowances for physicians, and Direct Online Connection (DOC) system capabilities.

CIGNA Government Services

2006 Medicare Part B Updates
Learn about the latest news and regulations that may affect your business and where to obtain current Medicareinformation, such as the CIGNA Government Services Web site and other resources. This class will be offered twice during the day.

Comprehensive Error Rate Testing (CERT)
This class will inform Idaho providers how the CERT process works and the importance of responding to the CERT contractor - AdvanceMed.

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).

Department of Health and Welfare (DHW/Medicaid) Healthy Connections Basics for New Medicaid Provider's Office Staff
This class will explain enrollment, referrals (including 3-way) and other hot issues that can help you coordinate your patients' care and billing needs.

Department of Health and Welfare (DHW/Medicaid) cont.

What You Should Know About Medicaid:

Durable Medical Equipment (DME) - basic and urgent prior authorizations
Required documentation for the top 10 DME requests
Complex case management process
Emergency department over-utilization

EDS

Medicaid Billing Tips
This session will cover Medicaid billing tips such as multiple procedures, Medical Necessity Form, use of attachments, modifiers, critical care admits, timely filing, National Provider Identifier (NPI), and much more.

Provider Electronic Solutions (PES)
This session will give you an overview of the features available on the Idaho Medicaid Provider CD. Learn how to use the free PES software, from installation and setup process, to creating lists, completing and submitting the 837 professional claim form, billing Medicaid as a secondary insurance, and submitting an adjustment request.

Provider Forum

Panel discussion with select Medicaid providers discussing current billing concerns, billing issues, and solutions.

Idaho State Insurance Fund

Workers' Compensation
This educational class will provide the latest information on our medical review process. 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

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 27xtransactions for eligibility, claims status, referrals and prior authorizations. Why do one-at-a-time transactions when you can send tens, hundreds, or thousands at a time and receive responses with equal speed? We will provide HIPAA-required updates on NPI, security and Medicare crossover/complementary claims for Regence BlueShield of 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. Additionally, electronic attachments will be discussed and when they will be accepted by the industry.

Provider Services
This session will focus on physician and other healthcare professional contracting issues, credentialing criteria, and contract effective dates. Other topics include MedAdvantage and Regence Select product updates.

TriWest Healthcare Alliance

TRICARE West Region Changes
This session will focus on TRICARE updates. Other topics will include Post Traumatic Stress Disorder (PTSD)

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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

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Idaho Health Professional Shortage Areas (HPSAs)

Designated Geographic Areas

COUNTY	AREA NAME/PARTS
Adams	All
Bannock	South Bannock Division South Bannock Division
Bear Lake¹	Caribou/Georgetown Georgetown Division
Blaine	Carey Carey (CCD)
Boise	All
Bonner⁶	Priest River Blanchard-Glengary (CCD) Priest River (CCD)
Bonneville	Swan Valley Division SA Swan Valley Division
Boundary	All
Butte²	Arco/Mackay
Camas	All
Carey ⁷	Baline Carey CCD
Caribou¹	Caribou/Georgetown SA Caribou

Clark	All
Clearwater¹¹	Clearwater SA C.T. 9701.00 Elk River Elk River Division
Custer¹	Stanley Stanley/Challis SA Stanley (CCD) Challis Challis (CCD)
Elmore	All
Franklin	All
Fremont	All

Gooding³	All
Idaho	Riggins SA Riggins Division Elk City SA Elk City Division
Jefferson⁵	C.T. 9601.00
Jerome⁴	All

Lemhi⁸	All
Lewis	Winchester /Nez Perce/Craigmont Lewis CT 9502.00 CT 9503.00
Lincoln	All

Oneida³	All
Owyhee	All
Payette	All

Teton	All
Washington	All

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
⁶No longer classified as a HPSA, effective April 12, 2005
⁷ Classified as a HPSA, effective November 30, 2004
⁸No longer classified as a HPSA, effective January 7, 2005
⁹ Classified as a HPSA, effective September 8, 2005

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