All San Juan IPA Members: 4th Quarter Round Table Meeting
San Juan IPA will be hosting our 4th quarter “Round Table” meeting on Wednesday November 20, 2019 at 12:00pm-1:00pm at the Farmington Civic Center.
This meeting is for all Members, Office Managers/Administrators and Billers and any other staff you believe may benefit.
Lunch will be provided and we want to be sure to have plenty of food, please RSVP with Heather DeLaBarcena (heatherd@sanjuanipa.com) or Margie LaRue (margie@sanjuanipa.com).
If you are unable to attend in person you are welcome to join remotely. For access information please email Heather or Margie.
Topic:
Blue Cross Blue Shield of New Mexico will be presenting on 2020 HEDIS Measures, Medicare and Medicaid changes and updates presented by Chris Resnick.
All San Juan IPA Members: We’re Counting Down to 2020!
San Juan IPA is seeing lots of things on the horizon as we barrel towards 2020. In an effort to keep our members informed, take a peek at what we have below!
CMS
CMS has released its 2020 Physician Fee Schedule (PFS), along with several new rules around E&M coding, new codes for telehealth, and documentation standards. The new conversion factor (CF) for Medicare is $36.09, a $.05 increase from 2019, but E&M codes look to have several changes for 2020 and 2021. Take a look at the CMS.gov fact sheet for more information:
Home Health
Not to be outdone, home health agencies are also facing significant changes in 2020. If you’re a home health agency or refer frequently to those agencies, these new rules will definitely affect you. Our thanks to San Juan IPA member Basin Home Health for alerting us to these changes and helping us get the information out!
Effective January 1, 2020, agencies will be requesting some different information from you. Changes include:
Principal Diagnosis for Home Health Services:
-
Much like the changes to ICD-10, there are now 432 more specific payment groupings for patient care; the new CMS diagnosis list is available atwww.basin.health/DXs for your convenience.
Payment Periods:
- 60-day episode will be divided into two 30-day payment periods, so reporting may be requested of you at 30 days
Comorbidity Diagnosis:
- Secondary diagnoses are to be reported if they may affect care; agency may request supporting documentation from you at start-of-care and other milestones.
Again, if you frequently refer patients to home health, we encourage you to contact any agency for additional information!
New Local Services
As many of you know, the payer community is requiring that providers send lab tests to their approved labs for processing. In the San Juan County area that has been a challenge since these labs didn’t provide draw or courier services, making compliance much harder. However, TriCore has now opened a new draw site in SJC at 1001 Broadway Avenue, Farmington, and as of December 1st is accepting all insurance plans for your patient’s convenience.
Casey Crotty
Chief Executive Officer
San Juan IPA and Affiliates
