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INSIDE THIS ISSUE: On the Web with Kaiser Permanente 3 Do Your Kaiser Permanente Members Know Where to Seek Care After Hours? 3 Our Goal is Complete Care 4 Kaiser Permanente of Ohio Sponsors Weekly Farmer’s Market at 9th Street Pier 5 Claims Corner 6 Improving Self-Pay at All Points of Service 8 Healthy Living Classes 9 Flu Facts – Giving Our Best Shot 9 Clinical Practice Guidelines 10 Keep Us Informed of Changes in Your Practice 11 Correction 11 PROVIDER CONNECTION + Produced by Kaiser Foundation Health Plan of Ohio FOR NETWORK PROVIDERS OF KAISER PERMANENTE providerskporg/oh ISSUE 2 | 2011 STATE-OF-THE-ART PATIENT SIMULATORS SAVE LIVES The next time you visit the Simulation Laboratory at the Kaiser Permanente Parma Medical Center, don’t be alarmed if you see what looks like a baby that’s bleeding It’s not the villain from the Child’s Play movies – it’s SimBaby – a lifelike patient simulator The new Simulation Lab houses six state-of-the-art patient simulators ranging in ‘age’ from a newborn to an adult These simulators are computer-supported and have audio and visual capabilities – they can talk, breathe, bleed, sweat, move, and even blink The lab has an emergency room and exam room equipped with cameras that can be monitored by a two-way mirror in the control room Simulations are broadcast real-time to a classroom located in the lab, and recorded for viewing and learning opportunities after the simulations have been completed “Over the course of the year, clinicians from all of our facilities will utilize this laboratory to expand and enhance their clinical skills,” says Brenda Peralta, Regional Lead – Nursing Education and Competency Kaiser Permanente’s Simulation Lab has been specially designed to create an environment that optimizes learning The lighting and color scheme create a warm, welcoming atmosphere, and the classroom has lockers for employees to store their belongings to reduce clutter in the room and emphasize a distraction-free space (continued on page 2) Y0705_Provider Connection Summer 2011.indd 1 8/17/2011 10:18:51 AM

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Page 1: PROVIDER+ CONNECTION - Kaiser Permanente

INSIDE THIS ISSUE: On the Web with Kaiser Permanente . . . . . . . . . . . . . . . 3

Do Your Kaiser Permanente Members Know Where to Seek Care After Hours? . . . . . . . . . . . . . . . . . . 3

Our Goal is Complete Care . . . . . . . . . . . . . . . . . . . . . . . 4

Kaiser Permanente of Ohio Sponsors Weekly Farmer’s Market at 9th Street Pier . . . . . . . . . . . . . . . . . . 5

Claims Corner . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6

Improving Self-Pay at All Points of Service . . . . . . . . . . 8

Healthy Living Classes . . . . . . . . . . . . . . . . . . . . . . . . . . . 9

Flu Facts – Giving Our Best Shot . . . . . . . . . . . . . . . . . . . 9

Clinical Practice Guidelines . . . . . . . . . . . . . . . . . . . . . . 10

Keep Us Informed of Changes in Your Practice . . . . . . 11

Correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 11

PROVIDER CONNECTION+Produced by Kaiser Foundation Health Plan of Ohio

FOR NETWORK PROVIDERS OF KAISER PERMANENTEproviders .kp .org/oh

ISSUE 2 | 2011

STATE-OF-THE-ART PATIENT SIMULATORS

SAVE LIVESThe next time you visit the Simulation Laboratory at the Kaiser Permanente Parma Medical Center, don’t be alarmed if you see what looks like a baby that’s bleeding . It’s not the villain from the Child’s Play movies – it’s SimBaby – a lifelike patient simulator .

The new Simulation Lab houses six state-of-the-art patient simulators ranging in ‘age’ from a newborn to an adult . These simulators are computer-supported and have audio and visual capabilities – they can talk, breathe, bleed, sweat, move, and even blink .

The lab has an emergency room and exam room equipped with cameras that can be monitored by a two-way mirror in the control room . Simulations are broadcast real-time to a classroom located in the lab, and recorded for viewing

and learning opportunities after the simulations have been completed .

“Over the course of the year, clinicians from all of our facilities will utilize this laboratory to expand and enhance their clinical skills,” says Brenda Peralta, Regional Lead – Nursing Education and Competency .

Kaiser Permanente’s Simulation Lab has been specially designed to create an environment that optimizes learning . The lighting and color scheme create a warm, welcoming atmosphere, and the classroom has lockers for employees to store their belongings to reduce clutter in the room and emphasize a distraction-free space .

(continued on page 2)

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PROVIDER CONNECTION+

“What we’ve done is create a safe environment where learning can take place and mistakes can be made without any harm to a patient,” Peralta says .

The Learning Solutions Team at Kaiser Permanente created mock patients in KP Health Connect that are used during training sessions to create an even more realistic simulation .

What really makes the simulations realistic is how the mannequins respond to treatment . If teams take the right steps, the patient improves . Take the wrong action, and the condition worsens .

After the simulation has been completed, participants return to the classroom to watch the simulation and discuss what went right, what went wrong, and what they can do to improve in the future .

“During simulation training, we’re not just looking to improve clinical skills,” Peralta says .

“We focus on communication skills and human factors

training . We may also identify equipment needs for a typical exam room setup or ways to improve the placement of instruments in the rooms .”

Simulation training gives clinicians an opportunity to expand and enhance their clinical skills in a realistic environment and prepare for emergencies they may not see every day .

Actual medical equipment adds to the realism . Trainees use expired syringes and other equipment, and utilize old exam tables . All of the supplies in the Simulation Lab are expired or recycled, resulting in a significant cost saving .

“We’ve found that people who have completed simulation training found it extremely helpful,” Peralta says .

“The simulators make things so real that you almost forget they’re not a real patient . Simulation training is so important to a health care setting . As a result of past simulations, we’ve already made process changes that saved members’ lives .”

State-of-the-Art Patient Simulators Save Lives (continued from page 1)

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3

At Kaiser Permanente we are committed to providing our members with the right care, at the right time, in the right place . If a Kaiser Permanente member has a medical concern, such as where to seek care after hours, all they need to do is call us . A member of our trained staff will assess their call and help the member seek the most appropriate treatment .

All of this is available at their fingertips, 24 hours a day, by calling the Member Service Center toll free at 1-800-524-7377 or 1-877-398-3187 (TTY/TDD) .

Some of the treatment options include:• Nurse advice• Physician advice• A same day appointment with a Kaiser Permanente doctor• An urgent care visit• An emergency department visit• A scheduled physician telephone visit

This service can help your Kaiser Permanente members save time and money by avoiding unnecessary trips to Urgent Care or the Emergency Department .

DO YOUR KAISER PERMANENTE MEMBERS KNOW WHERE TO SEEK CARE AFTER HOURS?

ON THE WEB WITH KAISER PERMANENTE

KP Online–Affiliate is our interactive program that can be used to access the following information for your Kaiser Permanente members:

• Review patient demographics• Verify insurance coverage• View benefit information• View a patient’s clinical information (Kaiser Permanente

records only)• Review and request patient referrals• Communicate with Kaiser Permanente clinicians and

administrative departments .

To sign up for Online-Affiliate, you will need to complete both the User Enrollment Form and the License and User Agreement Form . You can download the forms on the Community Provider Web site at http://providers.kp.org/oh/viewforms.html .

Once completed, simply fax the forms to our Online-

Affiliate coordinator for processing at 216-479-5550 . A welcome packet will be sent to you with your personal User ID, account activation materials, and instructions on how to use the program .

ARE YOU ALREADY USING ONLINE-AFFILIATE?

Please remember to sign onto Online-Affiliate at least once a month . Inactive accounts are monitored and will be suspended . If you cannot sign on and have previously activated your account, call 1-866-331-2089 for a password reset .

HELP AND CONTACT INFORMATION• For technical assistance, please contact our Help Desk

at 1-866-331-2089 . If it is after regular business hours, please identify yourself as a Provider/Affiliate calling from Ohio for assistance with KP Online-Affiliate .

• If you forget your password, you can reset your password by completing the steps in “Forgot Password .”

• Click the “User Tools” menu option for browser information, training materials, and general support tips .

• On-site assistance is available upon request . Please contact your Network Associate .

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Complete Care is available to all of our members, including those who receive care from our community network providers . Our Complete Care program is directed towards the following chronic conditions:

• Asthma• Coronary Artery Disease• Depression• Diabetes• Heart Failure• Hypertension

The program provides members diagnosed with these chronic diseases a wider variety of self-management and provider-directed care options . It engages patients to better manage their health by reinforcing the care plan that’s been established by the physician and the patient . As a result, patients can work more effectively with their doctors .

At the heart of our Complete Care program is the highly respected Care Management Institute (CMI) . Created in 1997 to improve the quality of care and health outcomes for our members, it is one of the first organizations in the United States to earn disease management certification in the category of “program design” by the NCQA . CMI developed clinical practice guidelines based on our own Kaiser Permanente research and clinical experience, and data received from research centers worldwide . By following these guidelines, our physicians are able to provide our members with care that is innovative, population-based, and personalized .

You can find our care management clinical guidelines for chronic diseases in the “Provider Information” section of our community provider Web site at providers.kp.org/oh .

By utilizing CMI’s clinical practice guidelines, our Complete Care program takes a proactive approach for delivering care to our members with chronic conditions including:

• Member self-management resources - Educational materials, healthy living classes, health tools, total health assessments (THAs), and online healthy lifestyle programs .

• Physician support - Decision and care support including clinical practice guidelines, automated appointment reminders/prompts, and telephonic outreach to program members .

• Data analysis - Use of population-based information systems and innovative technology, including disease-specific registries and tracking systems, to monitor patient condition, adherence to treatment plans, co-morbidities and lifestyle issues (e .g . smoking and obesity) .

• Performance monitoring - Ongoing monitoring and reporting to measure clinical effectiveness and performance (e .g . clinical outcomes, HEDIS, patient engagement, process measures, and provider compliance to guidelines) .

Our Complete Care program is further defined in the Provider Manual . For questions regarding our programs or member access to our programs, please contact Sharon Zahtilla, Assistant Director of Risk Management and Population Care Management at 216-778-6089 .

Kaiser Permanente believes that disease management is an essential aspect of delivering quality care to our members . Effective disease management programs assure that chronic conditions and co-morbidities are addressed efficiently, while managing the total health of each member . Our Disease Management program is referred to as the Complete Care program .

OUR GOAL IS COMPLETE CARE

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ISSUE 2 | 2011

KAISER PERMANENTE SPONSORSWEEKLY FARMER’S MARKET AT 9TH STREET PIERWith its locally grown produce and a great location for downtown Cleveland office workers, the 2011 North Coast Harbor Farmer’s Market is underway—proudly sponsored by Kaiser Permanente Ohio . The market attracts employees, residents, and visitors in search of great food choices that promote agricultural awareness .

Located on the North Coast Harbor at the E . 9th Street Pier, it’s the perfect place to shop for groceries and enjoy a relaxing lakefront lunch . Eating healthy, nutritious food is part of Kaiser Permanente’s message to our members, and sponsorship of this market is a perfect fit .

“I enjoy cooking with fresh fruits and vegetables, and encourage my patients to do the same,” says Ronald Adams, MD, Regional Chief of Internal Medicine .

The market has been well-attended the past two years by thousands of downtown workers looking for healthy summer fare .

The Farmer’s Market and Lunch on the Lake takes place every Thursday from 11:30 a .m . to 2:30 p .m ., June 2 through September 8, 2011 .

Vendors include: • Noah Hershberger – Amish Farmer• Naturally Yours Farms – vegetables, herbs, seeds for eating,

seeds for birds, seeds for flour, and fresh cut flowers

• Dever Dairy – various cheeses, peanut butter, almond butter, butter, fresh eggs, honey

• Blaze Gourmet – salsas and hot sauces• Ragin’ Woody’s Treats – organic dog treats• Trubadore Coffee and the Biscotti Factory – mother and

son cookies and coffee team• Chirs’ Kitchen Stow – homemade jellies, jams, preserves• OH Baby Cakes Bakery – cupcakes and other baked goods• Stacey – a vegan chocolate vendor .

The vendor list is currently growing, and Kaiser Permanente is sponsoring several events at the market throughout the summer .

Kaiser Permanente is a national leader in the farmer’s market movement . In May 2003, a Kaiser Permanente physician, Preston Maring, MD, founded a farmers market at the Kaiser Permanente Oakland Medical Center . The community embraced the market, and now Kaiser Permanente operates and sponsors more than 35 farmers markets in six states .

Seasonal recipes, cooking tips and more can be found on the Kaiser Permanente web site at http://recipe.kaiser-permanente.org/about/.

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ELECTRONIC FUNDS TRANSFER PAYMENT REQUIRED FOR ELECTRONIC DATA INTERCHANGE (EDI) SUBMITTERSStarting October 16, 2010, the State of Ohio requires that Kaiser Permanente pay contracted providers electronically when claims are submitted electronically . If you are not set-up for Electronic Funds Transfer (EFT) payment, please complete and return the EFT provider set-up form . The EFT form can be found on the Kaiser Permanente Community Provider web site at providers.kp.org/oh . Select the Forms section Claims and Payment forms EDI EFT Authorization Agreement . You may also contact our Network Development department to obtain a form at 1-800-441-9742 option 1 .

Complete this document and mail a signed copy to our EDI Coordinator with the required attachments .

EDI Coordinator, Kaiser Permanente 14600 Detroit Avenue, 7th Floor Lakewood, OH 44107

ELECTRONIC REMITTANCE ADVICE (835 TRANSACTIONS):If you would also like to receive more detail about your EFT payments, please sign up to receive electronic remittance advice (835) transactions . The remittance advice request form can be found on the Kaiser Permanente Community Provider web site at providers.kp.org/oh . Select the Forms section Claims and Payment forms EDI Electronic Claims Remittance Set-up Form . You may also contact our Network Development Department at 1-800-441-9742 option 1 to obtain a form .

Complete the request form and e-mail or mail it to our EDI Coordinator at the address above . The 835 set-up can usually be completed (without any further requests for information) in five to seven business days .

BENEFITING FROM AVAILITY 276 TRANSACTIONSAnesthesia Associates of Painesville enrolled with Availity’s multi-payor web portal service a few months ago . Their staff received training at a central location, along with other providers in the area .

This provider has increased their use of the claim status (276) inquiry transaction to solve a dilemma . In the past, when Anesthesia Associates submitted CRNA (Certified Registered Nurse Anesthetist) services with physician services on the same claim they experienced problems in how the claims were processed . The provider started submitting the CRNA services and physician services on separate claims, and monitored the claims by using the 276 claims status inquiry . Anesthesia Associates says that the Availity web portal service has been beneficial to their office, and it is very easy to use .

Anesthesia Associates also uses the Availity web portal to validate secondary insurance by typing in the patient’s social security number and performing a search . With Kaiser Permanente members, they type in the medical record number to verify member eligibility and benefits . (interviewed 1/27/11)

EDI CLAIMS Electronic claims submission (EDI) continues to grow at Kaiser Permanente . Since electronic claims do not have to be scanned or manually keyed, turnaround times for claims processing have improved . Submitting your claims electronically also saves you time .

SUBMITTING SECONDARY CLAIMS VIA EDIKaiser Permanente of Ohio welcomes electronic “commercial” secondary claims submissions . To process the claims correctly, we need the detail of the primary payment . Therefore, we require that providers adhere to the Coordination of Benefit guidelines specified in the HIPAA Implementation Guide section 1 .4 .2 . The claim must report all applicable claim level adjustment amounts (Loop 2320) as well as service line level adjustment amounts (Loop 2430) . Claims without this information will have to be denied and further information will be requested . Please note that Kaiser Permanente of Ohio is already accepting Medicare crossover claims . You do not need to send us your secondary Medicare claims .

SUBMITTING CLAIMS FOR DUALLY COVERED MEMBERSWhen a Kaiser Permanente member is covered under two Kaiser Permanente benefit plans, please submit the claim

CLAIMS CORNER

(continued on page 7)

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ISSUE 2 | 2011

once . Our Claims Operations team will pay under both plans so you will receive remittance advice and payment under both the primary and secondary Kaiser Permanente coverage .

PREPARING FOR THE FUTURE On January 16, 2009, Health and Human Services announced the final rules for the 5010 Transactions sets for electronically submitted claims and the ICD-10 code sets . Kaiser Permanente has started testing 5010 transaction sets and the ICD-10 codes on schedule . We will be testing with our national clearinghouses throughout 2011 .

We are on track for full compliance by December 31, 2011 .

TO SET UP ELECTRONIC CLAIMS SUBMISSION (837 TRANSACTIONS):

Contact your EDI clearinghouse to submit claims to Kaiser Permanente of Ohio through one of our contracted clearinghouses using the appropriate Payer ID . There’s no need for you to contact Kaiser Permanente to begin submitting your claims via EDI . We’re ready to accept electronic claims whenever you submit them .

Claims Corner (continued from page 6)

NATIONAL CLEARINGHOUSES

PAYER ID FOR KAISER PERMANENTE OF OHIO

TRANSACTIONS

RelayHealth(preferred provider)

RH007Professional claims (837P),Institutional claims (837I),Remittance Advices (835)

Ingenix NG007

Professional claims (837P),Institutional claims (837I),Remittance advices (835),Eligibility and benefits inquiry (270)

Capario KS005Professional claims (837P),Remittance advices (835)

Availity(AHIP pilot project for Multi-Payer Portal)

n/aProfessional claims (837P),Institutional claims (837I),Remittance Advices (835)

Through the Availity web portal you can submit claims, receive remittance advice, and inquire as to member eligibility and claims status .

For more information, please contact the Kaiser Customer Relations department at 1-800-441-9742

Quadax Contact clearinghouse directly Professional claims (837P)

Emdeon 34092

Professional claims (837P),Institutional claims (837I),Remittance advices (835),Eligibility and benefits inquiry (270)Claims status inquiry (276)

QUESTIONS…If you have any questions, please contact Network Development at 1-800-441-9742 option 1, or refer to the “Claims” section on the Community Provider website at providers.kp.org/oh .

If you have questions about setting-up remittance advices or EFT with Kaiser Permanente of Ohio, please e-mail the EDI Coordinator at [email protected] .

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The Kaiser Permanente Claims department staff recently met with Lynne Durham, executive director, Public Relations and Marketing Communications at RelayHealth. She shared the following suggestions to help enhance the collections of fees for which patients are financially responsible.

As healthcare costs continue to rise, businesses of all sizes are struggling with increasing employee healthcare costs . Physicians are expected to provide healthcare, and must also collect payment for it . However, as the burden of healthcare costs shifts to the patient, physician practices are finding it increasingly difficult to collect patient self-pay balances . This article outlines an effective strategy for maximizing your practice’s ability to collect payment .

Traditional collection methods focus on recouping payment after treatment, after the patient has left the medical office . Unfortunately, the probability that patients will pay their portion of the bill drops dramatically once they leave the office . Research shows that consumers are more likely to pay the mortgage, insurance, loans, and utilities before their healthcare bills . They’re also more likely to pay for cable TV, Internet, lawn care, and the newspaper – even when they have the ability to pay .

With the rise in self-pay, providers must adopt a different approach . Collecting from patients at all points of service can keep this self-pay revenue from falling away . Having the confidence that you have accurate insurance information at your fingertips can greatly improve the way you do business and serve your patients . Technology plays a pivotal role in making that possible .

Verifying eligibility is important for reducing payer rejects and getting reimbursed faster . It can also speed up registration and greatly enhance patient satisfaction when incorporated into your practice’s workflow . Regular eligibility checks also allow your staff to catch errors or updates earlier, reducing denials and rework .

Successful providers employ technology and workflows that check eligibility for every patient at every point of service, including post-service . Having eligibility discussions before and at the point-of-service enables medical office staff to have meaningful conversations with patients about what is owed .

This requires technology that extends beyond the traditional verification of insurance coverage . To ensure the most complete and accurate eligibility verification, providers need complete and accurate eligibility responses from a combination of EDI and Web-based searches . Successful providers also use a combination of real-time eligibility checking to ensure the latest information, and batch, which ensures ongoing checks for changes or updates in patient eligibility .

The RelayHealth network provides connectivity and clinical and financial applications to practices of all sizes . RelayHealth enables improved self-pay through eligibility verification services and helps drive cash collection . RelayHealth operates as a neutral partner in an open network environment, offering connectivity and interoperability among all organizations, systems and solutions .

The RelayHealth solution includes:RelayClearance™ EDI: Through its user-friendly Web portal, RelayClearance EDI enables a practice’s scheduling and back-office staff to obtain accurate and timely insurance information at all points of service . Inquiry responses can include patient demographics, member and subscriber IDs, coverage status, and co-payment amounts . This single solution replaces the telephone, point-of-service devices, and payer websites that are used to check eligibility . RelayClearance EDI also integrates with a variety of practice management systems .

Real-Time or Batch Verification: Staff can verify eligibility in real-time on a one-by-one basis or submit a batch file . With a batch file, staff can submit one file of 270 transactions from their practice management system . The batch file is then sent to payers for processing . Once the results are compiled, they are packaged into a 271 batch file and returned to the provider organization . You can also use RelayHealth’s real-time verification capabilities for walk-in patients .

For more information on how RelayClearance™ EDI can help your practice more effectively collect patient self-pay balances, call 1-888-743-8735 (toll free) .

Features of RelayClearance EDI • Identifies Medicaid-

eligible recipients • Standard HIPAA

270/271 transactions • Securely accessible

from any Internet-connected computer

• Single solution to check eligibility of all patients

Benefits of Relay-Clearance EDI • Reduces denials and

write-offs • Increases cash flow • Reduces A/R days • Decreases

administrative tasks, costs

• Improves self-pay collections

IMPROVING SELF-PAY AT ALL POINTS OF SERVICE

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ISSUE 2 | 2011

As flu season approaches, we encourage you to provide flu shots to our Kaiser Permanente members – especially those in high risk groups . It gives our members the best chance of avoiding the flu this winter .

All individuals 6 months and older are now recommended to receive annual influenza vaccination . This was a new and expanded recommendation for the 2010 season . In February, 2010, The Center for Disease Control’s Advisory Committee on Immunization Practice voted in favor of “universal” influenza vaccination in the United States to protect as many people as possible against the flu .

While health care providers should recommend a yearly flu vaccination for everyone 6 months of age and older, it is especially important for those high risk individuals to get vaccinated to prevent them from developing flu-related complications .

Members can receive their flu shot at regularly scheduled primary care physician appointments . They can also attend one of our flu shot clinics at the following Kaiser Permanente medical offices:

When: Saturday, October 8Hours: 9:00 a .m . to noon Location: Avon, Bedford, Chapel Hill, Cleveland Heights, Parma, Rocky River, Strongsville, Twinsburg, and Willoughby

When: Thursday, October 13Hours: 5:30 p .m . to 7:30 p .m .Location: Fairlawn

When: Saturday, November 5Hours: 9:00 a .m . to noon Location: Avon, Bedford, Chapel Hill, Cleveland Heights, Parma, Rocky River, Strongsville, Twinsburg, and Willoughby

Members can also schedule an appointment for a flu shot Monday through Friday at any Kaiser Permanente facility by calling 1-800-524-7377 (toll-free) .

Members 9 years and older may attend one of the upcoming flu shot clinics . Any member under age 9 requiring a flu shot must schedule an appointment .

For more information, members can call our Flu Shot Hotline at 216-778-6165 or 1-800-358-5666 or visit kp.org/flu.

FLU FACTS – Giving Our Best Shot

Kaiser Permanente offers a wide variety of healthy living classes and group therapy sessions, designed to help your Kaiser Permanente patients take charge of their health . Led by knowledgeable and experienced health care professionals, our programs focus on helping members achieve a more balanced sense of wellness in mind, body, and spirit . For patients facing an ongoing condition such as asthma or diabetes, our programs will help them learn to manage their condition so that they can live life to its fullest .

Current Healthy Living classes include:• Alcohol and chemical dependency• Exercise and fitness• Managing ongoing conditions such as asthma, chronic

obstructive pulmonary disease (COPD), cholesterol, diabetes, and heart disease

• Mind and body health• Pregnancy and prenatal education• Weight management

These programs are intended to improve our members’ confidence, knowledge, and skills, so that they can be more effective partners in health with you, the health care practitioner . Please inform your Kaiser Permanente members about these programs and encourage them to participate .

For more information, Kaiser Permanente members can refer to our website at kp.org/classes . Additionally, a printable brochure containing Healthy Living classes information can be found at kp.org/formsandpubs (on the drop down menu, select Ohio Health and Wellness Kaiser Permanente Healthy Living Classes and Group Therapy Sessions) .

HEALTHY LIVING CLASSES

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Updates were made to the following guidelines since May 25, 2011:

• Atrial Fibrillation

• Headache Medication Table

• CAD

• Breast and Ovarian Cancer Testing

• ADHD

• CT Coronary Angiography

The following guideline has been retired:

• Cancer-Use of ESG for Anemia

The reasons for this guideline being retired are as follows:

- There is no sponsor to update this guideline .

- No other Kaiser Permanente region currently has this guideline .

- Oncology has their own specific guideline to address ESG for Anemia for their department .

Kaiser Permanente has developed a wide array of Preventive Care and Clinical Practice Guidelines to support your clinical practice in providing quality care for our members . You can access these guidelines on our website . Clinical Guidelines are located under the “Provider Information” section . Each guideline can be downloaded and printed as needed .

Clinical Practice Guidelines are updated as changes and additions occur . We will note any guideline updates in Provider Connection and in the News and Announcements section of the website . If you are not able to access the Preventive Care and Clinical Practice Guidelines online, you may request that hard copies be mailed to your office .

CLINICAL PRACTICE GUIDELINES

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KEEP US INFORMED OF CHANGES IN YOUR PRACTICEPlease remember to notify us of your group practice and facility changes . These include the addition of new practitioners, office location changes, group affiliation updates, and group practice mergers . We know these changes will only enhance your ability to provide great medical care to our members .

Notifications should be sent to Kaiser Permanente as soon as possible with any practice change information . If your office has a practitioner who is retiring or is leaving the practice, you must send us written notification, including the effective date of the retirement or termination, at least 30 days prior to the date the practitioner is leaving . This ensures that continuity of patient care is not impacted . If you are adding a new practitioner to your practice, the practitioner must be cleared by our Credentialing department before seeing Kaiser Permanente members .

You can notify us of practice changes by contacting your Network Development Associate via phone, faxing the

information to the Network Development department at 216-479-5550, and/or mailing change notices to:

Kaiser PermanenteNetwork Development and PerformanceNorth Point Tower, Suite 12001001 Lakeside Ave .Cleveland, OH 44114-1153

Please include new W-9 statements for changes involving tax identification numbers, such as group affiliation changes and mergers .

Thanks for all your help in keeping us up to date .

In Issue 1, 2011, Provider Connection, “Claim Administration Changes for Added Choice® POS and Out-

of-Area PPO Products,” under the subtitle Out-of-Area PPO Product, P .O . Box 6316 should be corrected to

P .O . Box 5316, Cleveland, OH 44101-5316 .

CORRECTION

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PROVIDER CONNECTION+

Health Living Classes

�Clinical Practice Guidelines

On the Web with Kaiser Permanente

In this issue:

and more...

Patricia D. Kennedy-ScottRegional President, Kaiser Foundation Health Plan of Ohio

Ronald Copeland, MDPresident and Medical Director, OPMG

Carolyn HightowerVice President, Health Plan Administration and Strategy

Vanessa RogalDirector, Network Development & Performance

Karen SuhyNetwork Manager

Kim McKenzieEditor

Kaiser PermanenteNetwork Development Department1001 Lakeside Ave ., Suite 1200Cleveland, Ohio 44114

Published by the Network Development and Performance department at Kaiser Permanente . Please contact our Network Development and Performance department at 1-800-441-9742 or fax us at 216-479-5550 with comments, questions, or suggestions for future issues .

Provider Connection

NONPROFIT ORGUS POSTAGE PAIDCLEVELAND OH

PERMIT NO. 3116

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