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January 2014 Editors: Sandra Proud and Ann Bellah
Updates
**PHC has Moved** The Pueblo Health Care office has moved. We are now located at 425 W. 15th St. (corner of 15th and Greenwood) in the
Beaumont/Yaklich House. The phone and fax numbers remain the same.
Health Access Pueblo Effective December 31, 2013, the Agreement between Pueblo Health Care, Inc. and Health Access Pueblo (HAP) was
terminated. The Patient Protection and Affordability Care Act of 2010 (PPACA) expanded health care coverage options
to individuals and small businesses through an on-line market place or ‘Exchanges’ through Connect for Health Colorado.
This change made HAP obsolete and operations were shut down effective December 31, 2013. New identification cards
were distributed to all members in September with the expiration date December 31, 2013. Regardless of the date
printed on the card, all coverage expired on December 31, 2013. All outstanding claims and open issues must be closed
before March 31, 2014.
MultiPlan MultiPlan is encouraging the use of its Provider Service Portal, which has been operational for almost a year.
Participating providers have the ability to check claims, network status, roster requests and will find that they have
access to other helpful tools. MultiPlan continues to enhance its website features with the intent of assisting providers
who work with them. You are being encouraged to call toll free 877-460-0352 to request access to this portal.
Office Manager Roundtables/ICD-10 Webinars and Email list In preparation for the transition to ICD-10, PHC will be hosting group meetings for most of the ICD-10 webinars
presented by the ICD-10 Coalition. The webinars are from 12-1pm every third Tuesday of the month. Watch for your
invites which will indicate the location of the meeting. We will schedule the meeting until 1:30 pm to allow time for
discussion.
***PHC has created an Office Manager group email list. It is a great way for us to send information to you that we feel
may be beneficial to your office. If you would like to be included on the list, please let us know.***
Legacy Bank PHC would like to thank Legacy Bank for allowing us to hold meetings in their community room and hosting the lunch
once a year. This Community Meeting Room is available free of charge to the general public by contacting Kerstien
Zabukovic at 562-1800 or [email protected].
Educational In-ServicesPueblo Health Care recently offered the following in
Cigna (September 25Cards, New Contact Sheet
and Cigna’s regular Website.
Coding Boot Camp (October 28 –
Cowart, Humana, MHA-Healthcare Policy and
Mercer University, MHL–Healthcare Regulatory Compliance
Southeastern University, CHC–Health Care Compliance Assoc,
CCS-P–AHIMA,CPC, CPMA, CPC-I–AAPC, ICD
conducted a one week coding workshop that gave the attendees the tools and knowledge to be able to take
the test to become an AAPC Certified Professio
Kaiser (November 13) Kaiser representatives presented updates in several different areas.
Experience and Contracting Team – How Can w
Update by Sandy Williams and Ann Bellah
Information by Sandy Williams, and KPCC Services by Dawn Wainright and Donna Calhoon
claims representatives Vivian Espinoza-Lindsay, Sheila Canaday and Kelly
Service Recovery Organizational Effectiveness, presented a training session focused
healthcare employees handle challeng
the right words to say when a patient or family member:
quality of care they’re receiving, is frustrated or angry, goes over the line
personal. This presentation was worth
received CME credits for attending.
Upcoming In-services: February 6 - Colorado HealthOp
February 27 – ICD-10 Implementation
March 20 – Work Flow Improvements
Education Ideas???? The Educational in-services survey was sent out in December. The survey
in order of importance. If you have a specific
service you feel would be valuable to the PHC
for the group. We are trying to focus on what physicians and office managers/staff w
relevant, as we know how valuable your time is.
*Did you qualify for your $50 credit on your 2014 PHC Dues Invoice this year?
If not, be sure to attend at least 3 of the upcoming educational in
look forward to enjoying the credit on next year’s dues.
Services Pueblo Health Care recently offered the following in-services:
September 25) Glee Anderson from Cigna presented information about new
New Contact Sheets, ICD-10, Exchanges – Local Plus, Cigna Behavioral Health
and Cigna’s regular Website.
– November 1) Dennis
Healthcare Policy and Administration–
gulatory Compliance–Nova
Health Care Compliance Assoc,
AAPC, ICD-10 Trainer for both AHIMA and AAPC,
conducted a one week coding workshop that gave the attendees the tools and knowledge to be able to take
the test to become an AAPC Certified Professional ICD-9 Coder.
Kaiser representatives presented updates in several different areas.
How Can we Better Serve You? By Sandy Williams, High level Contract
llah, Connect for Health Colorado, Exchanges, Provider FAQ’s
and KPCC Services by Dawn Wainright and Donna Calhoon
Lindsay, Sheila Canaday and Kelly Turell available for claims issues.
Service Recovery (December 12) Elliott Ring, PMC Director of
Organizational Effectiveness, presented a training session focused
healthcare employees handle challenging situations. Specifically,
the right words to say when a patient or family member:
quality of care they’re receiving, is frustrated or angry, goes over the line
This presentation was worth 1.5 CME credits. Three p
eceived CME credits for attending.
y was sent out in December. The survey included topics that offices were asked to rank
If you have a specific topic for 2014 that was not on the survey or contact information for an in
service you feel would be valuable to the PHC network, please email or give us a call and we will look into
We are trying to focus on what physicians and office managers/staff will find most beneficial and
relevant, as we know how valuable your time is.
fy for your $50 credit on your 2014 PHC Dues Invoice this year?
If not, be sure to attend at least 3 of the upcoming educational in-services within the next 12 month
look forward to enjoying the credit on next year’s dues.
**** REMINDER ****
It is important if you sign up to attend a PHC sponsored
in-service that you show up. If you have responded but
cannot attend or if you would like information from an
in-service that you did not attend please let us know.
from Cigna presented information about new ID
Cigna Behavioral Health Website
conducted a one week coding workshop that gave the attendees the tools and knowledge to be able to take
Kaiser representatives presented updates in several different areas. Provider
Sandy Williams, High level Contract
Provider FAQ’s and Lab
and KPCC Services by Dawn Wainright and Donna Calhoon. Kaiser also had
available for claims issues.
Elliott Ring, PMC Director of
Organizational Effectiveness, presented a training session focused on helping
ing situations. Specifically, dealing with
is disappointed with the
quality of care they’re receiving, is frustrated or angry, goes over the line or gets
1.5 CME credits. Three physicians
included topics that offices were asked to rank
or contact information for an in-
and we will look into coordinating it
find most beneficial and
services within the next 12 month-period so you can
It is important if you sign up to attend a PHC sponsored
service that you show up. If you have responded but
cannot attend or if you would like information from an
you did not attend please let us know.
Membership Additions
Pueblo Health Care’s membership total is currently at 267. We are excited to announce the following recent additions
to our network:
Dr. Jeremy Brown (Hanson Clinic PC)
Dr. Kajsa Harris (Rocky Mountain Vein Institute)
Dr. Alison Hastings (Pueblo Associates in OB/GYN, PC)
Dr. Andrew Kamell (Parkview Adult Medicine Clinic)
Dr. Bhavani Suryadevara (IPC)
Dr. Harshal Shah (IPC)
Dr. Bhakti Dahale (IPC)
Dr. Iftikhar Ahmed (Southern Colorado Dermatology)
Dr. Aaron Fields (SCC)
Please welcome these physicians to the community and to the Pueblo Health Care Network.
Membership Changes
Pueblo Neurology (Dr. Rawat) moved from Medical Arts Building to 2001 Lake Ave.
Dr. Andrea Sciammarella left Parkview Behavioral and joined Southern Colorado Psychiatric.
Dr. Jamie Pollock added a location in Canon City.
Dr. Quazi Parvin closed her private practice and joined Southern Colorado Clinic, PC.
Dr. Drew Ritter left Pueblo Bone and Joint Clinic and joined Parkview Orthopedics.
Pueblo Bone and Joint Clinic moved from 3676 Parker Blvd. to 1919 W. Hwy 50.
REMINDER!!
If your office is planning on having any demographic changes, please provide PHC with this new
information. For your convenience, we have placed a demographic change form on our website. We
will notify all PHC Health Plan Partners of these changes on your behalf. This will help ensure that
remittances and correspondence are delivered to the proper address. We will request an updated W9 and CMS 1500
(HCFA) reflecting these changes, as some plans require us to submit these forms with the change request. Also, if you
are planning on having a physician join your practice, please notify us as soon as possible so we can send out new PHC
member information, along with a Pueblo Health Care application.
www.pueblohealthcare.com Don’t forget our website. The calendar displays all scheduled in-services and meetings. The resources tab has been
updated to include many helpful links such as ICD-10 Coalition, Health Plans, AAPC, Colorado Medical Society and many
more.
Messenger Model PHC is an Independent Practice Association that operates according to the
Messenger model. PHC does not negotiate rates but does provide contract
language support. PHC’s role is to act as a messenger between health plans
and physician practices.
“Working with Physicians,
for Physicians!”
Mission: The mission of Pueblo Health Care, Inc. is to
provide our physician partners the highest level of service
and support in terms of physician contracting, appropriate
educational in-services and administrative support for the
Pueblo Market Area. Understanding that maintaining
physician contracts is an on-going process, all efforts under
the model in which we conduct operations will be focused on
communication with our physician partners.
Vision: Our vision is to exceed the
expectations of our physician partners in
the areas of communication and education,
as it relates to Physician Relations, Employer
Relations and Payor Relations.
PHC Board Members Pueblo Health Care holds formal elections for Board positions every year. At least one position must be a primary care
physician. The term for each of the positions is two years. The Board meets approximately 4 times per year, during the
lunch hour.
2014 PHC Officers:
Ernie Steinle, MD – President
James Simony II, MD – Vice President
Bill Patterson, CFO PMC – Treasurer
2014 PHC Board Members:
Chris Vialpando, MD
Bruce Johnson, MD
Theodore Puls, MD
Steven Nafziger, MD – VP Medical Affairs PMC
Jim Hadley, ReMax of Pueblo – Community Rep.
Rob Thames – Sr. VP / COO PMC
Ann Marie Pruden – Chief Compliance Officer PMC
PHC Sub-Committee Pueblo Health Care holds formal elections for Sub-Committee members every year. The Sub-Committee is a six-person
committee comprised of Office Managers representing member physician offices.
The elected Sub-Committee positions are voluntary and unpaid, however; they are very much valued by Pueblo Health
Care and the Physician Board. The Committee provides important functions such as helping keep PHC informed of
current challenges and issues facing Pueblo’s physician practices, as well as guidance in determining appropriate
educational sessions to offer. The term for these positions is two years. The Sub-Committee meets approximately 4
times per year in the PHC office.
2014 PHC Sub-Committee Members:
Renee Espinoza-Atencio, Theodore J. Puls, MD, PC
Anne Greco, Pueblo Associates in OB/GYN, PC
Georgene Holcomb, Sangre De Cristo Surgical Assoc.
Sandi Maybee, Parkview Ancillary Services
Rita Montez, Southern Colorado Clinic
Shana Stollsteimer, Kenneth D. Danylchuk, MD, PC
Your Pueblo Health Care Staff: Ann Bellah, Executive Director ([email protected])
Phone: 584-4371
Sandra Proud, Provider Relations/Member Services ([email protected])
Phone: 584-4642
400 W. 16th St. Pueblo, CO 81003
Main Phone: 584-4806
Fax: 584-4038