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The Pulse of The Physician Alliance
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Health plan insurance forum coming soon
St. John Providence Partners in Care is hosting a health insurance plan forum to help practices learn more about PCP health plan incentive programs and updates for 2017. The forums will be held on
Tuesday, April 18 at 7:30am or Tuesday, April 25 at 7:30am.
Representatives from Blue Care Network, Blue Cross Complete, Total Health Care, HAP, Priority Health, United Healthcare, Molina, Meridian, Harbor Health, SmartHealth and The Physician Alliance will be available to answer your questions.
Target audiences are practice managers and billers. Other office representatives are also welcome to attend.
RSVP is required. For more details and registration information, view the flyer.
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New information about CMS' Provider Directory Data Quality Compliance Program
The Centers for Medicare and Medicaid Services (CMS) mandates that all health plans provide complete and accurate information regarding physicians who are available to new patients/enrollees in online and printed directories. To comply with the requirement, Blue Cross Blue Shield of Michigan (BCBSM) has launched a new program called the Provider Directory Data Quality Compliance Program which enlists physician organizations, such as The Physician Alliance, to provide outreach to practices to ensure that information is updated quarterly. BCBSM will be providing The Physician Alliance a monthly report that identifies practitioners who have not logged into the system to review and update their information and are at-risk of health plan sanctions. The Physician Alliance has outreached to all practices who are at risk for the first quarter 2017.
It is expected that quarterly verification, update and confirmation of this information will occur by the physician/practice to remain compliant. Consistent non-compliance over quarter to quarter by individual physicians/practices will result in successive sanctions by BCBSM, starting with the loss of any BCBSM valued-based reimbursement (5% - 40% additional reimbursement), and will result in ultimately being terminated from Blue Cross and BCN networks.
To reduce the errors in the information each quarter that need to be reviewed, information must be corrected using the procedure outlined by BCBSM/BCN. This link provides clear steps that are necessary for keeping your information accurate and up-to-date. Please follow this link to update your information and reduce the time spent in reviewing and validating incorrect information quarterly.
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New automated prescription system launches early April
The State of Michigan will be replacing the Michigan Automated Prescription System (MAPS) effective April 4, 2017. According to the Michigan State Medical Society, upgrading the software platform is a crucial element in improving and measuring physician use of MAPS and serving to help reduce the amount of prescription drugs available for illicit purposes.
Accounts on the current MAPS will not be transferred to the new system (effective April 4). Registration is now available for the new system. To register and for more information,
click here.
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Member practice welcomes new physician
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Joel Pelavin_ MD |
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Eastside Eye Physicians is pleased to introduce Joel L. Pelavin, MD, who joins the practice after more than 30 years as a solo practitioner in St. Clair Shores.
When he joins the practice April 1, Dr. Pelavin will provide cutting-edge treatments to patients in both the St. Clair Shores and Shelby Township locations.
Eastside Eye Physicians is a comprehensive ophthalmology practice that specializes in laser-assisted cataract surgery, LASIK refractive surgery, diabetic eye disease and treatment, glaucoma eye disease and treatment, as well as general eye care. The practice is dedicated to preserving and improving eye health through the latest in medical, surgical and optical techniques, and by creating an atmosphere of communication and trust.
The physicians and surgeons at Eastside Eye Physicians have been providing care in metro Detroit since 1955. The group also includes Anne M. Nachazel, MD, Neal M. Krasnick, MD, and Michael J. Clune, MD.
Eastside Eye Physicians has two convenient locations. Contact the St. Clair Shores office at 25511 Little Mack Ave. or (586) 774-2020. The Shelby Township office is located at 47100 Schoenherr Road, Suite F, and can be reached by calling (586) 247-2020. For additional information regarding services, visit the website at www.eastsideeye.com.
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News you can use
'Bad luck' mutations increase cancer risk more than behavior, CNN
Fewer medical malpractice lawsuits succeed, but payouts are up, CBS News
Ryan says House to revisit healthcare, offers no details, Modern Healthcare
Those indecipherable medical bills are one reason health care costs so much, NY Times
Physicians' group: Treat opioid addiction as a chronic medical condition, CBS News
Costly doctors don't provide better care, NY Times
Greatest rise in heroin use was among white people, study says, CNN
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Bio-MED Medical Waste provides high level of safety and compliance for the removal of waste services. TPA members receive 30 percent off of your current bill and no delivery fees.
Learn more about these services.
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The Physician Alliance | 20952 Twelve Mile, Suite 130, St. Clair Shores MI 48081 | 586-498-3555
thephysicianalliance@thephysicianalliance.org | www.thephysicianalliance.org
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