Mount Sinai Health Partners
Clinically Integrated Network Newsletter
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Provider Spotlight:
Dr. Danuta A. Jankowska, Internal Medicine
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Key to Quality Care is Managing Practice Operations Efficiently: MSHP Spotlight on CIN Primary Care Provider, Dr. Danuta A. Jankowska
Fee schedules. Coding. Rejected claims. Managing overhead. Staff communications. The financial and business elements of running a practice aren’t often covered in medical school and can be a cause of burnout for many physicians. We sat down with primary care physician, Dr. Danuta A. Jankowska, and her brother, Legal Analyst and Chief Clinical Officer, Dr. Slawomir
Jankowksa, to discuss their approach to managing the financial and business operations and ensure appropriate reimbursements, so that they can truly focus on quality care for their patients.
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Dr. Danuta Jankowska, a voluntary internist in the CIN, joins Dr. Fields in this latest episode of the MSHP podcast, and the second in a series of interviews with frontline providers. They discuss Dr. Jankowska’s approach to practicing medicine as well as the logistics of how she runs her practice. Her setup allows her to spend more time with her patients and less time worrying about inefficiencies. After all, according to Dr. Jankowska, the time she spends with her patients is where she can really be herself and where the best comes out of her.
Missed the first episode with Dr. Kearns-Stanley?
Listen here
.
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Practice Tips and Transformation in the News
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“The Act of Healing is More Joyful When It’s Communal”
Social Events
Opportunities for doctors to spend time together outside of work at sporting events, happy hours, art classes, cooking classes, and more
“This Is Me”
Each week one physician writes a brief autobiographical essay that is sent to the group. The story must be about the doctor but not about their day job. Dr. Kulkarni notes that the key here is that it “uses simple tools we already have.”
Midnight Snack Program
Physicians volunteer to bring snacks once a month to doctors working overnight shifts
Pebbles Project
Physicians discuss and solve small operational problems: “pebbles in the shoes”
Finding Meaning in Medicine
Physicians share stories of clinical care and explore concepts like compassion, awe, and loss that underlie everyday practice but are rarely explicitly discussed
Does your practice have any wellness initiatives that help combat loneliness?
Let us know
!
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New Quality Reporting Process in 2019 for Most PCPs
Primary care providers should have received a communication in February outlining the upcoming quality reporting process. The process has changed for 2019 and leverages claims data for quality reporting, depending less on manual reporting from providers.
For many primary care providers, you will be introduced to Lumeris’ Accountable Delivery System Platform (ADSP)
for quality reporting. With this tool, claims data will be loaded into ADSP for providers to attest to. Providers reporting this way will receive a preliminary quality reporting datasheet placed in their Box account by March 11, 2019, showing preliminary quality reporting results based on the paid claims data of your attributed patient population. You will have an opportunity to verify/update this data by updating numerator information and submitting documentation in Lumeris, ADSP. You should have received information from our February 26th communication. Please note that providers with denominators <10 for quality metrics will still need to report manually for those metrics.
Stay tuned for training on ADSP.
Practices will receive personalized training. All primary care providers can expect to receive training by Q2.
To ensure that providers are prepared and ready, all providers reporting through ADSP will receive credit for first quarter quality reporting.
If you are currently reporting through your EMR system’s numerator and denominator (N&D) feeds
, the process does not change. Reporting templates for Q1 2019 are now available in your Box account. Your quality reporting is due
Friday, April 19, 2019
. Additionally, if you are currently providing monthly feeds through your Quanum or Athena EMR, please continue to do so as your reporting process will not change.
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2019 Annual Dues: Deadline April 16, 2019
MSHP has been working diligently on behalf of the providers within our CIN. To ensure that we can continue to provide value and high quality service to our network, we are resuming collecting of annual membership dues. You should have received an email informing you of your dues on February 15 and paper invoices were mailed on February 28.
If you have already paid for your 2019 MSHP annual dues, please disregard.
To pay online with a credit card, please sign in to the provider portal and then click “Pay Dues” from the drop down menu. Please be sure to wait for the confirmation screen and write down your confirmation number at the end of your payment process.
If you prefer to pay by check, please mail your check along with the email or invoice you received to:
Attention: Sabrina Raghunandan, MHA
Senior Director, Clinical Integrated Network Operations
Mount Sinai Health Partners, IPA
150 East 42nd Street, Fifth Floor
New York, NY 10017
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Complete Your 2019 HIPAA Compliance Module
The 2019 HIPAA compliance module is now available in the Clinical Integration Learning Center (CILC). This online course explains the business and regulatory reasons for complying with HIPAA Privacy and Security regulations and includes examples that address common risks and challenges.
Completion of this requirement is due by the end of quarter 3 for both PCPs and Specialists
.
To access the course,
log in to CILC
, click on "Learning Events," select "Compliance" under Categories. On the Compliance page you should then see the below course:
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Tip of the Month: Where can I find resources on our website?
Many of the resources on the MSHP website are available only behind login. To access, visit
mshp.mountsinai.org
and click “Sign In” in the top right corner. Once you’re logged in, you’ll be able to view reimbursements for the top 10 E&M codes on the Relationships page, access CILC (Mount Sinai’s Clinical Integration Learning Center) via the Educational Activities page, and more.
Need help finding resources? Don’t hesitate to contact us at
mshp@mountsinai.org
or 877-234-6667.
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Updated Fee Schedules Now Available
We have updated the MSHP website with current reimbursements for the top 10 E&M codes for our contracted payers. To view, please visit
mshp.mountsinai.org
, sign in to the provider portal, and then go to the Relationships page. From there you will see a listing of payers and links to their fee schedules.
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Revised Cigna Precertification Requirements
Cigna updated its precertification list of CPT and HCPCS codes, effective January 1, 2019. They added the following:
- 101 new CPT codes that were released by AMA
- 71 new HCPCS codes that were released by CMS
- 9 existing PCT codes
No codes were removed from the precertification list.
To view an online list of monthly precertification updates, as well as the complete list of services that require precertification of coverage, log in to the Cigna for Health Care Professionals website
(
CignaforHCP.com
) and click Precertification Policies under Useful Links. If you are not registered for the website, go to
CignaforHCP.com
and click Register Now.
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Bright Health Precertification Update
Bright Health has updated their prior authorization requirements for colonoscopy-related services, effective March 1, 2019.
- Screening colonoscopy and colonoscopy-related services will only require a Level 1 review to ensure that the provider and site of service are in the Bright Health network.
- The Outpatient Prior Authorization Request Form for Bright Health Individual & Family plan or Medicare Advantage plan located at availity.com.
- No prior-authorization is required for anesthesia or deep sedation used for colonoscopy-related services.
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Population Health in the Literature & Media
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ACIP 2019 Vaccination Schedule Now Available
The ACIP 2019 vaccination schedule is available. Notable changes include approval of a new HBV vaccine (Heplisav-B, Dynavax) which can be used in a 2 dose series as a substitute for another HBV vaccination requiring 3 doses, and the inclusion of Persons who Experience Homelessness as an indication for HAV vaccination. Full schedule and update is
available here
.
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Q1 Quality Reporting Is about to Begin
If you are a PCP who reported manually last year, you may be eligible for a claims-based method, meant to improve quality reporting burden, the accuracy of quality reporting, and it’s alignment with value-based contracting. More information will be available in your Box account and through your Provider Engagement Manager.
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P: 877-234-6667
F: 212-523-5775
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