The 2013 Dual Eligible SNPs Program Goals are:
* Increased access to medical, mental health and social services demonstrated by 3% increase in referrals to these services (PCP, Specialist provider, MHSA/PsychCare, MTM/Outcomes)
* Promote healthy lifestyle changes through improved access to preventive health services as demonstrated by 3% improvement in the following Health Effectiveness Data and Information Set (HEDIS) indicators and 100% of members receiving education related to self directed care:
Osteoporosis Management in Older Women
* Improve member perception of independence and self-care management skills by 3%
* Reduce dependence on Emergency Department (ED) treatment as evidenced by a 1.5% decrease in ED visits from previous year
* Reduce inpatient facility admission (IP) rate by 1.5% from previous year
* Reduce readmission rate by 1.5% from previous year
* Increase HRA completion rate within 30 days by 1% from previous year
* Increase specialist provider training by 1% from previous year
* Improve coordination of care through:
An identified point of contact, the Care Manager, in 100% of managed members
Individualized Care Plans created for 100% of SNP enrolled members
* Improve transitions of care through:
Improving timeliness of Post Discharge Support contact by 5%
Improve process to communicate ICT reviews with PCPs via telephonic and written communication methods
* Conduct ICT reviews on 80% of managed SNP members annually
* Improve member satisfaction with health status and care management services by 3%
Medicare Guideline posts
- Finding Medicare fee schedule - HOw to Guide
- LCD and procedure to diagnosis lookup - How to Gui...
- Medicare Fee Schedule, Payment and Reimbursement Benefit Guideline,
- Step by step Guide Medicare participation program
- Medicare Fee for Office Visit CPT Codes - CPT Code 99213, 99214, 99203
- Medicare revalidation FAQ
- Gastroenterology, Colonoscopy, Endoscopy Medicare CPT Code Fee
- Medicare claim address, phone numbers, payor id - revised list
Top Medicare billing tips
URIBEL- methenamine, sodium phosphate, monobasic, monohydrate, phenyls alicylate, methylene blue, and hyoscyamine sulfate capsule Uribel i...
procedure code and description 71250 - Ct thorax w/o dye - average fee payment - $180 - $190 71275 CTA chest (noncoronary) 71260 CT ...
Procedure code and description 93000 - Electrocardiogram, routine ECG with at least 12 leads; with interpretation and report -average fee...
This post has Most used J code list and we are constantly updating with example . If you are looking particular J code, use search button. ...
Procedure Codes and Definitions 36415 Collection of venous blood by venipuncture - Fee schedule amount $3.10 36416 Collection of capi...
Procedure code and description 93015 (cardiovascular stress test using maximal or submaximal treadmill or bicycle exercise, continuous ele...
Procedure code and description 95004 Percut Tests w/ Extrac Immed React # Allergy testing - Percut allergy skin tests - Percutaneous ...
Coverage Indications, Limitations, and/or Medical Necessity This LCD describes conditions under which the coverage of nail avulsion/ex...
CPT CODES and Description 81000 Urinalysis, by dip stick or tablet reagent for bilirubin, glucose, hemoglobin, ketones, leukocytes, nitr...
Flow Cytometry is a highly complex process by which blood, body fluids, bone marrow and tissue can be examined. It provides important immun...