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 kzabukovic@legacyib.com.

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 (ann_bellah@parkviewmc.com)

Phone: 584-4371

Sandra Proud, Provider Relations/Member Services (sandra_proud@parkviewmc.com)

Phone: 584-4642

400 W. 16th St. Pueblo, CO 81003

Main Phone: 584-4806

Fax: 584-4038