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  • Thursday, October 17, 2019 9:23 AM | Jennifer Casasanta (Administrator)

  • Thursday, October 10, 2019 12:09 PM | Jennifer Casasanta (Administrator)

    Beneficiary Entitlement Date Errors Causing Incorrect Part A and Part B Claim Denials

    Date Reported: 10/9/2019
    Status: Open
    Provider Type(s) Impacted: Part A, Part B, HH+H
    Reason Code(s): N/A
    Claim Coding Impact: N/A

    Description of Issue

    National Government Services (NGS), along with all Medicare Administrative Contractors (MACs), is experiencing an issue with the Medicare eligibility contractor, resulting in incorrect claim denials. NGS is informing providers of this claims processing error involving invalid entitlement dates for all beneficiary entitlement periods. This is causing claims to incorrectly deny based on invalid beneficiary entitlement.

    National Government Services Action

    NGS is actively pursuing a solution to this issue which will be shared with providers as soon as possible.

    Provider Action

    Please continue to check the Production Alerts section of our website and Email Updates for additional status information

    Proposed Resolution/Fix Date


  • Tuesday, October 01, 2019 10:49 AM | Jennifer Casasanta (Administrator)

    Registration is now open for the 2019 Healthcare Innovations Conference hosted by Pandion Healthcare: Education & Advocacy. This full-day educational event will be held on November 13 at the Rochester Riverside Hotel. Last year, more than 200 physicians, healthcare administrators and clinicians attended the conference, representing more than 70 organizations across New York.

    Pandion has secured an award-winning speaker: Emmanuel Fombu, MD, MBA. Dr. Fombu is a physician, author, speaker, and healthcare executive turned Silicon Valley entrepreneur. He is the author of the book, “The Future of Healthcare: Human and Machines Partnering for Better Outcomes.”

    Attendees will also be able to choose from six different educational tracks:

    1. Consumer, Patient Engagement, and Digitally Connected Health
    2. Clinical Informatics and Clinician Engagement
    3. Cybersecurity, Privacy and Security
    4. Leadership, Governance, and Strategic Planning
    5. Long-term Care
    6. Supply Chain Management

    For more information and to register, please visit https://www.pandionalliance.com/healthcare-education-and-advocacy/2019-conference

    Questions? Please contact Christine Pittman Ballard at cballard@pandionalliance.com or 585.214.2411.

  • Tuesday, September 10, 2019 3:28 PM | Jennifer Casasanta (Administrator)

    Workers compensation banner

    CMS-1500 Resources: Video Available and Q&A Webinars Next Week

    The Workers Compensation Board is offering new resources to assist in the transition to Form CMS-1500, which will streamline medical billing and reduce the paperwork requirements currently in the workers compensation system.

    To help you prepare, the Board has developed a training video to show health care providers, and all others who will be using Form CMS-1500, how to use the form and the required narrative reports to bill for their services to workers compensation patients.

    Next week, the Board is also holding two follow-up Q&A webinars so that you can get answers to any questions you may have after viewing the training video and reading the CMS-1500 FAQ's on the Board s website.

    With that in mind, we encourage you to view the training video before attending one of the webinars. As you view the training video, take note of questions that come up so that you ll be prepared for the Q&A webinar. This will enable you to take full advantage of both resources.

    To view the training video, follow this link: CMS-1500 Training Video

    The webinars will be held next week on:

    September 17, 2019
    8:30 a.m. - 9:30 a.m.
    Register Here

    September 18, 2019
    4:00 p.m. - 5:00 p.m.
    Register Here

    In the meantime, please see CMS-1500 Initiative and the CMS-1500 FAQ for information.

    Please direct questions to CMS1500@wcb.ny.gov

  • Tuesday, September 10, 2019 12:32 PM | Jennifer Casasanta (Administrator)

    The HBA Rochester affiliate has been founded to support the

    Rochester healthcare community, fostering stronger relationships

    and advancing women in healthcare. Join us at our first networking

    event in Rochester,NY where we will learn the importance of

    resilience in our careers from esteemed guest, Rebecca Leclair. Take

    an opportunity to network with like-minded professionals in

    healthcare and learn about what HBA can offer you.

    HBA Rochester_ Launch Event 25 Sept.pdf

  • Tuesday, September 03, 2019 10:35 AM | Jennifer Casasanta (Administrator)

    Register Now!


    University of Rochester Medical Center Department of Psychiatry, Division of Collaborative Care & Wellness

    Rochester Behavioral Health Integration

    4th Annual Symposium

    The Economics of BH Integration

    Opportunities to Improve Care While Addressing Social Determinants of Health

    Friday, October 25, 2019

    8:00 a.m. – 3:30 p.m.

    Hilton Garden Inn

    30 Celebration Dr. Rochester, NY 14620

    We are pleased to announce this year’s symposium which will focus on the economic opportunities of integrating behavioral health into the medical setting and strategically deploying value added, integrated and financially sustainable BH services designed to improve the health of individuals and decrease disparities in care for populations in our area.

    The Keynote Address will be entitled:

    Integrating BH in Medical Settings; A Value Proposition

    By Stephen P. Melek, FSA, MAAA

    Principal, Consulting Actuary

    Denver Health Practice, Milliman

    Keynote Address – Steve Melek, FSA, MAAA

    Steve’s area of expertise include healthcare product development, management and financial analyses. He has advised HMOs, PPOs, Managed Care Organizations, ACOs and health insurance companies on integrated care. He has published research reports for Milliman and others on behavioral healthcare.

    Other presenters include:

    Daniel Maeng, PhD – Health Economist, presenting on the Impact of Behavioral health Integration and Healthcare Utilization and cost: Experiences and evidence for our community.

    Catherine Holland, MBA, BSN, RN –Director of Health Home Care Management at URMC and will present on integrated health home care management & the quadruple aim: improving outcomes in our community.

    AnneMarie White, Ed.D. – Executive Director of Children’s Institute. Her presentation is entitled: Health happens where you live: Community system strengthening and holistic health and wellness.

  • Thursday, August 15, 2019 9:04 AM | Jennifer Casasanta (Administrator)

    We invite you to participate in the third offering of an expanded patient safety course – nearly all of the topics in the prior course given in spring 2018 and earlier years will be covered in redesigned sessions plus we will have additional content on improvement and achieving high reliability.

    The faculty of the Division of Healthcare Management in the Department of Public Health Sciences are pleased to offer this free and innovative program on improvement science. This is a “mini” certificate course designed specifically for health care professionals, trainees, and students from medicine, dentistry, nursing, pharmacy, hospital administration, and health services research.

    Course Content The program, designed to increase your knowledge of how to improve healthcare quality and safety and to educate you on the latest theories on improvement science, consists of 11 sessions addressing topics such as leadership’s role in nurturing a culture of high reliability, an understanding of the science of errors and safety, the model for improvement in clinical practice, identification of “measures that matter” in healthcare, teamwork and communication techniques, performance improvement tools, ways to create a safer medication system, the challenges of health literacy and patient diversity, event reporting systems, designing care for to maximize value and safety, the impacts of information technology and safety, safety in clinical research and the business case for safety.

    Registration Information

    The registration deadline for the Rochester Improvement Science Education (RISE) Certificate Program is Saturday, September 21.  Sessions will begin on Thursday, September 5, 2019, and will be offered an average of twice per month on Thursdays, from 5:30 p.m. to 7:00 p.m.  There is no fee for this course.  Course materials will be available online.

    Existing MyPath/Achieve Users: Please refer to the attached instructions to register for the course.

    New to MyPath? Click here to create an account and begin the registration process.

    Parking Information

    Parking fees will be the responsibility of the registrant. A light snack will be provided beginning at 5pm.

    Program Completion
    Successful completion of the program involves attendance at a minimum of 8 sessions. Those who successfully complete the program will receive a certificate of participation from the University of Rochester School of Medicine and Dentistry. Physicians, dentists, nurses, dental assistants, hygienists, pharmacists, radiology technologists and social workers will be eligible for up to a maximum of 16.5 hours of continuing education credits. For social workers, partial credit for this multi-part course may not be awarded. Learner must attend all parts in order to earn the certificate for contact hours. Physicians should note that medical staff privileges at SMH and HH, as well as participation in BCBS managed care products (including Blue Choice) require 50 hours of CME per year. Physicians insured through UR and MCIC Vermont for malpractice insurance will be eligible for a reduced premium through the premium differential program.

    Please see the attached documents for further information. If you are unable to access any of the attachments, please feel free to contact Judy Hughes at 275-7712 or by email at judy_hughes@urmc.rochester.edu for another email version or fax copy. The materials are also available at the Quality and Safety Intranet Page for those who can access the URMC intranet and here for those who cannot: Healthcare Quality - Hospital Quality, Safety, and Service - University of Rochester Medical Center

    Don’t miss this opportunity to promote improvement science and patient safety by learning about the science, tools, and strategies for achieving safer patient care.

    More Links: 

    Registration Instructions for Existing MyPath Users.pdf

    Class Schedule_RISE_Fall_Final.pdf

    Faculty List_Revised v3 Final 8 13 19.pdf

    Patient Safety Program Announcement_RISE 8 12 19.pdf

  • Wednesday, August 14, 2019 8:59 AM | Jennifer Casasanta (Administrator)

    Project ECHO® Eating Disorders is an ongoing, twice-monthly web-based learning series providing case-based learning and brief lectures to build providers’ capacity to better serve people with eating disorders and their families in their home communities. The 90-minute sessions (first and third Tuesdays from 12:00 – 1:30 p.m.) promote evidence-based strategies and best practice guidelines for working with patients at all levels of care and support ongoing mentorship and interdisciplinary relationship building and care coordination. Sessions are cost-free, as are CME hours and social work CEUs for participants.

    For additional information, please go to: www.nyeatingdisorders.org/echo.html

    To register for this series, please go to: http://bit.ly/ECHOEDOREG

    There is also a parallel ECHO® series for all disciplines of K-12 school staff, focused on prevention, identification and support for children and adolescents with eating disorders and their families.  More information on that series: http://www.nyeatingdisorders.org/sb-echo.html

    For ECHO-related questions, please contact: Jim_Witmer@URMC.Rochester.edu

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