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UTP Best
Employees June Honorees

UT Physicians’ new
employee recognition program,
Best Employees,
allows employees, managers, patients and
physicians to recognize UT Physicians employees who have gone above and beyond
their day-to-day responsibilities to deliver excellent customer service.
Honors go to Brenda DeLeon (Otolaryngology),
UTP employee of the month for June. Best
Employee awards in June go to Christine Palomo (Orthopaedics), Melissa Torres (Adult Surgery), Alicia
Williams (Internal Medicine) and Mary Williams
(Medical Records).
Taroub Baba (Dermatology) is recognized with an honorable mention.
A
special "shout out" goes to UT employee Jacqueline
Legette (Family Medicine) for a job well done.
Each month
the Best Employees committee reviews
nominations to determine eligibility for recognition and the level of
recognition to be awarded. The Best
Employees program also arms
supervisors with the ability to reward employees with on-the-spot recognition
for providing exceptional customer service. For more information, visit
www.UTdocs.com and click on Best Employees
Program.
To
nominate a UT Physicians employee for
Best Employees
recognition, fill out the
Best Employees online nomination form or
pick-up a
nomination form in any UTP clinic, complete the form and place it in the Best
Employees box in the clinic.
Brenda, DeLeon
UTP June Employee of the Month

UT Imaging Now Offers Digital Mammography
Digital
mammography is newly available at UT Imaging.
Screening mammograms are offered Monday through Friday,
8:00 a.m. to 4:00 p.m. Diagnostic
mammograms and breast ultrasounds are available Mondays and Thursday,
8:00 a.m. to 11:00 a.m., with a radiologist trained in breast imaging
onsite to interpret those
studies.
Call
UT Imaging at 713-375-1260 to schedule patients for mammograms.
Patients that have had prior mammograms should bring their prior year's
study with them to their appointment for comparison.
Other diagnostic imaging studies, including DEXA bone density studies,
can be scheduled at the same time as the patient's mammogram.
Coming
soon at UT Imaging.Breast MRI.

UT Physicians to Open Walk-in Clinic Mid-August
To
improve access to care for UTP patients and UT/UTP employees, UT Physicians
Priority Care Clinic will open in mid-August.
The clinic, staffed by a UT School of Nursing
nurse practitioner, will accommodate walk-in patients with minor to moderate
medical concerns who are unable to get a same-day appointment with their regular
physician. After an office visit,
the Priority Care clinician will communicate the specifics of the patient
encounter to the patient's regular physician and instruct the patient to
follow-up with that physician. Patients
who do not have PCPs will be referred to a UTP PCP to manage their care and
refer, when necessary, to UTP specialists. Look
for updates on UT Physicians Priority Care Clinic in coming weeks.

UT
Ophthalmology Moves to New Clinic
The clinical faculty of
Department of Ophthalmology & Visual Science at The University of Texas
Medical School at
Houston
are now seeing patients in the new Robert Cizik
Eye Clinic located in the
Memorial
Hermann
Medical
Plaza
, next to the UT Professional Building. Call
713-599-1777 for information and appointments.

New UT Mental Health Clinic Opens in UTPB
The
UT Department of Psychiatry and Behavioral Sciences offers diagnostic,
psychotherapeutic and medication management services for children, adolescents
and adults experiencing mental health disorders. The department's new clinic
in the UT Professional Building serves patients of all ages and is staffed by
faculty physicians. Clinical
services provided:
.
Patient assessment within 48 hours of referral
.
Individual psychotherapy
.
Group therapy
.
Psychological testing
.
Medication management
.
Appropriate referrals, if required
The
treatment philosophy encompasses elimination of stigma related to mental
illnesses and offers the goal of full recovery and functioning in all spheres of
life (family, work setting, social environment).
Pedro Ruiz,
MD, Professor of Psychiatry and Vice Chair for Clinical Affairs, provides
oversight of the clinical operation of the mental health services at the Mental
Sciences Institute (MSI) and the UT Professional Building (UTPB). Dr. Ruiz has
extensive experience in clinical psychiatry and is the past president
(2006-2007) of the American Psychiatric Association (APA).
Insurance
coverage or full payment at the time of service is required. Locations
and contact information:
UT
Psychiatry and Behavioral Sciences
Mental
Sciences Institute (MSI)
Phone: 713-500-2525
1300 Moursund Street
, at the corner of
M. D. Anderson Blvd.
Fax: 713-500-2530
Houston
,
Texas
77030
UT
Psychiatry and Behavioral Sciences
UT
Health
Science
Center
Professional
Building
(UTPB)
Phone: 713-500-5880
6410 Fannin Street,
Suite
1520
Fax:
713-500-0506
Houston
,
Texas
77030
http://med.uthtmc.edu/departments/psychiatry/

CMS -1500 Claim Form Now
Accommodates up to Eight Diagnosis Codes
Effective for Medicare claims
processed on or after July 1, 2007, the Part B standard and carrier claims
processing systems will capture and process up to eight diagnosis codes on all
claims (both paper and electronic). Providers should make sure their billing
staffs are aware of this change. The complete article is available on the CMS
MLN Matters Web page at: www.cms.hhs.gov/MLNMattersArticles/downloads/MM5441.pdf.
An updated example can be found on the
TrailBlazer Web site at: ww.trailblazerhealth.com/Publications/Job%20Aid/Item%2021%20example.pdf

New LCD Job Aid
A New Searching
the Local Coverage Determinations Job Aid has been developed to assist providers with
accessing and searching the Local Coverage Determination (LCD) tool on the
redesigned TrailBlazer Web site. This job aid includes step-by-step instructions
and tips on how to search, sort and view LCDs as well as the types of
information that will display. The job aid is available on the LCD
Web page and on the Job
Aids page.

Find
MRA Descriptions on TrailBlazer Web Site
Part B POE recently
added a new feature to the Self-service option on the TrailBlazer Web site.
Users are now able to enter a reason code from their Medicare Remittance Advice
(MRA), and find the description of the reason code. An associated solution (in
red text) is also available from the search.
Example: If
your MRA indicates your claim did not process and you see a reason code of M20
on the MRA details, enter M20 in the reason code search, click search and obtain
the following message:
Details for Reason Code M20
Missing/incomplete/invalid HCPCS.
Providers should utilize a current HCPCS manual. Verify the HCPCS code submitted
in Item 24d or the electronic equivalent, make any necessary changes and
resubmit the rejected/unprocessable claim to Medicare.
Note: You
will see the "B" icon located next to the reason code. The "B" indicates
this reason code applies to Medicare Part B.
This Reason
Code Search tool is not currently an all-inclusive listing. TrailBlazer will
be adding new codes as they are identified, so please be sure to visit the site
often for updates.
You will
find the Reason Code Search tool on the TrailBlazer Web site at the following
link: www.trailblazerhealth.com/Tools/ReasonCodeSearch.aspx

Medicare Reject
"Old" CMS-1500 (12/90) Forms After July 2, 2007
Effective
July 2, 2007, providers who submit paper claims will be required to begin
submitting the new CMS-1500 (08-05) form. The CMS-1500 (12-90) form will be
returned/rejected if received on or after July 2, 2007. The claims will need to
be resubmitted on the new form. Read
the TrailBlazer Notice.

 TMA
Reports Physicians to Get a Raise from Medicaid
High
volume payments to physicians that care for Medicaid recipients will end August
31, 2007. But, physicians will be getting a raise.
·
Lawmakers voted to
boost long-neglected physicians' payments for children's Medicaid services
by a historic 25 percent, and adult services will see a 10-percent hike. U.S.
District Judge William Wayne Justice, who is overseeing the settlement in the
Frew
vs. Hawkins lawsuit, will hold a hearing on the details July 10. TMA is
not a party to the lawsuit. The new rates take effect Sept. 1.
·
CHIP enrollment
and eligibility requirements will be simplified under House Bill 109 by Rep.
Sylvester Turner (D-Houston) and many others. The changes include 12 months'
continuous coverage for nearly all children on CHIP and children's Medicaid.
·
A Medicaid reform
bill will give
Texas
the tools to join other states in finding new ways to stretch our state and
federal health care dollars. Senate Bill 10 by Sen. Jane Nelson (R-Lewisville)
will extend private coverage for low-income parents and reduce the number of
uninsured children, create and maintain local public-private collaborations to
address the uninsured, and test new initiatives such as health savings accounts
for Medicaid recipients.

TMA
Offers Tool to Access Physicians' NPI Numbers
The TMA has now activated
the tool to get physician NPI numbers. Go to www.texmed.org.
The NPI numbers available are TMA members who have input or reported to TMA
their NPI number. Physicians can
authorize staff to go into this section of the TMA Web site. Also,
the Harris County Hospital NPI numbers that TMA has collected are also available
at this site.

View
the
Harris
County
Medical Society Physician Newsletter Online
Access
the current HCMS Physician Newsletter and the newsletter archive at http://www.hcms.org/Template.aspx?id=122.

TrailBlazer Requests Users
Update Web Profiles
To assist TrailBlazer with mandated tracking and reporting requirements,
providers are asked to update their personal information under Edit Profile to
include their Medicare NPI or provider number. Any
providers that have not previously registered for TrailBlazer's Web site, are
encouraged to register at this time. Register today to take advantage of
all TrailBlazer's tools, training classes and listservs.
Providers
Requested to Update Web Site Profiles
FAQs
for TrailBlazer's Redesigned Web Site.
Introduction
to the New TrailBlazer Web Site Tutorial.
Utilizing
Education Information Tutorial.
Creating
and Editing a Web Profile Tutorial.

Try United Healthcare's Real Time Adjudication
The claim
submission feature on www.UnitedHealthcareOnline.com was recently enhanced to
include Real-Time Adjudication. Real-Time Adjudication allows organizations like
yours to submit and process professional claims for patients quickly and easily,
and receive an immediate return of a full adjudicated claim value including the
patient's responsibility based on contracted discounts and plan benefits. You
can also print a Patient Confirmation Statement and share this information with
your patient following their office visit. This will give you the opportunity to
inform patients about their medical expenses while they're at your office and
speed up the billing process for the patient's portion. Use United Healthcare
Online to submit a claim and see how easy it is!
Go to https://www.unitedhealthcareonline.com/b2c/CmaAction.do?viewKey=PreLoginMain&forwardToken
=PreLoginMain

Additional Managed Care/HMO
Information Now Available on the Part B Interactive Voice Response (IVR)
The CMS Medicare Contractor Beneficiary and Provider Communications Manual
100-09, Chapter 6, Section 50 indicates contractors shall update Interactive
Voice Responses (IVRs) to address provider needs. In response to the increased
number of calls the Customer Service department has received, the
IVR now provides a patient's managed care (HMO) effective and termination
dates, the plan name, plan address and plan type. As a result, a
Customer Service Representative (CSR) can no longer assist callers with
eligibility information regarding managed care. You must obtain this information from the IVR. To
learn additional information regarding this IVR process change, please view the
entire notice at: http://www.trailblazerhealth.com/Tools/Notices.aspx?id=11887

Medicare Pays for DEXA to Monitor Osteoporosis Drug Therapy
The claim
submission feature on www.UnitedHealthcareOnline.com was recently enhanced to
include Real-Time Adjudication. Real-Time Adjudication allows organizations like
yours to submit and process professional claims for patients quickly and easily,
and receive an immediate return of a full adjudicated claim value including the
patient's responsibility based on contracted discounts and plan benefits. You
can also print a Patient Confirmation Statement and share this information with
your patient following their office visit. This will give you the opportunity to
inform patients about their medical expenses while they're at your office and
speed up the billing process for the patient's portion. Use United Healthcare
Online to submit a claim and see how easy it is!
Go to https://www.unitedhealthcareonline.com/b2c/CmaAction.do?viewKey=PreLoginMain&forwardToken
=PreLoginMain

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