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UTP Best Employees June Honorees
UT Imaging Now Offers Digital Mammography
UT Physicians to Open Walk-in Clinic Mid-August
UT Ophthalmology Moves to New Clinic
New UT Mental Health Clinic Opens in UTPB
CMS - 1500 Claim Form Now Accommodates up to Eight Diagnosis Codes
New LCD Job Aid
Find MRA Descriptions on TrailBlazer Web Site
Medicare Reject "Old" CMS-1500 (12/90) Forms After July 2, 2007
TMA Reports Physicians to Get a Raise from Medicaid
TMA Offers Tool to Access Physicians' NPI Numbers 
View the Harris County Medical Society Physician Newsletter Online
TrailBlazer Request Users Update Web Profiles
Try United Healthcare's Real Time Adjudication
Additional Managed Care/HMO Information Now Available on the Part B Interactive Voice Response (IVR)
Medicare Pays for DEXA to Monitor Osteoporosis Drug Therapy
Provider Update: New and Inactive Providers
UTP Referral Tool
Access the UTP Telephone Triage Tool
Ideas, Comments and Questions

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



Provider Update: New and Inactive Providers
New Providers Credentialed in June 2007

Name

Specialty

Averill, Patricia, Ph.D.

Psychology

Bai, Yu, M.D.

Pathology

Beauchamp, David A., M.D.

Anesthesiology

Blakley, Olga P., M.D.

Anesthesiology

Boehme, Christopher L., M.D.

Psychiatry

Broussard, Stephanie L., N.P.

Nurse Practitioner

Chen, Lei, M.D.

Pathology

Droemer, Gayle P., N.P.

Nurse Practitioner

Fernandez, Jose M., Jr., M.D.

Psychiatry

Fu, Chiawan, M.D.

Anesthesiology

Gruber, Nelson P., M.D.

Psychiatry

Guardiola, Amalia, M.D.

Pediatrics

Gummattira, Pushpa K., M.D.

Psychiatry, Adult

Hildebrand, Mary P., N.P.

Nurse Practitioner

Hildebrand, Michael E., M.D.

Anesthesiology

Hoefer, Heidi F., M.D.

Anesthesiology

Le, Hieu H., M.D.

Anesthesiology

Littles, Sabrenda T., C.R.N.A.

C.R.N.A.

Logan, Mark J., P.A.

Physician Assistant

Malkina, Svetlana, M.D.

Psychiatry

Morgan, Sharon T., Ph.D.

Psychology

Movva, Sunil, M.D.

Internal Medicine

Probst, Xiao S., C.R.N.A

C.R.N.A.

Rieniets, Cynthia Y., M.D.

Radiology

Schatte, Dawnelle J., M.D.

Psychiatry

Schneider, Laurie, M.D.

Psychiatry

Scott-Gurnell, Kathy C., M.D.

Psychiatry, Child & Adolescent

Shah, Nurun N., M.D.

Psychiatry, Adult

Surabhi, Venkateswar, M.D.

Radiology

Vittone, Alicia B., M.D.

Psychiatry

Warneke, Kimberly A., M.D.

Psychiatry

Zhao, Bihong, M.D.

Pathology

Provider Status Changed to Inactive
(Notification Received by UTP June 2007)

Name

Specialty

Effective Date

Bilow, Ronald, M.D.

Radiology

4/21/07

Dancel, Marietta , M.D

Family Medicine

7/1/07

Knight, Richard, M.D.

Organ Transplant Surgery

7/1/07

Krampert, Steven, M.D.

Radiology

7/1/07

Livingston, Christopher, M.D.

Facial Plastic & Reconstructive Surgery

6/30/07

McNiece, Karen, M.D.

Pediatric Nephrology

5/31/07

Pereira, Kevin, M.D.

Pediatric Otolaryngology

6/30/07

Podder, Hemangshu, M.D.

Organ Transplant Surgery

7/31/07

Portman, Ronald, M.D.

Pediatric Nephrology

7/31/07

Shu, Tung, M.D.

Urologic Oncology

6/30/07

Stanton, Daniel, M.D.

Radiology

7/1/07

Woldesenbet, Mesfin, M.D.

Neonatal / Perinatal  Medicine