Volume I - 2017

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Summa Health Network
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Akron, OH 44309
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Medicare Revalidation Tool

 A listing of all currently enrolled Medicare providers/suppliers is available by using the Medicare Revalidation List. You can search for a provider/supplier by last name, first name, organization name, or by National Provider Identifier (NPI),or download a list of revalidation due dates.

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Coding to Specificity Changes with SummaCare

Since the implementation of ICD-10, SummaCare has not denied claims based solely on the specificity of the ICD-10 diagnosis code as long as the physician/practitioner used a valid code from the correct family.

Effective June 1, 2017, SummaCare will begin rejecting claims that are not coded to the highest level of specificity. The ICD-10 code set allows clinicians to more precisely describe diseases and conditions than they could before.

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CMS Requirement for Buckeye Health Plan - Questionnaire

The Centers for Medicare and Medicaid Services (CMS) has provided guidance on data elements which are required for tracking and which will be published in Buckeye Health Plan's Provider Directory. These data elements need to be collected at this time and will be required to be updated regularly.

CMS is now requiring all health plans to track and publish Accessibility, Hours of Operation, Language Spoken and Specialized Training information for all providers for all service locations.

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Molina Survey Seeking Offices to Participate

Molina Healthcare is going to offer a small survey in the next two weeks, and they will be seeking physicians and office staff to participate. The survey contains 10 questions regarding Molina Healthcare and should take 30 minutes or less.

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MultiPlan Is Getting a Makeover

This spring and summer, MultiPlan is making exciting changes to their brand. The makeover began in April as they introduced a refreshed MultiPlan logo and visual platform.

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