September 2014

In This Issue:

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Summa Health Network
168 E. Market St.
Akron, OH 44309
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Mark Your Calendars for Upcoming SHN Seminars

Summa Health Network (SHN) will be hosting the following three seminars:

  • October 15, 2014:  Medicare Updates
  • November 5, 2014:  Selected Topics in Coding Procedure (Transitional Care Management Services, Coding Multiple E&M Visits on Same Day and Medicare Annual Well Visits)
  • December 10, 2014:  Chronic Care Coordination for Primary Care Physicians

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Anthem Discontinuing Paper Remittance Vouchers for ERA Providers

  • In May 2014, Anthem Blue Cross and Blue Shield (Anthem) notified providers of a new online electronic remittance advice (ERA) only registration process to be implemented in Fall 2014.
  • The new online ERA only registration process is now available and replaces any previously used ERA registration forms or processes. Providers registering for ERA and EFT at the same time should continue to use the CAQH website.
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Fraud, Waste and Abuse - Electronic Attestation Reminder

  • SHN must maintain records for all SHN provider members and their staff on Fraud, Waste and Abuse (FWA) training as SHN contracted Medicare Advantage payers may request copies of these records at any time.
  • In early September, SHN Account Executives emailed provider offices a letter and link for FWA attestation that needed to be completed and submitted electronically. If you have not yet completed the electronic attestation, please do so as soon as possible.
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BCHP Is Now Buckeye Health Plan

  • Buckeye Health Plan (Buckeye), formerly known as Buckeye Community Health Plan, recently announced a new name and look designed to project the innovative, customer-centered mission and goals of the company.
  • The new branding strategy for Buckeye is part of the comprehensive brand alignment by parent company Centene Corp. for its member companies.
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Summa Learning Center: a FREE Resource for SHN Members and Staff

Did you know the Summa Learning Center, located at Summa's Corporate Services Center (1077 Gorge Blvd., Akron, OH 44310) has resources that are FREE to all SHN members and their staff?

  • Over 170 courses to study, including more than 25 online Leadership Webinar classes
  • More than 150 courses are online and can be taken at home or in the library
  • All courses are FREE to Summa Health Network members and their staff

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2015 Changes to Aetna's Preferred Drug Lists

  • Annually, Aetna reviews their preferred drug lists (formulary) which show many of the drugs covered by patients’ plans.
  • Aetna updates these lists based on the latest medical findings, information from the Food and Drug Administration (FDA) and drug manufacturers, and cost arrangements (which include manufacturer rebates).
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Notice of Buckeye Health Plan's Upcoming Prior Authorization Changes

  • Effective November 1, 2014, Buckeye Health Plan is making some changes to services requiring prior authorization.
  • Certified mail notifications were sent to all of Buckeye Health Plan’s contracted groups on or before August 1, 2014.
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Molina Healthcare Offers Electronic Funds Transfers

  • Molina Healthcare offers electronic remittance advices and electronic funds transfers (ERA/EFT) with their contracted vendor ProviderNet.
  • Molina Healthcare picks up any fees related to the accessibility of your payment data as well as the EFT payment processing.
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