2011 August/September - Physician and Practice Information
Are there children who have not yet been seen in your office this year? Now is the time to schedule their well child visits, as each child age 3-6 must receive a well child visit during 2011 to meet this PIP measure.
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This new measure in 2011 addresses chronic kidney disease and includes patients with diabetes and/or hypertension, ages 18-65.
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Plan average for 2010 year-end ePrescribing PIP measure was 47%.
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As we work together to provide quality care to our members, we’re educating them about the dangers of too much radiation. For example, the radiation in a CT scan equals 100 -800 chest X-rays, and fluoroscopic procedures could expose patients to as much radiation as 250 – 3,500 chest X-rays.
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Do your patients know costs vary based on where a procedure is done? If your patient is planning a non-emergency test or surgery, and a surgical center (or your office) is appropriate for their situation, it may be a cost-saving option.
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As part of our commitment to helping you provide excellent, affordable care to your patients, we’re increasing reimbursement for certain procedure codes to encourage more office-based procedures.
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This fall we’re upgrading our Find A Doctor tool to show HealthGrades® ratings for all physicians in our network.
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Priority Health requires that medical records submitted for review be signed by the practitioner.
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Beginning August 29, 2011, American Imaging Management (AIM) clinical guidelines will be updated.
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National Depression Screening Day (NDSD), held during Mental Illness Awareness Week each October, is Oct. 6, 2011.
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Clinical practice guidelines are developed in collaboration with area physicians based
on standards established by national organizations.
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Continue to educate patients regarding flu shots.
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Judy Breuker will offer the Code with Confidence classes in September 12.
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As of May 10, Express Scripts mail-order changed the pricing of many inexpensive generic medications.
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A correction to the article “Advair and Flovent move to non-preferred” from the June/July 2011 edition.
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On July 19, the Pharmacy and Therapeutics (P&T) Committee met and reviewed several drugs, policies and prior authorization criteria.
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The Centers for Medicare and Medicaid Services (CMS) is holding us accountable for ensuring that Medicare members who have diabetes and high blood pressure are taking an ACEI or ARB medication.
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Encourage your Priority Health Medicare patients to get their 2011 influenza vaccine. Recommend
the pneumonia shot as well, especially for those patients who have an underlying chronic condition
or respiratory disease, as they are at higher risk for fatalities.
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Each year, one in every three adults ages 65 and older falls. These falls can lead to injuries such as hip fractures and head trauma, and can even increase the risk of early death.
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More than 700,000 Americans visit an emergency room each year due to adverse drug events or incidents related to the use of a drug, but more than a quarter of these types of events are preventable.
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