FEBRUARY 2014--PIKES PEAK PAHCOM NEWSLETTER
EXTRA.. EXTRA... READ ALL ABOUT IT!!! IN THE
PPP-N!
HONORING OUR IMMEDIATE PAST CHAPTER OFFICERS:
Pikes Peak PAHCOM honored the legacy of some very special members during the February
Meeting. Their service and dedication to our chapter cannot be measured:
Serving as a Pikes Peak Chapter Office is a "volunteer" position! These special members have
given their time, talent and personal sacrifice to assure that Pikes Peak PAHCOM was
successful! It was long overdue to say thank you and honor each of them for their years of
service and dedication to our chapter!
IMMEDIATE PAST CHAPTER OFFICERS:
Janet Burch, CMM, Founding President of Pikes Peak PAHCOM (1998-2013)
Stephen Johanns, CMM, HITCM-PP, Vice President (2001- 2013)
Kathy Bosche, CMM, Secretary (2001 - 2013)
Susan Ogden, CMM, HITCM-PP, Membership Director (2002-2013)
There would be no Pikes Peak Chapter without the "vision" from Janet Burch, CMM and her
strong guidance and dedication to first developing our chapter and continuing that through
2013! She has made Pikes Peak PAHCOM a legacy that is well-known in our medical
community, has helped our chapter to be so successful earning PAHCOM's highest honor as
Chapter of the Year -- 3 times and has reached out and helped many of us individually! She
was presented with the Founding President Award and a Lifetime Membership Certificate to
the Pikes Peak PAHCOM. Her legacy lives within all of us!
Stephen Johanns, CMM, HITCM-PP, was honored for his dedication to Pikes Peak PAHCOM
and his years of service as the chapter's Vice President. He was presented with the Vice
President Award and a Lifetime Membership Certificate to Pikes Peak PAHCOM. His
dedication and sacrifice to Pikes Peak PAHCOM cannot be measured. He set a great
example for those that will follow!
FEBRUARY 2014 -- PIKES PEAK PAHCOM NEWSLETTER
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Susan Ogden, CMM, HITCM-PP, was honored for serving as the Membership Director to Pikes
Peak PAHCOM and helping grow the membership from just a few members into a large
chapter. She was presented with the Membership Director Award and Lifetime Membership
Certificate to Pikes Peak PAHCOM. Her dedication to managing the chapter's membership
will never be forgotten!
Kathy Bosche, CMM, Secretary, was not able to be present at our February Meeting but will
be honored in March for her amazing organization skills she has provided to Pikes Peak
PAHCOM. She will be presented with the chapter's Secretary Award and a Lifetime
Membership Certificate to Pikes Peak PAHCOM. Her organizational skills are a gift that we
each received!
NEW PIKES PEAK PAHCOM EXECUTIVE COMMITTEE 2014:
Sandra Robben-Weber, CMM, HITCM-PP, President
Tari Gilmore, CMM, Vice President
Bridget Pieffer, CMM, Secretary
Lori Trivelli, CMM, Treasurer
Val Chavez, CMM, Membership Director
Debbie Carlson, CMM, Sponsors' Director
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New Executive Committee Members "EC": Many new and two prior members remain!
These are volunteer positions and we all work full-time-plus jobs, serve on ad-hoc
committees, etc., and we need extra help!! Please see one of the EC-M (Executive
Committee Members) if you can help!
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Breakfast Club "BC": Ad-hoc committee that originally started as a group of managers
that came together to study for their CMM Exam! Once they all took their CMM
Exams and passed!!!!! -- They continued meeting (with some new members) and
today "BC" is a very important division of Pikes Peak PAHCOM! They have also
provided a great deal to the membership! Again, all volunteering their expertise and
help!!! The "BC" plans two large meetings for PP-PAHCOM Annually! Educators
Meeting (Judy Boesen, Chair) and the Annual Payer Meeting. Plus they provide ideas
for programs, projects and announcements. Just last year, "BC" brought you a special
ICD-10 Kick-Off Meeting and developed a large list of resources. Please consider
attending "BC." The members that regularly attend the Pikes Peak PAHCOM Breakfast
Club were honored during the February Meeting! Thank You for All You Give Every
Day to our chapter and medical community!
FEBRUARY 2014 -- PIKES PEAK PAHCOM NEWSLETTER
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 Remember -- this is your PAHCOM, so please consider helping with
programs this year and there are so many ways to help!!!
UPCOMING MEETINGS: Mark your calendars!
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March 6, 2014 -- El Paso County Medical Society Office Managers' Association (OMA)
Meeting -- OSHA, MAC, 8:00 a.m.
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March 13, 2014 -- Value-Based Contracting -- Contracting Update -- Todd Welter &
Associates, MAC, 8:00 a.m. Reminder to register, Registration form sent out last Friday!!
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March 18, 2014 (Date could change)--Colorado ICD-10 Training Coalition- 12:00 noon
Webinar. Topic: More on Physician Documentation. "DOCUMENTATIMN" is the KEY to
SUCCESS with ICD-10! www.cms.org/ICD-10
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March 21, 2014 -- Breakfast Club -- Vail Room, MAC, 7:00 a.m.
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April 3, 2014 -- Employment Law -- Ray Deeny, Sherman & Howard Attorneys, MAC,
8:00 a.m.
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April 9, 2014 -- El Paso County Medical Society Office Managers' Association (OMA)
Meeting -- Stress Management-- MAC, 8:00 a.m.
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April 16, 2014 -- Special Breakfast Club Meeting -- Educational Institutions -Judy Boesen, Chair, MAC, 7:00 a.m.
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April 23-25, 2014 4-Corners MGMA Regional Conference, Phoenix, AZ. The conference
theme: "Turn Your Health Care Mirage into an Oasis." Please visit the Colorado MGMA
website -- www.cmgma.com for additional details. Early Bird registration has been
extended to March 21st ($195.00).
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May 8, 2014 -- Patient Centered Medical Home & Specialty Practice Designation -Dr. Austin Bailey, MAC, 8:00 a.m. Event will be co-sponsored by Memorial Hospital and
held at the Olympic Training Center Venue.
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A SUMMER OF ICD-10!!!!! You will be prepared!!!!
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June 12, 2014--ICD-10 Workshop--Denny Flint, Complete Practice Resources, 4 hour
meeting -- 8:00 a.m. - 12:00 noon. *Different Location to be determined!
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July 17, 2014--More ICD-10 from one of our ICD-10 Consultants. ICD-10 is so
important that we will schedule a regular meeting this year! No Boulder Park
lunch!!, MAC, 8:00 a.m.
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August --TBD -- More ICD-10 and will be a regular scheduled meeting. MAC, 8:00
a.m.
FUTURE PROGRAMS IN DEVELOPMENT:
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September Date -- The Annual Regional Payer Meeting. This will be after Labor Day,
cannot conflict with the Fall CMGMA Meeting in Denver and it needs to happen
before ICD-10 starts. Breakfast Club will finalize date.
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October 2014 -- No "Official" Chapter Meeting -- 26th Annual National PAHCOM
Conference & we will all be handling ICD-10 Issues! May be we will just have happy
hour!!!!
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November 19, 2014, MAC, 8:00 a.m. -- Topic to be determined!
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December 11, 2014 -- Annual Holiday Celebration, Empty Stocking Fund Auction!
MAC, 8:00 a.m.
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WINTER WEATHER -- MEETING CANCELLATIONS/POSTPONED: The Pikes Peak PAHCOM
Meetings during the winter months will be postponed if District 11 (D-11) is closed on
the meeting days. This is posted on all area TV stations and websites. If there is
enough notice, something will go out through national website email system and you
would receive an email but otherwise we will follow the D-11 Rule. We really try not to
cancel or postpone but many of our speakers come from Denver in inclement
weather and it can be difficult travel.
MEMBERSHIP:
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Membership with Pikes Peak PAHCOM requires both a National PAHCOM Membership
and PP-PAHCOM Chapter Membership! Yes, there are separate dues $$! Renewals for
National PAHCOM Membership are completed on-line; renewals for Pikes Peak
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PAHCOM will be emailed from the New Membership Director -- Val Chavez, CMM!
Please keep both memberships current! If you are a CMM or HITCM-PP do not let your
recertification(s) expire every other year.
 Did you know that you can save $100 when renewing the National PAHCOM
Membership by choosing "auto renewal." This does require a secure credit card to be
on file.
 PAHCOM's mission is about Sharing Knowledge ---- recruit your colleagues!! We need
more Pikes Peak PAHCOM members!! Bonus $$ -- a discount on your next chapter
renewal when you refer a new member to join!!
OTHER IMPORANT ANNOUNCEMENTS:
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Visit the National PAHCOM Website often -- lots going on! www.pahcom.com. PP-PAHCOM
Chapter Meeting Notices will be posted through the National PAHCOM website. You can
now upload your photo to your membership profile.
2013 Meaningful Use Attestation date for the 2013 reporting period has been delayed from
February 28th to March 31st! www.cms.gov/Regulations-and-Guidance/
Legislation/EHRIncentivePrograms/index.html
Lots happening in Washington with possible changes to the SGR Fix that could change how
physicians are paid by Medicare. The current fee schedule is in place until March 31, 2014
Email your congressional leaders often!! www.ama-assn.org/grassroots.
OB-GYN Practices: I received an alert from Kim Martinez, Physician Advocate for Colorado
Springs UHC/Tricare: Kim Martinez, Physician Advocate kimberly_r_martinez@uhc.com Phone: 719-275-2541.
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We have received clarification regarding penalties assessed for OB providers not calling in the OB
Admissions. It has been determined the OB provider must also call in the inpatient admit so that he or
she will not be assessed the 10% penalty for no authorization.
Please note this is a not a change. Also, please be aware this is a clarification from the Department of
Defense.
Please see supporting documentation in the Provider Handbook.Provider Handbook info Page 14
When a provider signs a contractual agreement to become a PCM (only applicable in PSAs), the
provider must follow TRICARE procedures and requirements for obtaining specialty referrals and prior
authorizations for nonemergency inpatient and certain outpatient services. Claims submitted for
services rendered without a required prior authorization are subject to a penalty based on the
contracted rate.
Page 57 Referrals and Authorizations
If you are the PCM or primary care provider for a beneficiary who becomes pregnant, you will need
to either refer her to an obstetrician or, if you are going to manage the pregnancy, handle the required
prior authorizations throughout her pregnancy. Obstetric services require prior authorization from
UnitedHealthcare for TRICARE Prime, TPR, and TPRADFM beneficiaries. The prior authorization should be
obtained at the mother’s first appointment with the PCM or primary care provider involving the
pregnancy. The prior authorization will begin with the first prenatal visit and remain valid until 42 days
after birth. Prior authorization must be obtained for both inpatient and outpatient services. If your
patient intends to deliver in a civilian (non-MTF) facility or birthing center, a separate prior authorization
FEBRUARY 2014 -- PIKES PEAK PAHCOM NEWSLETTER
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for the delivery portion of her maternity care must be obtained at the time of delivery. If the
patient is a TRICARE Prime beneficiary, she must use a network facility for delivery.
Additional prior authorization is required for maternity inpatient stays (length of stay cannot be
restricted to less than 48 hours following a normal vaginal delivery and 96 hours following a
cesarean section). Please contact Kim Martinez for additional questions, contact information
above.
More Tricare Update: Members of UHC Advisory Board (many of which are also
PAHCOM Members) met with Colonel Timothy Ballard, M.D., Senior Market Manager,
COS Market. He has a team of eight and is out in the community developing
relationships with providers and organizations along with assuring that coordinating
care for the17K+ members. The military is being faced with many of the same
challenges that practices are facing with EHR and all the comes with that, they have
to now work more closely with community providers and Colonel Ballard is being
faced with large budget cuts in his department. He will be with us until summer and
then his replacement will take over. We have requested some town-hall meetings in
the future to continue communications and truly collaborate with the Military
Treatment Facilities and the COS area providers.
One stop place for COS providers to speak with military providers: This
is something that has been needed in this community for years:
719.524.4152 (M-F) 7:30 am - 3:30 pm
After Hours Provider Calls: 719. 524.CARE (2273) Option 4, then specify
facility
Reminder to fax All Clinical Documentation to: 877.813-1756
Prescription Information: They are working on an E-prescribing system.
Evans Rx Fax Line: 719.526.5917
USAFA Rx Fax Line: 719-333-5694
Written/Faxed Rxs only: Pick up at MTF (M-F 8:00 a.m. - 5:00 p.m.)
Colonel Timothy Ballard, M.D. contact information: 719.440.3294 (cell);
timothy.ballard@us.af.mil
National Office: Please keep our National Executive Director, Karen Blanchette and her
husband Dan Labelle in your thoughts and send "positive energy" and /or prayers their way
as Karen has requested. Her husband Dan is undergoing a life-saving surgery this week. For
those of you that have attended a last few National Conferences, Dan is Karen's right hand
at these conferences and such a great person! Pikes Peak PAHCOM sends A LOT of Positive
Energy to Florida for a safe procedure for Dan and support for Karen!
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FEBRUARY 2014 PIKES PEAK PAHCOM MEETING SPONSORS RECOGNIZED:
 Corporate Sponsor(s): Debbie Carlson, Sponsors' Director. Each month two of
our corporate sponsors are invited to briefly present information about their
services and organizations. February's Corporate Sponsors:
 Peak View Behavior Health: www.peakviewbh.com (719) 444-8484. Behavior
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health services for seniors, adults and adolescents struggling with non-crisis and
crisis situations. Contact: Robin Patterson, Community Liaison
rpatterson@strategicbh.com
Hub International: www.hubinternational.com (800) 748-2400 (COS office). Is
able to help practices with employee benefits, voluntary benefits and all types
of insurances for the medical practice. Contact: Andrea Baldrica, Client
Executive, Vice President, andrea-baldrica@hubinternational.com
Memorial Hospital: Provides our room and refreshments each and every
meeting that Pikes Peak PAHCOM is in the MAC facility. We specifically want to
thank Debra Miller, Stephanie Nixon and CJ McCormack.
Pikes Peak PAHCOM would like to thank ALL of OUR SPONSORS for all their
support at each and every meeting! We could NOT provide such valuable
education programs without ALL of their ongoing support!
QUOTE: The True Definition of Putting in an EHR, etc...........We're trying something
new ... we're going to be bad at it...we're going to do it anyway... then we'll get better at it!
Chris Clarke-Epstein
Sandra Robben-Weber, CMM, HITCM-PP, PP-PAHCOM 2014 President
FEBRUARY 2014 -- PIKES PEAK PAHCOM NEWSLETTER
sandra@cspulmonary.com
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