MedCost hosts an educational teleconference for providers each month. If your practice or facility is new to the MedCost network or if there have been recent changes in your billing or accounts receivable staff, we encourage you to participate in one of these beneficial sessions. Each teleconference will offer an overview of MedCost’s PPO and Health Management services, as well as efficient claims filing techniques to ensure prompt payment for your practice. You may register for the teleconference online at www.medcost.com. Summer teleconferences are scheduled for June 17, July 15, August 19, and September 16.

MedCost would like to express its appreciation for all the providers who stopped by its exhibit booths at the North and South Carolina Healthcare Management Conferences. Our provider relations specialists enjoyed meeting many people from MedCost participating practices and facilities.
 
“Spring Into Action and Empower Your Practice” was the theme for North Carolina’s conference held April 23-25 in Myrtle Beach, SC. Approximately 161 provider participants visited the MedCost booth, and we appreciate your participation. The NCMGM presents an annual award to the Medical Mutual Administrator of the Year. MedCost recognizes and congratulates Debbie Cashion with Catawba Pediatrics as this year’s recipient of that award.

Approximately 140 people visited MedCost representatives at the South Carolina Healthcare Managers Association conference April 17-18 in Columbia. “Dancing Around the Issues” was this year’s theme.

Has your office relocated? Changed business contact numbers? Added treating physicians? Opened a satellite location? These types of changes can affect the prompt processing of claims for your practice/facility. According to accreditation standards, MedCost cannot assign retroactive effective dates for provider participation. Therefore, it is critical that any and all changes to your practice/facility information are forwarded to MedCost as soon as possible. You may fax changes to 336-970-2199,

ATTN: MedCost Network Operations. Keeping us informed enables us to provide the most efficient, highest quality service to you.

MedCost is pleased to announce the recent addition of a bilingual customer service representative. We hope this will allow us to better serve all of our Spanish-speaking callers. For assistance, please call 800-824-7406.

On May 21, 2008, the President signed House Rule 493, known as the Genetic Information Nondiscrimination Act of 2008, into law. This Act makes changes to the HIPAA portability rules in ERISA, the PHSA, and the Code, adding new provisions regarding genetic information that will apply to group health plans and insurance issuers offering group health insurance coverage, as well as provisions for insurance issuers in the individual market. It also requires amendments to the HIPAA privacy regulations and prohibits discrimination in the workplace on the basis of genetic information.

For a copy of the legislation click here:

Did You Know…?
Did you know that you could check on state and federal introduced/pending/passed bills related to health care on the MedCost web site? Visit www.medcost.com, click on the Physicians & Providers section, and then choose Legislative News from the left navigation bar.

MedCost is the leading independent health management company in the Carolinas. MedCost is not an insurance company; we serve clients across North and South Carolina through our extensive PPO network and innovative health management programs.

MedCost has been in business since 1983. Even though we’re the largest organization of our kind, our customers don’t have to worry about bureaucratic red tape. We’re still a company that regards our clients as partners, and we respond quickly to their needs. We’re innovative, too, always seeking new ways to use technology to deliver our products and services with increased speed and accuracy.

Like our customers, we’re results-oriented, so we’ve made our reporting as informative and helpful as possible to assist those managing employee health care benefits. Put simply, MedCost offers its customers the benefits of 25 years’ experience without the bureaucratic hassles.

Our Mission
MedCost is committed to providing customers with high quality, cost-effective managed health care programs delivered by conscientious employees, operating under high standards of performance and integrity. We accomplish this by:

• Listening to our customers.
• Placing our customers’ needs and concerns ahead of our own.
• Responding to our customers promptly and accurately.
• Constantly searching for ways to improve the services we provide to our customers.

More than 300 medical group managers from North Carolina, South Carolina, and Georgia will participate in the first-ever Tri-State Healthcare Management Conference in Asheville, NC, from August 10-13, 2008. The conference, “Uniting Today’s Leaders for Tomorrow’s Healthcare,” will be held at the historic Grove Park Inn Resort and Spa. MedCost is exhibiting at the conference and welcomes you to visit our booth. You will be able to speak directly to Network Operations/Provider Relations staff members, collect helpful information about MedCost’s services, and register for wonderful door prizes. We are excited to be a part of this groundbreaking opportunity, and we look forward to seeing you there!

As providers work to ensure their compliance with NPI mandates, some confusion has surfaced regarding the need to file claims with the physician name located on the claim. Some organizations have been advised by external sources that filing with the provider’s NPI number and “signature on file” notification is sufficient for claims processing. As a result, MedCost has received some claims with an NPI number, but no corresponding physician or facility name. Since all providers have not submitted NPI numbers for their practices/facilities, MedCost cannot process such claims. If claims cannot be processed, then they are represented on the non-priced section of the online Claims Repricing Report. To process claims efficiently for your practice, MedCost urges all providers to file claims with both the registered NPI number and provider name.

MedCost works diligently to ensure your claims are processed and forwarded for payment as soon as possible. The absence of an NPI AND the rendering provider name may cause an unnecessary delay in our ability to process a claim.

Important NPI Filing Tips:

• To ensure claims repricing accuracy, please file your claim
  with both your registered NPI number and provider name.
• File a separate claim form for each rendering provider.
• Place the rendering provider NPI in the following location:
  

• View all claims processed for your practice during a specific date range;
• Verify the billed amount and repriced amount for claims;
• Review any claims that were not repriced; and
• Download information into Excel or DBF format so you can sort and save as needed.

[As a reminder, MedCost no longer mails Claim Activity Reports to providers, nor do we return claims that require additional information. The online Claim Activity Report should be routinely reviewed to evaluate any claims requiring further action from your practice.]

Our Claims Repricing Inquiry allows you to:

• Verify receipt of claims and repricing;
• Query individual claims;
• Link directly to the claim administrator;
• View messages regarding additional information needed for claims; and
• Submit additional claim information via e-mail for faster processing.

With the Reference Guide, you can:

• View a comprehensive listing of payers/employers who access the MedCost network; and
• Verify basic benefit plan information, including group names, group numbers, and Claim Administrator contacts.

To begin using MedCost online services, designate one individual from your practice/facility to be the Account Administrator. This person will register first, and then establish Staff Accounts for others who need access to the MedCost web tools. To register, go to www.medcost.com, select the section entitled Physicians & Providers, select Provider Claim Activity Report from the left page border, and follow the onscreen prompts to complete the registration process.

A detailed explanation of each tool is offered online, or you can join one of our monthly provider teleconferences. (See article on teleconferences for dates.) We strongly encourage you to take advantage of the full range of web services we offer. If there are additional web-based tools that would assist your practice/facility in its interface with MedCost, please e-mail cswebservices@medcost.com with additional details.

MedCost Participates in Workshop on Pandemic Flu Preparedness

MedCost recently took part in a “Workshop on Community Partnerships for Pandemic Influenza Planning,” sponsored by the Centers for Disease Control and Prevention (CDC), in partnership with the Oak Ridge Institute for Science and Education.

The workshop was conducted April 22 – 24 in Indianapolis, Indiana, and provided an opportunity for collaboration between community partners to plan for an influenza pandemic and its impact on their local healthcare systems. The goal of the workshop was to identify internal and external gaps in disaster plans and strategize ways to fill these gaps. The CDC will use information and ideas from the workshop as a model for communities throughout the United States planning to develop a disaster plan.

Winston-Salem was one of only two communities selected to participate in the workshop; the other chosen community was Champaign, Illinois. Winston-Salem was selected after a physician from Wake Forest University Baptist Medical Center applied for the workshop grant available through the CDC.

Attendees at the workshop included representatives from the following national, state, and local organizations:

• Centers for Disease Control and Prevention (CDC)
• City of Winston-Salem
• Department of Health and Human Services
• Department of Homeland Security
• Emergency Management Strategic Healthcare Group
• Forsyth County Department of Public Health
• Forsyth County Emergency Medical Services
• Forsyth County Fire Department
• Forsyth County Office of Emergency Management.
• Forsyth Medical Center
• Forsyth-Stokes-Davie Medical Society
• Gentiva Home Health
• North Carolina Office of EMS Disaster Medical Services
• Novant Medical Group
• Oak Ridge Institute for Science and Education
• Salisbury Veteran’s Administration Medical Center
• Triad Regional Advisory Committee (regional trauma planning)
• Wake Forest University
• Wake Forest University Baptist Medical Center
• Winston-Salem/Forsyth County Schools

Topics covered during the workshop included: keeping key sectors and services going through loss of personnel (including chain of command and succession planning); making ethical choices related to equipment and resource shortages; maintaining communications, transportation, and security; managing fatalities, ensuring proper credentialing of outside workers coming in to assist, suspending certain health and wellness activities (physicals, colonoscopies, etc.), and dealing with the post-pandemic backlog of insurance claims filing and reimbursement.
Pandemic flu is virulent human flu that causes a global outbreak, or pandemic, of serious illness. Because there is little natural immunity, the disease can spread easily from person to person. In a normal flu season, 5 - 20% of the population is affected.

In a pandemic, approximately 30% of the population is affected. An especially severe influenza pandemic could lead to high levels of illness, death, social disruption, and economic loss. Impacts can range from school and business closings to the interruption of basic services such as public transportation and food delivery. Health care facilities can be overwhelmed, creating a shortage of hospital staff, beds, ventilators and other supplies. The demand for a vaccine also is likely to overwhelm its supply, and the supply of antiviral drugs is also likely to be inadequate early in a pandemic.