This teen has commercial insurance through the bio dad and bio mom and dad share joint custody but teen does not live with them.
The insurance is not the question. It is more who and how do we financially hold responsible without signatures from bio parents.
The teen can fill out all of the paperwork…Read more

Does the teenager have access to a telephone? They should be able to apply for OHP…Read more

We are having success with the following:

ASQ – (DX -Z13.42) – Modifier XU 96110001
MCHAT (DX -Z13.41) – Modifier XU 96110002
Vanderbilt ADHD screen- (Z13.39) – Modifier XU 96127001
Connors Scale for ADHD 96127002
Edinburgh Post-Natal Depression – Modifier XU…Read more

They need to love their jobs.

Take a good look at how the providers are treating the MAs. Do they call out more when they are working with someone difficult? Are the managers and providers standing up for them when…Read more

I recall at least one CHA clinic was utilizing Nectar Employee Rewards platform to increase employee engagement. That platform may not…Read more

I recall at least one CHA clinic was utilizing Nectar Employee Rewards platform to increase employee engagement. That platform may not…Read more

I recall at least one CHA clinic was utilizing Nectar Employee Rewards platform to increase employee engagement. That platform may not…Read more

I hope my asking this question will be helpful to others beside CHA.

CHA is planning to move from Pacific Office Automation to Solutions Yes for our copier rental / printing service.

Does your clinic have a recommendation for a reliable, affordable Copier vendor with good customer service?

Thank you in advance!

Linguava and Passport to Languages state that their interpreters do not have to assist with paperwork if the interpreter chooses not to.

Some interpreters state they will assist with this is someone from the…Read more

“On October 1st, CMS released its quarterly updates to
NCCI edits that many payers use. This edit was
implemented in error and has resulted in the COVID-19 vaccine
administration code 90480 being bundled with…Read more

There is a…Read more

They use IT Group NW and are happy with their services.

For any other replies, It would be very helpful if you would use the link at bottom of the email notification to write your answer here on this board.

Thank you!

Thank you!

Susan Jacobs of CHA

I got a message from our clearinghouse support team today that basically, our clearinghouse has exhausted all efforts to get any missing ERA’s. I think we have gotten all of ours in actually now…..but it’s been a chore. I ca…Read more

Or did you contact them by email?

A clinic has asked – Do any CHA clinics have a recommendation for a vendor who calibrates audio medical equipment?

They have used the same company, Crystal Clear Audio-Medical, for years and they’ve done excellent work, but are no longer returning messages. Clinic fears this vendor has gone out of business.

Does your clinic have a…Read more

https://oregoncertified.com/

Thank you in advance!

Susan Jacobs

If your clinic is utilizing the Reach Out and Read Program, how are you funding the program?

Thank you!

A clinic reached out to ask what Providence OHP is reimbursing for CPT code 87428, for a dual COVID & Flu test. Is anyone presently billing for code 87428, for a dual COVID & Flu test?

I do not see this code in the 2024 CMS Lab fee schedule. And it is listed at a rate of $0.00 in the 2023 CMS Lab fee schedule. Wondering if this is…Read more

A clinic recently shared with us that they were having non payment issues with CareOregon for Flu shots that were administered to patients 19 and older.

If you are having this issue could you email me at sjacobs@ch-alliance.org and remind me of the issue you are having and how you are billing those claims?

Thank you!!

Susan

Ever since the Change Healthcare debacle, we were forced to switch our clearinghouse. Due to this switch, we had to post our Cigna payments manually for a period of time. While manually posting we realized Cigna has been changing our well child visits CPT codes to a different CPT code…Read more

A CHA clinic is updating their needlestick/sharps/exposure workflow. Does your clinic have a workflow you like or forms you are confident about and would be willing to share?

Your feedback would be greatly appreciated.

Thank you!

Can anyone recommend a “local and reputable repair service” who works on Vaccine storage Refrigerators?

Thank you!!

Any clinics who’ve added New Providers to your practice in the last 6-9 months, could you share how long it is taking to get those Providers Credentialed with Health Plans?

Are there any plans that are taking longer than others?

Thank you!
Susan

I sent you an email about correcting addresses for new providers if OHP plans are the ones being affected. Let me know.

Thank you,
Susan Jacobs

We know there are ongoing denials and payment issues from CareOregon for the Administration of VFC distributed Beyfortus (Nirsevimab), CPT codes 90380, 90381. I’ve heard from Metropolitan Pediatrics, The Children’s Clinic, Olson Pediatrics, among others regarding CareOregon denying claims for the Administration of Beyfortus, when…Read more

From Providence’s Coding Policy #34 – Administration of Immunizations and Injections

Vaccines for Children Program
APPLIES ONLY TO OHP
Under the Vaccines for Children (VFC) Program, the State of Oregon…Read more

Diagnosis Codes
Administration of nirsevimab is not reported with Z23 Encounter for immunization. Z23 is specific to immunization related to vaccines. While nirsevimab is categorized as a monoclonal antibody by CPT, ICD10 CM’s index g…Read more

As your practices begin to see payment for Beyfortus claims from various payers, it would be helpful if you could share confirmation of paid claims and associated Health…Read more

The clinic has waiting room area furniture available to anyone who want it. Letha Young says the furniture is “actually very nice and in great condition – this could be free to someone who could use it.”

You may reach out to Letha Young at Vilhauer…Read more

A clinic that did not pre-order Flumist this year has asked how best to acquire Flumist at this point in the season for the clinic, as their patients are asking for it.

Can you please advise?

Thank you!
Susan

Oregon City Pediatrics and Pediatric Associates of Gresham both utilize Office Practicum for their EHRs.
I’m sending you an email about this.
*kristil* “kristil”
*kjoseph* “kjoseph”
I’m not sure if I’m tagging folks right, but I’ll come back to edit this if not.

Thank you,
Susan

They should just be billing the blood poke, not the S code.

Newborn Metabolic Screening HCPCS Code
Note: See Healthcare Common Procedure Coding System Codes section on page 34 for explanation of HCPCS codes.

S3620 Newborn metabolic screening panel, includes test kit,…Read more

Does your clinic bill for collecting the PKU specimen other than a heel poke?

The Infographics that the AAP has included in their Drowning Prevention Campaign are great and are formatted to use for Social Media posts. The majority of graphics are available in both English and Spanish.

Link to AAP Drowning Prevention Campaign here

CareOregon says they will reprocess the denied claims and clinics will not have to resubmit anything. I hope I’m getting the word after the fact and that perhaps they are already doing this. But if not, it…Read more

Still waiting to hear from CareOregon. Will let you know when I hear.

Providence Commercial currently has a Pharmacy Prior Authorization Policy on Pneumococcal vaccines (dated July 2022) which some of you may have seen, but states the following. CHA’s Medical Director is following up with Providence Commercial to see if…Read more

That is happening in CareOregon’s system because they must still have Vaxneuvance listed as an adult only vaccine. It was originally just for adults and then was approved for pediatric use in June of 2022. But just came onto the market in October 2022 commercially and then through VFC in January 2023.

They have not updated their…Read more

Deborah Rumsey reached out to Liz Stuart at OHA about this and we had the following answer stating that there will be no change in age for children receiving VFC immunizations that correlates to the EPSDT benefit changes.

“There are no changes to the age range for the Vaccines for Children program; VFC remains available for children ages…Read more

Sponsored by: HealthyChildren.org – The only parenting site backed by 67,000 AAP member…Read more

I have a question from a clinic that is gearing up to begin Applying Fluoride to patients for the first time.

*Can those of you doing this already, can you advise what product(s)you are buying for this?
This clinic is planning to purchase it through McKesson and says there are many options.

Also, another clinic is looking at…Read more