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AuthorAngela Grizzle

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2016 OSHA Seminar

The Annual HPI sponsored OSHA Seminar for 2016 is scheduled for September 14, 2016.  To allow us time to prepare materials, the deadline for registration is September 7, 2016.  Please click the link below for the 2016 OSHA Seminar Registration From.

Should you have any questions, please call HPI at (423) 392-1920


2016 OSHA Seminar Registration Form

2016 OSHA Registration

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USPSTF Recommendations, Approved by Highlands Physicians/Highlands Wellmont Health Network

USPSTF Recommendations, Approved by Highlands Physicians/Highlands Wellmont Health Network

The USPSTF Recommendations are evidence based standards of care and have been approved
as the HPI/HWHN recommended adult preventative services schedule. Dr. Stephen Combs, HWHN Medical Director, Dr. John Green, Chairman, HPI Clinical Integration Committee and the HPI physician quality committee reviewed and approved these recommendations. The USPSTF recommendations are reviewed annually with changes and/or updates to the HPI/HWHN recommended services schedule as appropriate.  Network providers are encouraged to follow the USPSTF recommendations and discuss the recommendations with the patient. The USPSTF Recommendations, the Clinical Summaries for the more recently approved recommendations (approved 2014-2016) and the 2016 HWHN Recommended Adult Preventative Services Schedule are listed below with links to each document.
Contact Sharon Harper, sharper@highlandsphysicians.com or 423.392.1920 with any questions.

USPSTF A and B Recommendations – USA Preventative Services



2016 Adult Preventative


Clinical Summaries:

AAA Abdominal Aortic Aneurysm:



Chlamydia and Gonorrhea


Depression Screening Adults Final Recommendation Statement



Hepatitis C Virus Infection In Adults




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As an HPI member, provider offices may order books/publications directly from OPTUM 360 at a substantial savings. Shipping is FREE.  Attached is the 2017 order form with pricing. If this list does not include all resources you need, please contact Angela Gregg, HPI’s OPTUM 360 Account Manager for a complete listing. Her contact information is included on the order form.

I just received the below information from OPTUM.  Order early for the best pricing!

“During the month of June, we offer the deepest discounts on the best coding books available. Our clinical and technical editors are again preparing market-leading publications for 2017 and I am hopeful your group can take advantage of these once-a-year incentives to order NOW!”

Orders placed before July 1 will include the following:

  • FREE shipping and FREE returns (within 60 days)
  • An extra 10% discount over last year’s pricing on ICD-10, HCPCS, specialty and e-books
  • FREE ICD-10 t-shirts (2017 edition)
  • Our enhanced spiral bound CPT® book (Item # CE17) for only $49 (with tabs!)
  • Any online education course (with CEU’s) for only $29 (regular price: $79) if purchased by Dec 31, 2016.

Go to Optum360coding.com and click on Training and Education and the Online Coding Courses drop-down for more details.

Click the link below for the 2017 OPTUM order form as a pdf file:

Should you have any questions or need assistance, please contact Jane Berke:jberke@highlandsphysicians.com

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Below are links to Zika information that was prepared and shared by the TN Department of Health. Dr. Gail Stanley, WHS Infectious Disease physician, asked HPI to distribute this information to provider offices. Please click the links below for the Zika information.




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INTotal Health – Important Updates

Beginning July 1, 2016, INTotal Health will have a new TPA to process claims for their providers.  Below is a link for the provider notification that can be found on the INTotal website and has been mailed to their provider network.  Providers are to continue submitting claims as normal until 7/1/16; any claims with DOS 7/1/16 and after should be sent to the new TPA.

Click here for INTotal Health’s notification:  InTotal.Eff.070116.TPA Change.05.03.2016


Change regarding medical documentation required for ED Level 4’s and 5’s – INTotal Health has recently reviewed their policy regarding medical documentation required for ED level 4’s and 5’s and has decided they will no longer require such documentation. Click the link below for the letter that was sent to the INTotal Health network.




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CrestPoint Health discontinuing Medicare Advantage plan effective 06/01/2016

Highlands Physicians, Inc. received notification that CrestPoint Health will discontinue offering the CrestPoint Health Medicare Advantage plan effective June 1, 2016. For dates of service prior to June 1, 2016, the CrestPoint Medicare Advantage Contract allows for claim payments up to 364 days.

Included with this update is the CrestPoint notice that was forwarded to HPI providers currently participating through the HPI contract. Also included is the notice that CrestPoint sent out to members so that the provider offices would have a reference point when addressing member concerns.

Medicare Advantage contracts offered through Highlands Physicians include BCBS LPPO, Humana and WellCare.  CrestPoint has also confirmed that members moving from CrestPoint during this Special Election Period (SEP) will be able to switch plans again when Open Enrollment occurs.

HPI appreciates the continued support of our members.

Please click each of the links below for the additional information from CrestPoint:




TOSHA – Consultation Services

Workplaces and regulations change over time. Due to this, please consider working in a partnership with us to help identify workplace hazards, evaluate programs, make recommendations to improve workplace safety and health and potentially reduce direct and indirect costs of workplace injuries and illnesses.

Click the link below for more information:
TOSHA.Request for Consultation Services-2016

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Wider HIPAA audits may drive stronger vendor contracts

The feds appear to be preparing to clamp down on the sometimes porous flow of patient data handled by vendors of healthcare organizations, which has exploded with the growth of EHRs, analytics and mobile devices in healthcare.

Click here for more information:  http://www.modernhealthcare.com/article/20160323/NEWS/160329942?utm_source=modernhealthcare&utm_medium=email&utm_content=20160323-NEWS-160329942&utm_campaign=dose

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CoventryCares of Virginia (VA Medicaid) name change to Aetna Better Health of Virginia

Effective April 1, 2016, CoventryCares of Virginia, which offers a Virginia Medicaid managed care plan began doing business as Aetna Better Health of Virginia. This trade name will refer only to the Medicaid health plan.

For medical providers, the provider contract you currently have in place with CoventryCares of Virginia will remain active for the Aetna Better Health Medicaid product. For behavioral health providers, the contract you currently have in place with MHNet will remain active for the Medicaid product.

Please note that although your current agreements will remain active through this transition, we plan to move all Medicaid providers to an Aetna Better Health contract in the near future.

For more important information on this change, please click the link below:


For a Quick Reference Guide, click here:  AetnaBetterHealthOfVA QuickReferenceGuide.04.14.2016

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