5 Star Reports Sent Out Last Week
The latest 5 Star Reports were emailed out to members last week. This contains the latest analysis for your organization.
Last week’s AU article regarding the Medicaid Rate Incentives contained a link to the 5...
Why is My Reimbursement Less Than the Published Medicare Rate?
There are multiple factors that are impacting rates this year, and it can be quite confusing.
First, there is 2% withheld to fund the value-based purchasing (VBP) program, but that is already built into the...
Change in SNF Reimbursement 7 Days Away
We are 7 days away from the most substantive change in SNF reimbursement for quite some time. There are a number of resources that are available and ongoing. One of our partners, BKD, has...
PDPM Grouper Update From CMS
The below message just came in from CMS announcing the second revision to the initial release of the Patient-Driven Payment Model (PDPM) Grouper software. (The first revision was released within jRAVEN only.) Effective beginning...
CMS SNF Provider Preview Reports- Now Available
CMS Skilled Nursing Facility Provider Preview Reports have been updated and are now available. Providers have until November 30, 2018 to review their performance data on quality measures based on Quarter 2 -2017 to...
KanCare Clearinghouse Update
Lisa Stuever and Rachel Monger from LeadingAge Kansas, along with KACE and KHCA, met with Chris Swartz, KDHE Deputy Director of the KanCare Clearinghouse to discuss continued issues LeadingAge Kansas members are experiencing with...
Aetna Better Health of Kansas Makes Immediate Changes to Address KanCare Shortcomings
Aetna Better Health of Kansas has created a specialized email box for provider claims issues that need to be escalated for an immediate review. The email address is ABHKSEscalations@AETNA.com. Please use this address if you...
KanCare Issues
Members and consumers continue to have issues with the KanCare Clearinghouse and Medicaid Application processing. A concern we hear is that patient liabilities are typically too high. It is important to communicate this to the...
Latest Clearinghouse Newsletter Available
The KDHE Clearinghouse has published their September 2018 issue of Long Term Care News. This issue highlights communication issues and suggestions. It also has information about their quarterly survey that was sent out to...
KanCare Member Transitions
KDHE has sent to each MCO the service authorizations for members transitioning from Amerigroup to other MCOs. Read the state’s transition of care policy.
Notice from Aetna Better Health for HCBS Providers
Aetna Better Health is prioritizing the loading of HCBS providers into their systems, including financial management services (FMS) providers. Once providers are loaded, Aetna will align applicable authorizations for Aetna Better Health members to...
Sunflower Health Plan News for Provider
There's always a lot going on for providers at Sunflower Health Plan, and we want to make sure you stay in the loop. On this page, you can find all of our latest notifications...