November1_2018

November 1, 2018www.unityhc.com

News Unity Healthcare and Lafayette Cancer Care Welcome Vandana Raman, MD Nancy DiMartino, MD, is pleased to welcome Vandana Raman, MD, to Lafayette Cancer Care. Dr. Raman obtained her medical degree from Maulana Azad Medical College, University of Delhi, New Delhi, India. After medical school, she completed two residencies; her first in Internal Medicine at Lok Nayak Hospital in New Delhi, India, and her second, also in Internal Medi- cine, at Mt. Sinai St. Luke's - Roosevelt Hospital Center in New York, New York. She then completed her fellowship in Hematology and Medical Oncology at Mt. Sinai St. Luke's - Roosevelt Hospital Center in New York, New York. In her spare time, Dr. Raman enjoys spending time with her family, hiking, read- ing, and photography. Welcome to Unity Healthcare!

Compliance Corner Accurate Coding and Documentation Drive Revenue and Ensure Compliance Throughout [email protected] Appropriate 25 Modifier Usage CPT and most commercial/government payers have policies regarding their expected usage of the 25 modifier. Current Procedural Terminology (CPT) describes the 25 modifier as “Significant Separately Identifiable Evaluation and Management Service by The same Physician or Other Qualified Health Care Professional on the Same Day of the Procedure or Other Services”. Each payer then expounds on their version of what thatdescription means. For instance, our local MAC Wisconsin Physician Services (WPS) has a fact sheet thatdetails their explanation of appropriate use and inappropriate use. United Health Care (UHC) has a ModifierReference Policy, which ties the 25 modifier to eight (8) other policies, such as CCI Editing, Global Days andSame Day Same Service. All modifier 25 policies are available on line or can be found in the Unity Portal underthe Coding Icon. A flow sheet is created below to help the clinician determine appropriate use of the 25modifier. If further instructions are desired, please contact the Coding Department or the Coding Helpdesk. 25 Modifier Use The following is a list of the individual payer(s) and their Documentation is The amount of work performed is consistent policies. Seperate & Identifiable with that normally performed with the BCBS – E/M Services & Related procedure Modifiers 25 & 57 #0026. Cigna – Modifier 25 #M25 Only Procedure global Does not NO - A seperate UHC – Modifier Referenceappended period is 000 or require a E/M code should Policy #2018R0111A seperate not be reported Medicare – Modifier 25 Fact to E/M 010 days diagnosis Sheet codes YES - A seperate Medicaid – Follow Medicare code guidelines E/M service is Humana – Common CPT and appropriate HCPCS Modifiers # CP2013101

Compliance Corner Comprehensive Error Rate Testing (CERT) Medicare – WPS CERT is currently looking at Home Visit Services (CPT Codes 99341-99350). They have noted significant errors in the documentation that did not support the reason for home visit. CERT wants to remind providers that the CPT code should be based on the key components (history, exam and medical-decision making) of the Home Visit Service. Additionally, the medical record should document the medical necessity of the home visit versus an office visit. Payer UpdatesUHC – Multiple payer updates and coverage change effective now through the end of the year, include the followingprocedures, tests and preventive services: Breast Reduction Core Decompression for Avascular Necrosis (added CPT code 21299) Functional Endoscopic Sinus Surgery Hepatitis Screening (added diagnosis codes) Panniculectomy Percutaneous Vertebroplasty & Kyphoplasty Preventive Care – Numerous revisionsBCBS – E/M policy update regarding established patient, effective 1/1/19CIGNA – Several policies changes including: Effective 9/16/18 – Omnibus Policy - If a Lumbar laminectomy is reported with a posterior lumbar interbodyfusion (PLIF) it is considered incidental to the PLIFMedicaid - Coverage for the FluMist (90672) effective 10/2/18, reimbursement $24.10 plus administration Coverage for Shingrix (90750) effective 9/7/18, reimbursement $147.00 plus administration Medicaid encourages providers to begin reporting data on Members social determinants of health usingdiagnosis code Range Z55-Z65.Medicare – LCD34525 – Intra-articular Knee injections of HyaluronanBilling Guidelines will be replacing the retiring the LCD on12/1/18, future coverage will be released the same day. PerWisconsin Physician Service (WPS). There will not be a lapse in coverage. Claim Denials Due to Medical NecessityYour claim was denied even with a prior authorization, what happened? Or you were told a prior authorization was notneeded. We will look at an LCD from our local MAC - Wisconsin Physician Services (WPS) on removal of benign lesions. TheLCD is divided into several sections such as Contractor Information, Coverage Guidance, Coding Information and others.To determine the coverage and medical necessity of the service, the LCD lists the medical indications, Repair and Limitations.For example, the LCD lists several indications they consider appropriate. The patient presents with a lesion that is subject torecurrent trauma or is inflamed or obstructs an orifice. All these conditions support the medical necessity for the removal ofthe lesion. The LCD also lists limitations when Medicare will not pay, such as asymptomatic lesions removed for cosmeticpurposes. Finally, the LCD lists the CPT codes covered under the LCD and the diagnosis codes they consider medicallynecessary. A chart has been created below with the key criteria and then a brief description of what the criteria contains. Nextmonth we will review a payer policy from BCBS. A URL for this LCD is attached. LCD L35498 – Removal of Benign Skin Lesions Section InformationDocumentation Information Information includes source, effective date and revision(s)CMS National Coverage Policy Lists all the CMS policies pertaining to the LCDCoverage Guidance Coverage indications, Limitations and/or Medical NecessityCoding Information CPT, HCPCS codes covered and diagnosis codes coveredGeneral Information Documentation requirementsRevision History A list of all associated revisions of the LCDAssociated Documents Billing & Coding Guidelines, related NCDshttps://www.cms.gov/medicare-coverage-database/details/lcd-details.aspx?LCDId=35498

HR Department OPEN ENROLLMENT REMINDERS The open enrollment period for 2019 elections is October 22nd – November 5th. Please make sure to submit elections during this period to receive any applicable new ID cards by January 1st. If you are enrolled/will be enrolling in Employee plus spouse/family medical coverage, we will need a new Spouse Verification Form to process your request. If you will be enrolling in Employee plus spouse/family medical coverage, we will need a copy of your marriage certificate and a copy of your dependent’s social security card(s) and birth certificate(s) to process your request if we do not already have them on file. RAPID NOTIFY MOVES TO RAVE MOBILE SAFETY Earlier this year the vendor Unity Healthcare uses for emergency notifications (Rapid Notify), was purchased by Rave Mobile Safety. This requires a move from the Rapid Notify system to the Rave Mobile Safety system. All Unity employees should have received an email notification requesting that you log in to activate your account. If you have not activated your account yet we highly encourage you to complete ASAP. You may choose additional e-mail and/or cell phones numbers to be notified when a Rave alert is sent. If there are any questions or concerns, please contact the Helpdesk at 446-5321 or Ext 35321. AND THE WINNER IS… Thank you to everyone that attended an Open Enrollment 2019 meeting! For those of you that were in attendance, your name was entered in to a drawing for an Amazon Echo, donated by Reliance Standard Life, our voluntary life benefits carrier. The lucky winner is Amber Britton, Medical Receptionist with Lafayette Orthopaedic Clinic! Congratulations, Amber! HR RELATED TOPICS If you need assistance with any HR related topics you can visit the Unity Portal and click on the HR tab located on the left-hand side of the page. There are resources for both Employees and Supervisors.

HR Department HEALTH SAVINGS ACCOUNTS

Thank You!Thank you for all of your dedication, service and commitment to Unity Healthcare!Congratulations on this great achievement! We greatly appreciate all that you do forour company. Please acknowledge and congratulate the individuals listed below. OCTOBERFIRST YEAR ANNIVERSARYBrooke Speakman 10/06/2017 Unity Surgical CenterAmber Allen 10/23/2017 Pain Care CenterDarla Morrison 10/23/2017 Unity Surgical CenterBrianna Rose 10/23/2017 Unity Surgical CenterBritany Wescott 10/30/2017 Unity Immediate Care CenterFIVE YEAR ANNIVERSARYAbigail Neblett 10/03/2013 InnerVisionAnna Hudlow 10/15/2013 Pain Care CenterDawn Happ 10/29/2013 Lafayette Cancer CareTEN YEAR ANNIVERSARYMark Page, MD 10/01/2008 Lafayette Orthopaedic ClinicVelma McKinney 10/31/2008 Central Billing OfficeJessica Alford 10/31/2008 Lafayette Cancer CareRebecca Cutchin 10/31/2008 Lafayette Cancer CareMichelle Smith 10/31/2008 Lafayette Cancer CareKara Yocum 10/31/2008 Lafayette Cancer CareTeresa Hendren 10/31/2008 Unity Immediate Care CenterFIFTEEN YEAR ANNIVERSARYRobert Phillion, PhD 10/01/2003 Sycamore AssociatesDoreen Dunfee 10/21/2003 AdministrationTWENTY YEAR ANNIVERSARY Chadha-Internal MedicineGagan Chadha, MD 10/01/1998 THIRTY YEAR ANNIVERSARYNancy Siple 10/01/1988 Lafayette Surgical ClinicBe part of our CommUNITY. Become our fan onFacebook - facebook.com/unityhealthcare You will have access to our upcoming news / events.Twitter - twitter.com/unityhcYouTube - youtube.com/unityhcLinkedIn - linkedin.com/company/unity-healthcare-llc

Thank You!Thank you for all of your dedication, service and commitment to Unity Healthcare!Congratulations on this great achievement! We greatly appreciate all that you do forour company. Please acknowledge and congratulate the individuals listed below. NOVEMBERFIRST YEAR ANNIVERSARYBridget Swing 11/01/2017 Company Clinic Indiana PackersPamela Garrison 11/06/2017 Estep Family MedicineCaleb Patty 11/06/2017 Unity Surgical CenterBreyanne VanHoose 11/06/2017 Unity Surgical CenterFIVE YEAR ANNIVERSARY 11/01/2013 Company Clinic Indiana PackersLorraine Dougherty 11/25/2013 Ear Nose & Throat of LafayetteJenna Fadness TEN YEAR ANNIVERSARYMariah Smith 11/03/2008 Magnante Eye CareKaren Rose 11/24/2008 Miracles Rehabilitation EastBe part of our CommUNITY. Become our fan onFacebook - facebook.com/unityhealthcare You will have access to our upcoming news / events.Twitter - twitter.com/unityhcYouTube - youtube.com/unityhcLinkedIn - linkedin.com/company/unity-healthcare-llc

HR DepartmentUnity HealthcareNew Hires: WelcomeOctoberAdministration, Computer Hardware Technician, Austin EnglishAdministration, Information Systems Generalist, Susannah SiglerFlora Family Medicine, Medical Assistant, Morgan MusickInnerVision, MRI Technologist, Aleta CableLafayette Cancer Care, Infusion Nurse, Kristin SchweigertLafayette Cancer Care, Employee Physician, Vandana Raman, MDPickerill, Adler, Reed & Williams Family Medicine, Medical Assistant, Samantha PhelpsRegional Occupational Care Center, Medical Receptionist, Bethany Rigdon

HR Department LIFEMART IN ADP LifeMart is a proprietary, members-only discount shopping website that provides discounts on nationally recognized brand-name products and services and local retailers. We provide employees with real savings to help them manage everyday needs. Log into ADP and select Myself > Benefits > Employee Discounts- LifeMart. If you have issues logging in, please contact [email protected].

CLICK, CLICK, HOORAY!SEE WHAT VSP® CAN DO FOR YOUR EYES AND YOUR WALLETWHEN YOU CREATE AN ACCOUNT ON VSP.COM. Get tips and information on keeping your eyes healthy for life. View your benefits and find a VSP network doctor near you. Receive emails about special offers, rebates, and other Exclusive Member Extras.AFTER YOU’VE CREATED YOUR ACCOUNT, YOU’LL BE ELIGIBLE TOWIN A $5,000 SHOPPING SPREE!Already have an account? No problem! You can still enterthe sweepstakes by visiting the website below.GET STARTED TODAY AT WWW.VSP.COM/SWEEPS©2018 Vision Service Plan. All rights reserved.VSP is a registered trademark of Vision Service Plan. All other brands or marks are the property of their respective owners. 22168 VCCM

Balance out yourRetirement PortfolioDetermining which investments to include in your Retirement Portfolio can be confusing. Thereare a lot of options, and it is often difficult to know which ones are right for you.Getting the Right FootingOne way to help you achieve your target mix is to consider a model portfolio—a collection of investments(stocks, bonds, etc.) pre-assembled by experts. Each is designed with a different investment strategy inmind. Some are more conservative, ideal for those who prefer a lower amount of risk. Others areaggressive, suitable for people willing to take on bigger risks in exchange for potentially greater returns.Achieving a BalanceIt’s up to you to determine how much risk you’re comfortable with. Some questions to consider:• What age do you want to retire?• How many years do you have to save until then?• Are you willing to accept the risk that comes with more aggressive investments?It is also important to remember that your risk tolerance level and objectives may change over time. That’swhy you should review your investments to make sure they match up with your risk tolerance and years leftuntil retirement. When you’re in the early stages of your career, it might make sense to be in a moreaggressive option. However, as you get closer to retirement, you may need to adjust to a more conservativemodel.Next Steps• Log into newportgroup.com• Determine the level of risk you’re willing to take (e.g., conservative or aggressive)• Select the portfolio that best matches your profileFor informational use only. This should not be construed as investment advice. Investment insecurities involves risks, including possible loss of principal.1Some Risk-Based Model Portfolios may be offered through Newport Group Consulting, LLC, aRegistered Investment Adviser and affiliate of Newport Group, Inc. Have questions or need help accessing your account? Call 888-401-5488 to speak with a representative. © Newport Group, Inc. 2018. All rights reserved. E058-061318

Paper Secure Document Shredding ServiceShred MOBILE DOCUMENT DESTRUCTION Day“A Division of Lafayette Copier Sales & Service.”Wednesday, N7o:3ve0mabmer-149t:h3|07a:3m0am - 8:30am All Unity Healthcare EmployeesFREE PAPER SHRED DAYGet rid of those unwanted paper materials that are stacking up! • PERSONAL PAPER DOCUMENTS such as: • TAX FORMS, OLD CHECK STUBS, BANK STATEMENTS. Eco Shred will be located on the Unity Healthcare MedicalCampus, in the East Patient Parking lot. Employees can drop off their “paper products” into a bin to be shredded on site. *You must take your container box home with you.*

Unity Immediate Care Center Staff!Administration & Central Billing Office Fun!

Events VISIT LAFAYETTE – WEST LAFAYETTE: https://www.homeofpurdue.com/events/calendar.phpFeaturing Unity Healthcare’s Dr. Robert Hagen, Dr. Michael Krauss & Judah Phipps, PTAhttps://vet.purdue.edu/ce/workshops.php#The%20David%20Van%20Sickle%20Musculoskeletal%20Days Boilermaker Free Ride Fridays https://purduereamerclub.org/boilermakerspecials/Bill Nye the Science Guy visits PurdueNovember 8, 2018 http://www.convocations.org/YWCA 12th Annual Holiday Bingo & Silent AuctionNovember 8, 2018 http://www.ywcalafayette.org/holidaybingo2018

RecipesCorn Casserole8 servings | Prep Time: 8 minutes | Cook Time: 55 minutesINGREDIENTS • 1 (15 1/4 oz) can whole kernel corn, drained • 1 (14 3/4 oz) can cream-style corn • 1 (8 oz) package corn muffin mix (recommended: Jiffy) • 1 cup sour cream • 1/2 stick butter, melted • 1 to 1 1/2 cups shredded Cheddar cheeseDIRECTIONS: • Preheat oven to 350 degrees F. • In a large bowl, stir together the 2 cans of corn, corn muffin mix, sour cream and, and melted butter. Pour into a greased 9 x 13 inch casserole dish. Bake 45 minutes, or until golden brown. Remove from oven and top with Cheddar. Return to oven for 5 to 10 minutes, or until cheese is melted. Let stand for at least 5 minutes and then serve warm.https://www.foodnetwork.com/recipes/paula-deen/corn-casserole-recipe-1943617Brussels Sprouts with Bacon & Garlic12 servings | Prep Time: 5 minutesTotal Time: 30 minutesINGREDIENTS: • 2 pounds fresh Brussels Sprouts (about 10 cups) • 8 bacon strips, coursely chopped • 3 garlic cloves, minced • 3/4 cup chicken broth • 1/2 teaspoon salt • 1/4 teaspoon black pepperDIRECTIONS: • Trim Brussels Sprouts. Cut sprouts lenghtwise in half; cut crosswise into thin slices. In a 6-quart stockpot, cook bacon over medium heat unti crisp, stirring occassionally. Add garlic; cook 30 seconds longer. Remove with a slotted spoon; drain on paper towels. • Add Brussels Sprouts to bacon drippings; cook and stir until sprouts begin to brown lightly, 4-6 minutes. Stir in broth, salt and pepper; cook, covered, until Brussels Sprouts are tender, 4-6 minutes longer. Stir in bacon mixture and serve.https://www.tasteofhome.com/recipes/brussels-sprouts-with-bacon-garlic/