August 2012

What is NEW?

Integra Providers NOW have Access to Wellcare of NY

We are excited to report the positive progress with the addition of WellCare of NY; our newest health plan member covering both the Durable Medical Equipment and Orthotic and Prosthetics.  Here are some fast facts about WellCare of NY:

  • NY membership approximately 100,000 members
  • Primary plans: [Medicare HMO, Medicaid HMO, Medicare Advantage]
  • A for-profit public company with a stock market value of $3 billion

Other Health Plan updates:

  • *NEW* as of 7/1/12:   Village Care
  • *NEW* as of 4/1/12: Access Medicare
  • Changed as of 6/1/12: GHI – O&P only
  • Ended as of 7/31/12: Humana

We at Integra, continually strive to improve our offering of health plans and services for you, our provider community.  We have additional initiatives underway with more health plans and services, while we look to improve our communication with you. 

**** NEW Referral Cards**** to help you grow your referral base

Are you looking to increase your referral base??? Give us a call and we will mail you Referral cards; a marketing piece outlining current Health plans with a space for your business card.  Network Development team can be reached at 718-298-256 or networkdevelopment@accessintegra.com

**** NEW Electronic Direct Deposit ****   

Integra Partners is pleased to announce it will soon be offering its provider community a new and faster way to receive reimbursements.

In the near future, providers will have the ability to have their weekly reimbursement checks deposited directly into their bank accounts as an ACH deposit. This will eliminate the time it takes to mail, receive and deposit funds and speed up cycle time by a week on average.

The Customer Service Team – same familiar voices, just different numbers

We strive to be the best in the industry and have implemented a new phone system that will help us reach our goals. Rita and her team are available every day to answer your questions.

The NEW Direct contact number for Customer Service is: 718-369-0012.

NEW Fax number: 718-287-1229 or service email is Administration@AccessIntegra.com

 A friendly reminder from the Customer Service team: please enter all the patients’ demographic information in Doctor.com. The more information we have; the better we can service the patients!

Introducing – the Network Development team!

Integra Partners is growing and we recently added several team members to our Network Development department.

Craig Gambardella – Account Manager                  cgambardella@accessintegra.com  or 718-541-4344

Scott Brennan – junior Account Manager              sbrennan@accessintegra.com or 718-715-1724

Nicole Robinson – junior Account Manager         nrobinson@accesintegra.com or 718-819-3922

Bianca Flikweert – VP of Network Development   bflikweert@accessintegra.com or 718-298-2156

Contact the Network Development team to order Referral cards!!

Update from the Accounts Receivable Team- a Clarification for Non Medicare codes

Please note that both Neighborhood and Healthfirst are contracted under Medicare guidelines. Procedures that are not listed under Medicare but are listed under Medicaid will be paid 100% of Medicaid rates.

Other important facts form this team:

Incorrect information will cause a delay in the processing of claims, so when entering a member’s insurance information:

  • Carefully select the correct plan type, as some plans have separate selections for Medicare and Medicaid.
  • Always verify your patient’s demographic information and review the entry of this information into the billing system.  Correctly captured member name, ID number, and date of birth, gender and policy effective dates are needed for uninterrupted claim processing.

Health Plus Medicaid -T Codes (T4521 – T4543) for incontinence products should not have a modifier when billing.

Upcoming Events:

  • American Orthotic & Prosthetic Association National Assembly Meeting – Hynes Convention Center Boston, MA – September 6-9, 2012
  • New Jersey Academy of Orthotists & Prosthetist Annual Meeting – Bally’s Hotel & Casino, Atlantic City, NJ – November 7-9, 2012

In Closing
We look forward to assisting you and helping to grow your business through accessing a greater network with Integra Partners.  As always, we welcome any feedback on how we can further strengthen our relationship, improve our services or increase the value we are providing you.

December 2011

Dear Integra Providers,

Happy Holidays and best wishes for a great New Year! With 2012 having just begun, we want to remind you that the 2012 Fee Schedule for Durable Medical Equipment, Prosthetics, Orthotics and Supplies (DMEPOS) is now effective. You can find all your information on the code changes on our website. As a reminder, CMS announced an overall 2.4% rate increase for DMEPOS in 2012!

New Email Contacts

In order to help improve our response time to any provider questions, required assistance and claims needs, we have created new direct email addresses. Your use of these email addresses will help us to quickly, orderly and efficiently respond to any needs you might have:

administration@accessintegra.com – for bill entry corrections, copies of Integra documents, copies of pre auths/denials, doc-tor.com entries and software issues or questions

claims@accessintegra.com – for any claim status, cost invoices and detailed LMN/clinicals

consents@accessintegra.com – patient consents from providers to Integra 

info@accessintegra.com – general questions or information requests

Billing Software Training Manual

We have recently introduced a customized, easy-to-use, Integra training manual that provides a step-by-step tutorial on how to use all the features of the doc-tor.com billing software along with a short Q&A guide. If you should have any questions about using the billing software, features and capabilities or just need to train a new employee, please email us at administration@accessintegra.com and we will email a copy of the manual and answer any questions you might have.

Claim Reminders and Tips

In order to help reduce some common mistakes in submitting claims and avoid inaccurate reimbursements or denials from payors, please find some helpful reminders and tips.

Patient and Benefit Verification
The member’s policy/insurance must be verified on the initial visit and again for each date of service along with the benefits. This verification will identify those patients who might have lost coverage after the initial visit or who are not covered for certain DME or O&P benefits.

After authorization is given for service, it is important that all services are provided within the effective date span. Failure to submit within the given date span will result in a claim denial by the payor.

Paper Claims

GHI – claims with an ID that begin with “NA” must be sent by paper to American Plan Administrators (APA)

Multiplan – all claims must be sent to the claims submission address on each participant’s individual card

Modifiers

All DME procedures for all insurances require an NU or RR modifier.

All orthotics must include an RT or LT modifier for payors: BCBS, Fidelis, GHI, Health Plus, HIP and MetroPlus.

Prosthetic claims require a K functional modifier for payors: BCBS, Fidelis, GHI, HIP and Montifiore CMO.

In Closing

As always, we appreciate the trust you have placed in us and we will continue to work on improving our partnership with you. Over the coming year, we will roll out new features, capabilities and services to assist you and improve how we interact. We also want to hear from you and welcome any feedback on how we can further strengthen our relationship, improve our services or increase the value we are providing you. Please email us at info@accessintegra.com.