How to Better Manage Incoming Calls 

Phone Service

Seven easy ways to expedite the incoming phone call process. 

1). Simplify, shorten, and reorder the greeting.

2). Reduce the number of rings before rolling to voice mail.

3). Tell patients when to expect action or a call back (this is crucial).

4). Equip staff to handle calls effectively.

5). Secure a portal for patient communication.

6). Provide patients with educational materials they can reference at their leisure. 

7). Provide patients with a summary of the visit. 

To gain a better understanding of root cause please read this short informative article from Physicians Practice. It can be a great revamping and or training tool. 

By Carol Srtyker

DEA Registration Requires Training

Physicians who must register or renew their registration for a Drug Enforcement Administration license will face a new requirement as of June 27:

To register, they will have to attest to taking a one-time, eight-hour training on how to treat patients with opioid or other substance use disorders.

Training Required

More on UHC Electronic Submissions

Get to know the basics of electronic submissions

Now that claim reconsiderations and appeals must be submitted electronically,* we want to help make sure you have the how-to information you need to manage them with ease.

How to submit electronically
You have 2 electronic submission options — through the UnitedHealthcare Provider Portal or Application Programming Interface (API). See the Online Reconsiderations and Appeals interactive guide for step-by-step instructions on how to submit reconsiderations and appeals electronically. 

TIPS:

  • Check the TrackIt Action Required bar regularly to see the status of claims, reconsideration requests and more
  • To take action on a specific claim in the portal, go to Claims & Payments and search for a claim. Once you’ve searched for a claim and selected Act on a Claim, a list of actions will appear (e.g., View Claim Reconsideration, File Appeal/Dispute). Based upon the current status of the claim or previously taken actions, the buttons will either be blue or grayed out. If grayed out, that specific action is unavailable.
    • Please note: Available actions may vary based on the member’s plan type, provider’s participation status and regulations
  • If a claim(s) from your claim search results shows an “Acknowledgement” status, it hasn’t been processed. You’ll be unable to submit requests related to this claim.
  • Reminder: Appeal response letters are no longer mailed, but you can view and print them through the portal using Document Library

ASK THE EXPERT

TMA RESOURCES

Ask the Expert: End of the Public Health Emergency

On March 29 via Zoom, join TMA experts in this interactive Q&A session as they discuss how best to prepare your practice for upcoming changes as the public health emergency winds down on May 11. They will discuss the impact on Medicaid coverage, telehealth, and COVID vaccines and treatments for which you can earn CME. Send your questions in advance. Register now

Superior Risk Adjustment Training

Superior will be hosting a series of webinars to assist providers with Risk Adjustment Documentation and Coding. All levels of clinicians and billing and coding staff are encouraged to attend. 

Upcoming Texas Incentives for Physicians and Professional Services (TIPPS)

REPORTING PERIOD

October 10 – November 6, 2022

Below please find information on the upcoming Texas Incentives for Physicians and Professional Services (TIPPS) reporting period (October 10 – November 6, 2022) for state fiscal year (SFY) 2023 (year [Y] 2.

  • HHSC will hold a reporting webinar to provide instruction on the reporting process and template. The Y2 Round 1 reporting webinar will be held on October 13, 2022 at 2:00 PM. Please register using the link below. 
  • HHSC will notify participating providers when the reporting companion (instructions for using and submitting the template) and reporting template are posted to the reporting portal Bulletin Board by October 10, 2022. HHSC will post a link to the recorded Y2 reporting webinar on the bulletin Board by October 14, 2022. 
  • Participating providers must report data using the data measurement period of January 1, 2022 – June 30, 2022 (i.e., the first six months of calendar year 2022). All of the calendar year 2022 will be reported during Y2 Round 2 in April/May 2023

A few other links of interest: 

Contact the HHSC CPP Quality Team: [email protected]

Contact the Provider Finance Department (PFD): [email protected]

See Comments for Definition of TIPPS

UHC Network News

Do you and your staff have the UHC Prior Auth Blues?

Looking to Start In House Meetings

The thought of having you guys back in our office is exhilarating!

Help us get this show back on the road!

Tell us your thoughts. 

  • What are your concerns?
  • Where do you need the most help?
  • What training is your staff missing?

You may leave a comment below, or email us. 

Leave us a comment.

Cigna MA Stars 101 Webinar

NEED A REFRESHER

Register to Join

Cigna MA

Overview of the Stars Program

Cigna’s West Region Stars Team will provide an overview of the Stars Program and available reporting and resources:

  • What is the Star Rating and why is it important
  • Components of the Star Rating
  • A review of available reporting related to Stars
  • Tools and Resources available for your office

Event Number: 179 385 5641

Event Password: stars

June 9th, 1:30 CST

You won't want to miss it!

Submitting Claim Appeals to Humana

Learn how to use Availity Essentials’ Appeals function to submit appeals and disputes. You can upload needed documentation and check the status of requests that were submitted online.

FREE TRAINING