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July 2015
Reminder: Submit 2015 service dates for Medicare Advantage Diagnosis Closure Incentive program
Need access to Health e-Blue?
If your primary care office doesn’t have access to Health e-Blue, apply today. Visit bcbsm.com/provider and then:
- Click on Provider Secured Services.
- Under Solutions available through Provider Secured Services, click on Health e-Blue for Blue Care Network patient data and Blue Cross Blue Shield of Michigan Medicare Advantage patient data.
- Complete all fields on both the Health e-Blue Application and the Use and Protection Agreement and return to the address on the form.
To maintain access to the system, make sure you sign in to Health e-Blue at least every six months.
Tips for signing up for Health e-Blue
- All applications need to be completed and signed by a primary care physician or PCP manager.
- The practice name has to match across the application.
- Provide state license number (can send additional pages if you are out of space).
- Include any previously created web-DENIS ID to help the Health e-Blue team provide faster service. (Web-DENIS IDs usually start with a D or F.)
- Use your full legal name on the application.
The 2015 Diagnosis Closure Incentive program is effective for dates of service Jan. 1, 2015, or later. As part of the program, health care providers should complete patient diagnoses, supported by any necessary documentation in their medical records, following M.E.A.T. (manage, evaluate, assess or treat) guidelines.
You’re required to address 2015 diagnosis gaps with a face-to-face visit with your patients by Dec. 31, 2015. You then have until Jan. 31, 2016, to submit results of your 2015 patient visits on Health e-Blue. (See article at right for information on accessing Health e-Blue.)
Your patient’s diagnosis gaps are identified on Health e-Blue’s Diagnosis Evaluation panel. Health care providers may use the monthly reports on Health e-Blue to document that diagnosis gaps have been closed.
Keep in mind that if a prior service year date is entered for a 2015 diagnosis gap, the diagnosis gap will open with the next refresh and the gap closure won’t count toward your 2015 incentive payment.
Physicians who close 100 percent of all identified gaps for each attributed patient will receive $100 per patient. Your incentive payment will be mailed to you by the end of the third quarter in 2016.
See the February Record for details.
For questions about dates of service, diagnosis gap submissions or the Diagnosis Closure Incentive program, contact Tom Rybarczyk at 1-313-225-0445 or Corinne Vignali at 1-313-225-7782, provider consultants on the HEDIS and risk adjustment provider outreach team.
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