An enhanced electronic payment software called Payformance will be implemented in July which will further compliment timely payment, specifically electronic payment capabilities.

Dr. W. Michael Crecelius has received a 2010 Summit Award for Excellence in Care from MHS and parent company Centene Corp.

The award honors Crecelius, a board-certified pediatrician with Deaconess Clinic in downtown Evansville, for demonstrating exemplary performance when following up with examinations and consultations after patients’ emergency room visits, providing routine preventive and well-care services for children and adults and establishing a medical home for new enrollees in the MHS healthcare plan.

“MHS is proud to recognize Dr. Crecelius for the outstanding service and quality of care he provides to Managed Health Services members in the greater Evansville community,” said Dr. Robert Baker, vice president of medical affairs at MHS. “Our primary focus is on delivering the best possible care to our members and we could not do that without strong relationships with our plan’s physicians. The Summit Award is one way we can thank Dr. Crecelius for his ongoing dedication to helping children live healthy lives.”

Crecelius graduated Indiana University’s School of Medicine and completed his pediatric internship and residency at Riley Hospital for Children in Indianapolis. He is a Fellow, American Academy of Pediatrics, and a member of the Indiana State Medical Association and the Vanderburgh County Medical Society.

A total of 16 physicians from around the country were awarded a 2010 Summit Award by Centene Corp.

“These honors underscore Centene’s distinction as a physician-driven company that provides quality care to our healthcare plan members,” said Centene Corp. Chairman and CEO Michael Neidorff. “Physicians are selected for exemplary performance in several areas.”

Cenpatico has prepared and mailed a letter to its Indiana provider network outlining this change.
July 1, 2010 Changes for Mental Health Partial Hospitalization Letter to Providers from Cenpatico (PDF)

OMPP has published a Bulletin (BT201019) reviewing the change: IndianaMedicaid.com Bulletins.

For questions about this benefit change, please contact Cenpatico at (877) 647-4848 or visit www.Cenpatico.com.

Dr. Sharon Gilliland has received a 2010 Summit Award for Excellence in Care from MHS and parent company Centene Corp.

The award honors Gilliland, a board-certified pediatrician who runs Rainbow Pediatrics in Indianapolis, for demonstrating exemplary performance when following up with examinations and consultations after patients’ emergency room visits, providing routine preventive and well-care services for children and adults and establishing a medical home for new enrollees in the MHS healthcare plan.

“MHS is proud to recognize Dr. Gilliland for the outstanding service and quality of care she provides to Managed Health Services members in the greater Indianapolis community,” said Dr. Robert Baker, Vice President of Medical Affairs at MHS. “Our primary focus is on delivering the best possible care to our members and we could not do that without strong relationships with our plan’s physicians. The Summit Award is one way we can thank Dr. Gilliland for her ongoing dedication to helping children live healthy lives.”

Gilliland opened Rainbow Pediatrics in 1996 and also maintains a solo practice supported by call partners. After earning an undergraduate degree from Northwestern University, she graduated Indiana University’s School of Medicine and completed her pediatric residency at Methodist Hospital in Indianapolis. From 1989 to 1996, Gilliland provided community pediatric care at HealthNet, a Federally Qualified Health Center located in Indianapolis before opening Rainbow Pediatrics.

Rainbow Pediatrics is located at 5711 N. Michigan Road in Indianapolis and online at www.rainbow-pediatrics.net. The center is open 9 a.m. to 4 p.m. Mondays, 9 a.m. to 5 p.m. Tuesdays, 1-7 p.m. Wednesdays, 9 a.m. to 3 p.m. Thursdays and 10 a.m. to 4 p.m. Fridays.

A total of 16 physicians from around the country were awarded a 2010 Summit Award by Centene Corp.

“These honors underscore Centene’s distinction as a physician-driven company that provides quality care to our healthcare plan members,” said Centene Corp. Chairman and CEO Michael Neidorff. “Physicians are selected for exemplary performance in several areas.”

Dr. Binod Balakrishnan has received the 2010 Summit Award for Excellence in Care from MHS and parent company Centene Corp.

The award honors Balakrishnan, a primary care physician in the MHS healthcare plan who specializes in pediatric medicine at the Navarre Pediatric Group, located at 100 Navarre Place, Suite 4440 in South Bend, for demonstrating exemplary performance when following up with examinations and consultations after patients’ emergency room visits, providing routine preventive and well-care services for children and adults and establishing a medical home for new enrollees in the MHS healthcare plan.

“MHS is proud to recognize Dr. Balakrishnan for the outstanding service and quality of care he provides to Managed Health Services members in his South Bend community,” said Dr. Robert Baker, vice president of medical affairs at MHS. “Our primary focus is on delivering the best possible care to our members and we could not do that without strong relationships with our plan’s physicians. The Summit Award is one way we can thank Dr. Balakrishnan for his ongoing dedication to helping people live healthy lives.”

Balakrishnan received his medical degree from the All India Institute of Medical Sciences in New Delhi, India. He completed his pediatric residencies at the All India Institute of Medical Sciences and at Women’s and Children’s Hospital of Buffalo, N.Y. He is board-certified by the American Board of Pediatrics and his interests include acute care, infectious diseases and asthma.

A total of 16 awards were awarded by Centene health plans throughout the nation.

“These honors underscore Centene’s distinction as a physician-driven company that provides quality care to our healthcare plan members,” said Centene Chairman and CEO Michael Neidorff. “Physicians are selected for exemplary performance in several areas.”

The rewards program works the same. You or your child visit the doctor for check-ups, screenings, and tests and you automatically receive rewards on a pre-paid debit MasterCard®. The difference is you don’t have to call to activate your new card. It’s ready for you to buy health-related items or to use on www.Diapers.com. You can also use it for prescription or future doctor visit co-pays. Once you get your new CentAccount card, your old Healthy Rewards card is no longer active and can’t be used.

If you need to check your balance you can call (866) 809-1091. Follow the directions when you are prompted. For all other CentAccount questions call the CentAccount information line at (877) 259-6959.

As part of Managed Health Services’ statewide campaign to raise awareness about the dangers of childhood obesity, a nationally known cartoon character will bring a special message to students in Elkhart on Tuesday (May 18) – one that warns them about the dangers of not being active or living healthy.

Thumbs Up Johnnie is a lovable cartoon character who owns The Longhorn Diner, where all the cowboys and cowgirls in Happy, Texas, gather for the best flapjacks around. He always has his hands full, flipping flapjacks, pouring milk and coffee and catering to his customers – things he couldn’t do if he weren’t physically active and mindful about his own good personal health. The character is the creation of Michelle Bain, who motivates herself as an author to create a world where children can learn through humor and by example.

“As a child, reading fueled my imagination,” said Bain, who created Thumbs Up Johnnie in 2002. “My stories are purposely structured with multi-layered humor, double entendres and idiosyncratic characters to make story lines interesting to many different types of readers.”

Bain will read her latest book, “Super CENTEAM 5: The Adventures of Thumbs Up Johnnie,” to students at two Elkhart schools Tuesday. At 8:45 a.m., she will read to kindergarteners through second graders at Roosevelt Elementary, 201 W. Wolf. At 10:15 a.m., Bain will share her message with third- to fifth-grade students at Hawthorne Elementary, 501 W. Lusher Ave.

Thumbs Up Johnnie will make a personal appearance at each school. Students will receive autographed copies of Bain’s book, character-themed bracelets and will take part in a pre- and a post-presentation test that will be issued by their classroom teachers.

Bain’s appearances are part of the Adopt a School program sponsored nationally by Centene Corp. and in Indiana by Centene-owned Managed Health Services (MHS), one of the state’s healthcare providers for Hoosier Medicaid recipients.

“Childhood obesity is a serious health concern that is wreaking havoc on our Indiana children,” said Dr. Robert Baker, vice president of medical affairs at MHS. “The prevalence of obesity in children ages 2 through 19 has increased up to nearly 18 percent in some age groups from just 20 years ago. Today, 15 percent of Indiana youth in grades 9-12 are overweight and another 14 percent are obese. Those numbers are far too high.”

MHS is currently in the midst of raising awareness about the dangers of childhood obesity among its membership throughout the state and promoting physical activity, an increased consumption of fruits and vegetables and a decline in the time youth spend watching TV and playing video games.

Elkhart schools are actively promoting the consumption of more fresh fruits and vegetables in all schools as well, including a free fruits and vegetables program in place in its three middle schools and two high schools.

Paid for from the district’s Food Service budget, students can select among apples, peaches, pineapple, pears and mixed fruits as a morning boost and green beans, corn, mixed vegetables, peas and carrots at lunchtime or in the afternoons.

“The program is becoming more and more popular every day,” said Pam Melcher, director of food service with Elkhart Community School Corp.

The free fruit and vegetables program was implemented this year. More fresh fruits and vegetables are being offered in the district’s elementary schools as well; the program will fully expand to elementary schools next year, Melcher said.

The survey results for the first quarter 2010 for key provider-related questions reflected:

• Members were highly satisfied with the MHS program and indicated they were happy with the outcome of the phone calls they placed to MHS (86%), happy with their MHS doctors (86%) and were likely to keep MHS in the future (84%).
• Members indicated their doctors were compassionate and genuinely cared about their well being. The small group of members reporting lower levels of satisfaction were unhappy with the distance they had to travel to the doctor’s office, unhappy with the wait times at the office or trying to make an appointment or unhappy because the doctor couldn’t assist them with their condition.
• Members were satisfied with the amount of time they had to wait for an appointment (88%). Overall, members indicated they could get same-day appointments (10%).
• Only three in ten members thought their visit to their doctor could have been better. The reasons most often given were long office wait times and that the doctor could have spent more time with them or could have done a better job explaining their condition and treatment plan.
• 39% of members reported using tobacco.
• 74% of those who indicated current tobacco use reported being advised by their doctor to stop tobacco use or receiving information regarding cessation.
  MHS recommends referring members who want to stop using tobacco to the Indiana Quitline at 1-800-QUIT-NOW, www.indianatobaccoquitline.net

MHS thanks you for your efforts to provide quality care to MHS members. Together, we can continue to improve the health of Hoosiers. If you have any questions or comments regarding the above appointment standards, please contact your MHS Provider Relations Specialist, or call us at (877) 647-4848.

Vaccines save lives. They protect both vaccinated individuals and entire communities by preventing the spread of infectious diseases.

National Infant Immunization Week is April 24-May 1.This year’s theme is, “Love them. Protect them. Immunize them.” The awareness campaign highlights the importance of protecting infants from vaccine-preventable diseases and celebrates the achievements of immunization programs and their partners in promoting healthy communities.

Managed Health Services, which provides affordable healthcare to more than 211,400 Hoosiers who receive health insurance through the Hoosier Healthwise program, is stressing the importance of infant and child immunizations this last week of April by encouraging members to schedule well-baby and well-child visits for their children and ensure their immunizations are current.

“Parents, healthcare providers and the media are important partners for promoting National Infant Immunization Week,” said Dr. Robert Baker, vice president of medical affairs at MHS. “These groups are all key stakeholders in ensuring children are fully immunized by two years old. The resounding message to parents on the MHS healthcare plan is to set aside 15 minutes now, schedule pediatrician and physician appointments and have their children immunized.”

Because of the success of vaccines in preventing disease in the U.S., parents are often unaware that their children are at risk for so many serious and life-threatening diseases, Baker said.

“Infants are particularly vulnerable to infectious diseases. Nearly 12,000 babies are born here each day and they will need to be immunized against 14 vaccine-preventable diseases before they reach age 2,” Baker said.

Raising awareness about the importance of infant and childhood immunizations is another step MHS is taking to get its members throughout the state to focus on living healthy lives. With a focus on infants and children, MHS hosts quarterly Health Check Health Days throughout Indiana, geared toward providing members the opportunity to complete recommended well-baby and well-child examinations. MHS reminds parents to keep their children’s immunizations up to date through birthday-card reminders and outreach calls. MHS is also in the midst of conducting Healthy Lifestyles events in several Indiana communities which offer important blood pressure, glucose and cholesterol screenings free of charge to its members.

Immunization schedules that parents can follow are posted on Managed Health Services’ Web site at www.managedhealthservices.com. Parents can visit the Web site and click on the Community Events tab to learn about Health Check Health Day and Healthy Lifestyles opportunities in their community.

MHS is headquartered in Indianapolis in the Landmark Center at 1099 N. Meridian St. MHS is a wholly-owned subsidiary of St. Louis-based Centene Corp., a leading, multi-line healthcare enterprise that offers both core Medicaid and specialty services.

NPI Requirements
MHS continues to adhere closely to NPI requirements and has recently strengthened claim acceptance criteria to ensure compliance. Some providers may experience claim rejects for practices which were previously accepted. Professional claims billed by a provider who is part of a group, must place the group “BILLING” NPI ID in box 33A on the claim form when providing services for the group (box 33A is for billing provider information). This is the most common error on recent claim submissions. Should you have questions regarding a rejection, please contact Provider Services at (877)-647-4848.

Previous EDI Issue
MHS experienced a problem with EDI rejection notifications providing incorrect reject reasons starting March 14 through April 1, 2010. The error primarily affected professional claims submitted through Emdeon during this timeframe. The rejection or acceptance logic was applied correctly, however, the incorrect reject reason was provided. We do apologize for this confusion and the issue has now been resolved. Emdeon and MHS have regenerated correct error reports dating back to March 14. Again, please contact Provider Services at (877) 647-4848 if you have any questions regarding this issue.

Facility Radiology Rate and Home Health Rate changes effective April 1, 2010 per Bulletins BT201005 and BT201007 issued on March 9, 2010 by OMPP
The Indiana Office of Medicaid Policy and Planning (OMPP) is promulgating regulations on an emergency basis to avoid an anticipated budgetary shortfall and to remain within the available Medicaid appropriation. MHS has updated our programs to be in compliance with the State’s directive as follows:
• A permanent change in reimbursement for certain radiology services reported on the UB-04 claim form. For more details, view bulletin 201005: www.indianamedicaid.com/ihcp/Bulletins/BT201005.pdf
• Reimbursement for home health services with a “from” date of service on or after April 1, 2010, through June 30, 2011, will be reduced by 5 percent. For more details, view bulletin 201007: www.indianamedicaid.com/ihcp/Bulletins/BT201007.pdf