Halloween Trivia - Kansas Health Solutions

KHS
Dispatch
Volume 3
Issue 4
October 15, 2009
In This Issue...
Halloween Trivia pg1
Member Services Update pg2
SED/PRTF Updates pg3
PHI and Email pg3
KHS Training Insider pg4
Billing Members pg4
KHPA Transportation Announcement pg5
CEO Update pg6
Halloween Trivia
♦♦ Tootsie Rolls were the first wrapped penny candy in America.
♦♦ The ancient Celts thought that spirits and ghosts roamed the countryside on Halloween night.
They began wearing masks and costumes to avoid being recognized as human.
♦♦ Jack o’ Lanterns originated in Ireland where people placed candles in hollowed-out turnips to
keep away spirits and ghosts on the Samhain holiday.
♦♦ Chocolate candy bars top the list as the most popular candy for trick-or-treaters with Snickers
#1.
♦♦ Bobbing for apples is thought to have originated from the roman harvest festival that honors
Pamona, the goddess of fruit trees.
♦♦ Halloween was brought to North America by immigrants from Europe who would celebrate the
harvest around a bonfire, share ghost stories, sing, dance and tell fortunes.
♦♦ Halloween is on October 31st, the last day of the Celtic calendar. It was originally a pagan
holiday, honoring the dead. Holloween was referred to as All Hallows Eve and dates back to over
2000 years ago.
♦♦ The mask used by Michael Meyers in the movie “Halloween” was actually William Shatner’s mask
painted white.
♦♦ The common little brown bat of North America has the longest life span for a mammal it’s size,
with a life span averaging 32 years.
Page 1 of 6
Consumer Advisory Update
The Committee has developed a mission statement and a set of goals as its guide:
Mission
Strengthen and improve the processes of care for members and family by voicing
issues and working toward collaborative solutions.
Goals
•
•
•
•
To be the eyes and ears of the community to identify issues and concerns
Use “lived” experience in the improving of the care process
Act as an emissary to take helpful information back to the community
To create more collaborative interactions between members and providers
The Committee oversees the members’ newsletter, “Recovery in Action” (RIA). RIA was
developed as another means to distribute information to members. RIA has included
such articles as member recovery stories, educational pieces, and current event items
to name a few.
If you have any questions please feel free to contact Tammy Broadbent, Advisory
Groups Coordinator at [email protected].
Grievances
From July 1, 2009 to October
15, 2009 there were a total of 31
grievances filed. The KHS contract
with SRS states grievances will be
resolved within 14 days.
Language Line
KHS contracts with “Language
Line Services” for interpreters to
meet the needs of Members.
May
Spanish 42
The Ombuds-person thanks all
Providers for helping to resolve
these grievances to meet the
goals of the contract.
Language Line: 866-874-3972
Page 2 of 6
Alternative format available upon request
Dinka: 2
People may forget what you said; people may forget what you did - but people will never forget how you made them feel. ~Maya Angelou
The Consumer, Family and Community Committee is comprised of family members,
consumers, as well as KHS staff and other stakeholders. Currently, 23 members from
across the state make up the Committee. The committee serves as a focus group, a
problem solving group and creator of consumer and family member programs and
initiatives.
SED and PRTF Information Updates
• Just a friendly reminder that all domains must be addressed on the Strengths and Needs assessment for the SED Waiver or PRTF Grant plan of care. For example, in the needs section of the legal domain the words ‘no need identified’ may be used. This language supports the domain was addressed. The designator (N/A) is not acceptable.
• Effective October 2009, the SED Waiver and the PRTF CBA reviews will move in Kansas Health Solutions from the Audit department to the KHS Care Management department. The CMHCs will not see a significant change in the review process. SRS Disability and Behavioral Health Services, Mental Health, will continue to manage the review process with KHS Care Management. Julie Figgs and Bobbie Graff-Hendrixson, SRS, will remain in their role as the State, SRS central office mental health representatives. Lori Libel, KHS Waiver Manager, will be the primary contact for Formal Responses to the waiver review results. The review process will be supported by continued involvement from Anne Werring, KHS Corporate Compliance Officer.
• The new SED Waiver manual and attachments is now posted on the KHS website. The manual and attachments are in PDF format. The attachments are also saved individually and have been saved in Word 97-2003. As always, please contact me with any questions.
Lori Libel
Manager of SED Waiver, PRTF CBA Grant and Care Management
It is Kansas Health Solutions’ Policy to not
transmit Protected Health Information (PHI)
via email. If a provider submits information to
a KHS employee that includes PHI, employees
may delete any PHI included in the email
when they reply to you. We apologize for any
inconvenience this may cause.
Anne Werring, Corporate Compliance Officer
Page 3 of 6
KHS Training Insider
Training requirements for KHS credentialed Providers per the PAHP contract and Federal regulations.
Refer to the KHS Provider Manual July 2009, p. 12
Newly credentialed KHS Providers
• Provider Manual (includes Documentation Training)—due within 30 days of credentialing date (must be KHS training)Corporate Compliance—due within 6 months of credentialing date (must be KHS training)
• Cultural Competency—due within 6 months of credentialing date; if you take the training elsewhere, you may attest to taking the training and send the documentation to KHS
• HIPAA—due within 6 months of credentialing date; if you take the training elsewhere, you may attest to taking the training and send the documentation to KHSEthics—due within 6 months of credentialing date; due every 2 years per BSRB requirements
Existing credentialed KHS Providers
• Provider Manual (includes Documentation Training)—due annually (must be KHS training); if an individual has taken the full Provider Manual training the prior FY, then they can opt to take the Provider Manual Mini Refresher to satisfy the Provider Manual requirement
• Corporate Compliance—due annually (must be KHS training)
• Cultural Competency—due annually; if you take the training elsewhere, you may attest to taking the training and send the documentation to KHS
• HIPAA—due annually; if you take the training elsewhere, you may attest to taking the training and send the documentation to KHS
• Ethics—due every 2 years per BSRB requirements
Please complete the trainings listed according to the timeframes above. These trainings are required
every year; the year is defined as July 1 – June 30, with the exception of Ethics. Ethics will follow
provider licensure board requirements. We are currently in Fiscal Year
(FY) 10.
You can take the trainings online at:
www.kansashealthsolutions.org -->Providers -->Training -->Online Training. If you do not have
Internet access, please contact the Training Department for an alternative method to complete the
trainings.
If you have any training questions, please feel free to contact the Training Department toll-free at
(866) 547-0222 ext. 335 (Michelle) or 351 (Carla).
Billing Members
Providers are reminded that KHS Members may not be billed for covered services, even when normal
charges exceed the KHS allowed fees. This is typically referred to as balance billing. If Members
request mental health services that are not covered by KHS, Providers are permitted to request
reimbursement from the Member.
If you have any questions about this, please contact the KHS Provider Services/Claims staff at
866-547-6457 or Michele Johnson, Director of Provider Network Development at 866-547-0222.
Michele Johnson, Director of Provider Network Development
Page 4 of 6
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Page 6 of 6
CEO Update
Dear Providers:
You may have heard that KHS has identified duplicate paid claims
with our system and that we are planning recoupment actions. Large
numbers have been quoted as likely recoupments. This is not accurate.
KHS has identified POTENTIAL duplicate claims, as well as claims that
are clearly duplicates. Those which are clearly duplicates will be subject
to recoupment and are relatively small in total dollar volume across
the system. Other claims that are identified as possible duplicates may
require additional documentation (progress notes) to be submitted by
the provider. However, KHS is still in the process of determining exactly
“A friend is
someone who
understands your
past, believes in
your future, and
accepts you just
the way you are.”
~ Unknown
which claims will require further documentation. It is likely, as additional
documentation may show, that a large percentage of these potential
duplicate claims are not duplicates. Thanks for your patience and
cooperation as KHS prepares to work with you on this issue.
I would also like to extend many thanks to those of you who attended
our fall conference - the feedback was overwhelmingly positive. Each
year, we are broadening the content of the Kansas Behavioral Health
Conference, and I hope that the conference will continue to attract more
and more attendees from a variety of organizational settings. In this time
of dramatic reform to the health care system, this conference can help
prepare our state for the coming changes, thus ensuring we continue to
provide the highest quality of care.
Michael Goldberg, CEO
534 S. Kansas Ave., Suite 510 Topeka, KS 66603 785.575.9393 toll free 866.547.0222 fax 785.234.2410
www.kansashealthsolutions.org