ECPHO Eastern Connecticut Physicians Hospital Organization, Inc.

News & Resources

News & Resources

news

As a service to you, we have provided links to the NPPES website:

To search for a provider’s NPPES information, click here to
access the NPI registry
.

To update your own NPPES information, click here to access the NPI login page.

Download the recent issue of our NewsPHOlash newsletter.

Here is the latest news from ECPHO:

Important Message from Aetna Regarding 2015 Billing

Physicians and other providers should be aware that they need to use new HCPCS and CPT-4 codes when billing for patient services in 2015. The Centers for Medicare & Medicaid Services (CMS) and the American Medical Association (AMA) are making changes to both:

  • The Healthcare Common Procedure Coding System (HCPCS)
  • The Current Procedural Terminology (CPT-4) code sets

These changes include deleting some existing codes and replacing them with other codes. These changes are effective for dates of service on or after January 1, 2015.

You can access the code changes information online through Aetna’s secure provider website at www.aetna.com. Once logged in:

  • Select “Aetna Support Center” from the menu bar on the left
  • Select “Doing Business with Aetna” then “AMA/CMS Reimbursement Code Updates”
  • Select “Designated Standard Maintenance Organization (DSMO)” to reach the website links for the various code updates

We’ve updated the agreement with us to reflect these changes. The current agreement with us includes compensation rates for the HCPCS and/or CPT-4 codes that CMS is deleting. This compensation:

  • Includes, but isn’t limited to, fixed rates, global payments and capitation
  • Will now apply to the new HCPCS and/or CPT-4 codes replacing the deleted codes, where applicable and as intended under the agreement with Aetna

Please use the new codes when billing Aetna for services with dates of service on or after January 1, 2015. Please note that not all deleted codes have replacement codes. If CMS or the AMA hasn’t designated a replacement code, we will remove the deleted code from your contract.

Providers may contact their local Aetna network account manager with any questions.

The Latest News from Cigna

Download the January 2015 issue of Cigna’s Network News for Health Care Professionals.

ConnectiCare Changing its DME and DSM Network

ConnectiCare, Inc. (CCI) has changed its Durable Medical Equipment (DME) and Disposable Medical Supplies (DMS) network. It is very important for providers to check the provider directory at www.connecticare.com/ProviderDirectory to ensure you refer CCI members to in-network providers only.

Effective October 1, 2014, CCI’s DME and DMS networks only include the following providers. This applies to both Commercial and Medicare Advantage networks.

Please note: These changes do not apply to CCI’s participating network of insulin pump providers, power wheelchair providers, orthotics & prosthetic providers or providers of specialized, non-standard DME services. It is important that you check www.connecticare.com/ProviderDirectory to confirm a provider’s participation status.

DME Providers for Standard DME:

  • J & L Medical Services LLC – 203.757.4991
  • Professional Home Care Services Inc. – 877.225.7427

Standard DME includes:

  • Oxygen equipment and related supplies
  • Respiratory equipment and related supplies (nebulizer drugs are not included with the nebulizers and will need to be obtained by a retail pharmacy or DMS vendor if available)
  • Manual wheelchairs and related accessories
  • Canes, commodes, walkers, etc.
  • Tracheostomy supplies
  • Nebulizers (nebulizer drugs are not included with the nebulizers and will need to be obtained by a retail pharmacy or DMS vendor if available)

DMS Providers:

  • Better Living Now – 631.348.0032
  • Byram Healthcare – 800.200.1100
  • CCS Medical – 800.726.9811
  • Edgepark Medical Supply – 800.321.0591
  • Pelton’s Home Health – 860.761.0008
  • Sterling Medical Services – 800.216.5500

Standard DMS include (but are not limited to):

  • Diabetic supplies
  • Injection supplies
  • Ostomy supplies
  • Incontinence supplies
  • Dressings
  • Miscellaneous supplies

Providers with any questions may call Provider Services at 1.800.828.3407 from 8 am to 6 pm Monday through Thursday, or from 9 am to 5 pm Friday.

Connect through CINECT, the Clinically Integrated Network of Eastern Connecticut

ECPHO, ECIPG and ECHN have been working on the structure of the new clinically integrated network that will transform patient care east of the river. ECPHO will be replaced by the Clinically Integrated Network of Eastern Connecticut, currently being referred to as CINECT. It’s pronounced “KIN-ect”. Think: “connect”.

The new “PHO” CINECT board of managers will be over 66 percent comprised of physicians with a mix of specialties and PCPs. This is crucial for clinical integration.

In January, we began employment of two nurse Care/Disease Managers and a Data Analyst to support CINECT.

We are looking to the physicians to help us to build upon the protocols and measures that we already have in place. We need to continuously reevaluate the care that we provide and find the best strategies that make sense with our patients in the communities we serve.

We are enthusiastic and look forward to building together a model that makes sense for this community.

ECHN Donation to Practices Without an EHR

eClinical Works (eCW) is ready for those practices that qualify for an Electronic Health Record (EHR) donation.

Some practices prefer to adopt Allscripts as their EHR vendor. ECHN is diligently working to close negotiations with Allscripts.

If your practice qualifies as a first-time EHR adopter and is interested in the donation program for eClinicalWorks for qualified practices, please contact Brian Wright at MPP at 860.872.2289.

Main Navigation