Current Provider Newsletter - Bluegrass Family Health

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Bluegrass Family Health Partners with ConnectYourCare for Consumer- Directed Healthcare Administration Solutions Since 2012, Bluegrass Family Health has partnered with ConnectYourCare to provide best-in-industry administrative service and tools for Consumer-Directed Healthcare accounts. By partnering with ConnectYourCare, an industry leader in the administration of HSAs, FSAs, HRAs, and other tax-advantage accounts, Bluegrass Family Health is able to offer top-tier solutions and expert support to our employer clients and account participants. Providers also benefit from this new relationship as Bluegrass Family Health and ConnectYourCare equally value the ability to process claims and release payment as quickly as possible. Employees can review and pay healthcare claims quickly and conveniently from their accounts with enhanced application features. Payments may even be sent directly to the healthcare provider. Bluegrass Family Health believes simplifying healthcare to be vital to strengthening its relationship with members, employer groups, and network providers. Important Notification Regarding Your Claims Payments from Bluegrass Family Health, Inc. Bluegrass Family Health, Inc. (BFH) has teamed up with Emdeon to offer you several payment and remittance advice options. Coming soon: Instead of receiving paper check payments with your Explanations of Payment (EOP), you will begin receiving Virtual Card payments from BFH. The virtual card payment includes all the information necessary to collect the payment using your current Point of Sale (POS) terminal. This payment process is similar to manually keying in patient payments today. Be sure to enter the payment information for the full amount of the card’s value prior to the expiration date on the card. Please note: Your standard merchant fees will apply. Virtual Card payments can help you get paid faster using your existing POS terminal! No enrollment is necessary! Since funds will be deposited almost immediately from BFH into your merchant account, you get paid faster. BFH providers will automatically begin receiving Virtual Card payments on EOPs soon. The Virtual Card Payment is the newest option that BFH is making available to our provider network as a payment option. In addition to the Virtual Card Payment, BFH offers electronic funds transfers (EFT via Automated Clearing House (ACH)) and electronic remittances via (ASC X12 835 TR3). Additional information and details regarding this new payment options will be sent to you by Emdeon unless you have previously opted out of the Virtual Credit Card program through Emdeon. If you have any questions, you can visit the Emdeon ePayment Enrollment website at http://www.emdeon.com/epayment/ enrollment/. Mental Health & Substance Abuse Services Bluegrass Family Health (BFH) uses OptumHealth SM Behavioral Solutions 1 (Optum) provider network, claims, and case management services. All claims for Bluegrass members will need to be submitted to the following address and payments will be based on your agreed-upon rates with Optum: OptumHealth Behavioral Solutions P O Box 30757 Salt Lake City, UT 84130-0757 In addition, please note that all mental health services are required to be reviewed for medical necessity. You may contact Optum at 877-369-2201, with further information available at www.ubhonline.com. 1 OptumHealth Behavioral Solutions is a service mark of United Behavioral Health.
Restrictions on the Use of Oral Ketoconazole The FDA has placed strict limitations on the use of ketoconazole tablets. Ketoconazole is now used orally only as a last resort to treat life-threatening fungal infections for patients who cannot take other antifungal drugs or when other antifungals are not available. However, liver damage may be associated with its use – particularly when ketoconazole is taken at high doses or when it is taken by patients who have liver conditions or alcoholism. Additionally, oral ketoconazole interferes with the way that a large number of other drugs are used by the body. Taking ketoconazole together with certain drugs, such as some statins or some anti-anxiety agents, has resulted in higher than expected blood levels of the other drug. Serious, sometimes fatal, side effects have occurred, including heart problems and kidney failure. Ketoconazole also is known to block the production of steroids by the adrenal glands, a condition known as adrenal insufficiency. Untreated adrenal insufficiency may affect blood pressure, blood sugar, heart function, and weight. The FDA now requires the labels of oral ketoconazole products to have warnings about all three safety issues. A Medication Guide explaining the safety concerns is required to be given to every patient who is prescribed oral ketoconazole. Topical forms of ketoconazole do not have similar risks and they are not included in the new restrictions. More information regarding this safety update can be found on FDA’s MedWatch website at: http://www. fda.gov/Safety/MedWatch/default.htm Newer Oral Anti-Coagulants - Xarelto, Pradaxa, and Eliquis Please note: The newer oral anti-coagulants - Xarelto, Pradaxa, and Eliquis - require Prior Authorization (PA) for BFH members. Even if initiated inpatient, PA is required to continue therapy outpatient. BFH criteria requires the member to have had a documented trial and failure, intolerance, or contraindication to warfarin therapy, which may include highly variable International Normalized Ratio (INR) lab results while on warfarin therapy, pregnancy, gastrointestinal bleeding, or other generally accepted contraindications to the use of warfarin. Bluegrass Family Health Welcomes New Medical Director - Melissa V. Avery, MD, MMM, FAAFP, CPE After growing up in East Tennessee, Dr. Avery matriculated with a B.S. in Biochemistry from Rhodes College and received her medical degree from the University of Tennessee College of Medicine Health Sciences Center, both in Memphis. She was trained in Family Medicine at Greenville Hospital System in Greenville, South Carolina, whereby she started her own family practice. Later, Dr. Avery worked with Medicare and Medicaid Managed Care as well as commercial insurers in all areas of operations. Dr. Avery is a Fellow of the American Academy of Family Physicians and a Diplomat of the American College of Physician Executives; she is Board Recertified by the American Board of Family Medicine and Certified by the Certifying Commission in Medical Management. Locally, she is an active member of the Lexington Medical Society. Dr. Avery lives in the Lexington, Kentucky area and has farms on the Kentucky/Tennessee border.
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Current Provider Newsletter - Bluegrass Family Health

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