Devon Health Staff Updates
(Devon Health Network Management Team)
Bill Bruce, VP of Hospital Contracting and Relations, has assumed added responsibility for Provider Relations. He will also now be managing the Provider Relations team and overseeing day-to-day operations of physician and ancillary contracting. Bill can be reached at wbruce@devonhealth.com or 610.757.4114.
Territory II
Quentin Dancer, formerly the Manager of Client Services, has taken the position of Manager, Provider Relations Territory II. Quentin can be reached at qdancer@devonhealth.com or 610.757.4185. Josh Bean has been promoted to Manager, Recruiting and Project Management Services. Josh can be reached at jbean@devonhealth.com or 610.757.4952. Dorothy (Dolly) Noel has recently joined the team as Data Entry Specialist. Dolly can be reached at dnoel@devonhealth.com or 610.757.4211.
Territory I
Domonique Adams has recently joined the team as a Provider Relations Specialist and can be reached at dadams@devonhealth.com or 610.757.4170. Richard (Rick) Higgins has recently joined the team as Data Entry Specialist and can be reached at rhiggins@devonhealth.com or 610.757.4208.
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Importance of Keeping Practice Information Up to Date
We highly encourage all providers in the Devon Health network to ensure that they are keeping us up-to-date on any demographic changes regarding their practice. Without current information, your re-credentialing process may be hindered, which could potentially result in your practice no longer being listed as in-network.
All in-network providers have a contractual obligation to keep us current on changing information. You can easily change your information online or you can download an information change form and fax it in to 610-757-1392.
We also ask that your practice routinely submits group practice rosters to update us on changes. This enables our clients to pay providers in a timely fashion.
We appreciate your efforts to keep us current on changes. This helps us help you as a network provider!
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ICD-10 Implementation
Starting on October 1, 2013, Devon Health will be compliant with all HIPAA requirements for ICD-10. We will be ready to begin processing claims with ICD-10 codes at that same time. After that date, we may still accept claims with either ICD-9 or ICD-10 codes, but will be encouraging the switch over to ICD-10. We will not be able accept any claims with both ICD-9 and ICD-10 codes. These claims will be returned non-priced with explanation of incompatible diagnosis codes. If you have any questions about the code implementation, please feel free to contact Telza Brown, Director, Provider Pricing and Payment at 610-755-4953 or tbrown@devonhealth.com.
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Reminder: Implementation of Modifiers
As a reminder, beginning with the 2011 fee schedule, Devon Health began to apply the following Modifiers to payments: 27, 50, 51, 52, 53, 54, 55, 56, 62, 66, 73, 74, 78, 80, 81, 82, 91, 92, 99, AA, AS, QK, QY and QX. These are industry standard adjustments and the provider community is well aware of these.
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2012 Fee Schedule Updates
While there are no sweeping changes being made to Devon Health’s 2012 fee schedule, we will be introducing and including preventative services. Please be looking for more information regarding this in the next several months.
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5010 Reminder
Starting January 1, 2012, all providers will be required to switch from version 4010 to 5010 of the HIPAA electronic transaction standard. To ensure that this is done in a timely manner, all providers should contact their billing clearinghouse to allow for all updates to be made on schedule in order to remain compliant.
If your current address to which payment is remitted to has changed, please update your information with us right away. This will ensure that you continue to receive timely payments. You can easily change your information online or you can download an information change form and fax it in to 610-757-1392.
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State Worker’s Insurance Fund now accessing Devon Health Injury Management Network
The PA State Worker’s Insurance Fund is now accessing Devon Health’s Injury Management Network. The Injury Management Program, introduced last year, encompasses both the Worker’s Compensation and Motor Vehicle/Auto products. Devon Health has been actively recruiting and building the Injury Management Network for several years now in order to be able to offer a robust product to clients.
The PA State Worker’s Fund covers thousands of subscribers across the state. Many other employers in the tri-state region access Devon Health’s network, providing participating providers with increased access to additional patients.For more information on how to become a participating provider, please contact Josh Bean at 610.755.4952 or jbean@devonhealth.com.
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Sub-Delegation Status Awarded to Groups Meeting NCQA Standards
Devon Health is now requiring NCQA standards for credentialing. Those group practices that had delegated credentialing status under non-NCQA requirements can go to either sub-delegation status (provided they are already meeting NCQA standards), or will have to revert to individual credentialing. It is not recommended that practices go the individual credentialing route.
If you believe you are currently adhering to NCQA standards and have a Credentialing Committee, please contact our Provider Relations team at 866.498.4773 so a determination can be made if sub-delegation is right for your practice.
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Individual Credentialing Standards
For some time now, we have been sending out information about the changes to our credentialing standards for individually credentialed providers in Pennsylvania and Delaware. If you have not been re-credentialed, you will be listed as such; if you have not been contacted, received a notice or responded yet, please contact us to complete your re-credentialing.
For more information, please contact Christy Cozzi at ccozzi@devonhealth.com or speak with a member of the Provider Relations team at 866.498.4773.
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Online Checklists Make Credentialing Process Easier
The process of credentialing for the first time, or re-credentialing for the fifth time, can be confusing. We want to make the process as painless as possible for you and your staff, so we have posted checklists for the credentialing process on our website. These checklists will help keep you organized and will remind you of each item that needs to be submitted for fast and easy processing of your credentialing application.
You can now download PDF versions of the checklist on our website at your convenience. If you need additional assistance with your credentialing process, please call the Provider Relations Hotline at 866.498.4773 or email us at providerrelations@devonhealth.com.
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Devon Health Presents Our Credentialing Committee
Front Row: Dr. Denise Ranucci (OBGYN), Dr. Elliot Menkowitz (Orthopedic Surgeon and our Chairman and Chief Medical Officer), Richard A. Longo (R.N., FACMPE, FACHE Senior Vice President, Network Management), Dr. Birgit Wiswe (Family Practice) Back Row: Dana De Luca-Peters (Project Manager, Devon Health), Christy Cozzi (Manager of Credentialing Services, Devon Health), Dr. Nainesh Patel (Cardiology), Dr. Michael Stulpin (Family Practice), Dr. Joseph Ardito (ENT), Nicholas Leh (Former Manager, Provider Services, Devon Health), William Bruce (VP, Hospital Contracting and Relations, Devon Health)
Devon Health is pleased to introduce the members of our credentialing committee. The committee is comprised of a variety of specialties.
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Updating your Demographic Information
Please make sure to report all Demographic Changes to Providers Relations:
Phone: 866.498.4773
Fax: 610.757.1392
Email: providerrelations@devonhealth.com
Example of Changes: Terminations, Practice Name, Tax Id, Practice Address, Practice Phone, Practice Fax, Practice Email, Mailing Address, Billing Information
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