AVISO IMPORTANTE | Coronavirus (COVID-19)

In: Circulares, Comunicados, Noticias

16 de marzo de 2020

Ante los acontecimientos relacionados a la propagación mundial del Coronavirus (COVID-19), la seguridad y salud de los clientes y nuestra gente son prioridad para ASSERTUS.  Es por ello que, nos mantenemos atentos a las indicaciones oficiales del Centro para el Control y la Prevención de Enfermedades (CDC, por sus siglas en inglés) y el Gobierno de Puerto Rico. 

AL momento, una de las medidas más efectivas para prevenir la transmisión del virus en la comunidad es el distanciamiento social.  Esto reduce el ritmo de contagio, evita la sobrecarga del sistema de salud y ayuda a proteger el sistema inmunológico. 

Somos una empresa que da apoyo al sistema de salud de Puerto Rico, es nuestra responsabilidad y compromiso establecer medidas que permitan atender y mantener nuestras operaciones de manera continua. Con ello en mente hemos establecido protocolos para atender la seguridad de nuestros empleados, socios de negocios, clientes, proveedores y visitantes en general; incluyendo protocolos de higiene y sanitización de nuestras facilidades.   Sin embargo, como medida cautelar los adiestramientos grupales que se llevan a cabo en nuestras facilidades se estaránbrindando de manera remota tipo “webinar” comenzando el 26 de marzo de 2020, hasta nuevo aviso. 

Para ver los horarios y disponibilidad de estos adiestramientos en línea, puede acceder el siguiente enlace: https://mobile.assertus.com/es/calendario_de_adiestramientos/.  

El periodo de este protocolo puede extenderse según se estime necesario para salvaguardar la salud y seguridad de todos. 

Si usted tiene alguna inquietud o pregunta no dude en contactarnos vía telefónica al 787-622-2202 o escribiendo un correo electrónico a info@assertus.com

Nuestro equipo está preparado para apoyarle y orientarle sobre estos cambios. Seguiremos monitoreando el desarrollo del Coronavirus y las recomendaciones por parte de las instituciones pertinentes para la implementación de cualquier otra política adicional. 

Le invitamos a que nos siga por nuestros medios sociales; LinkedIn, Instagram, Facebook y página de Internet, donde informaremos cualquier cambio, política o protocolo adicional para la continuidad de nuestras operaciones y servicios.  

Agradecemos su confianza y reiteramos nuestro compromiso en ofrecer servicios con la más alta calidad, mientras que nos mantenemos en alerta al desarrollo de esta enfermedad novel.

Agradecemos su confianza y reiteramos nuestro compromiso en ofrecer servicios con la más alta calidad, mientras que nos mantenemos en alerta al desarrollo de esta enfermedad novel.

Ver comunicado original

By: Ray

CMS NEWS: Detailed Guidance to Providers about COVID-19

In: Circulares, Comunicados, Noticias

CMS NEWS

FOR IMMEDIATE RELEASE
March 10, 2020

Contact: CMS Media Relations
(202) 690-6145 | CMS Media Inquiries

 

  CMS Sends More Detailed Guidance to Providers about COVID-19
Healthcare workers in home health agencies and dialysis facilities are the latest group to receive important information on protecting staff and at-risk patients

Today, the Centers for Medicare & Medicaid Services (CMS) is supplementing its guidance to home health agencies and dialysis facilities to protect the health and safety of our nation’s patients and providers in response to the 2019 Novel Coronavirus (COVID-19) outbreak.

The memoranda were developed from frequently asked questions the agency has received about interacting with patients amid COVID-19. The guidance offers clear, actionable information to healthcare workers on the screening, treatment and transfer procedures to follow when interacting with patients. This action is part of the broader effort by the White House Task Force to ensure that all of our nation’s healthcare providers and patients – particularly those at high-risk of complications from COVID-19 – remain healthy while helping to contain the spread of the disease.

“We are arming our providers on the front lines with the information they need to remain safe, while giving quality care to their patients,” said CMS Administrator Seema Verma. “Today’s guidance will help providers identify patients who may have contracted the disease and minimize further transmission. It will also equip them to get these patients the medical care they need in order to recover.”

CMS is responsible for protecting beneficiaries who receive home healthcare services as well as those who receive treatment in dialysis facilities. Today’s guidance is an enhancement to the agency’s health and safety requirements and aims to help control and prevent the spread of infection. In particular, the new guidance advises all Medicare-enrolled dialysis facilities to identify high risk individuals prior to appointments or upon arrival, and immediately begin screening for fever or symptoms of a respiratory infection, such as a cough and sore throat, international travel within the last 14 days to restricted countries, and contact with someone with known or suspected COVID-19. Additionally, the guidance recommends screening visitors for potential exposure to the virus, gives detailed instructions for dealing with staff who have either been exposed or are showing signs of illness, and offers a list of frequently asked questions that include responses to help safely treat patients in this setting.

The guidance to home health agencies echoes recommendations set forth by the Centers for Disease Control and Prevention (CDC), with specific considerations of when it is safe to treat patients at home, when patients should be considered for hospitalization and recommendations for family member exposure, when evaluating and caring for patients with known or suspected COVID-19. CMS is recommending home health agencies remain vigilant, regularly monitor patients for any symptoms of the virus, and communicate effectively with patients, family members and other caregivers so that the entire care team understands a patient’s individual needs and goals of care. CMS’s guidance ends with a frequently asked question section offering answers to information that will ensure safe, quality care in the face of COVID-19.

To view, CMS’s guidance for home health providers, visit:https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/guidance-infection-control-and-prevention-concerning-coronavirus-disease-2019-covid-19-home-health

To view, CMS’s guidance for dialysis facilities providers, visit:https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and/guidance-infection-control-and-prevention-coronavirus-disease-2019-covid-19-dialysis-facilities

This guidance, and earlier CMS actions in response to the COVID-19 virus, are part of the ongoing White House Task Force efforts. To keep up with the important work CMS is doing in response to COVID-19, please visit the Current Emergencies Website.

Summary of CMS Public Health Action on COVID-19 to date:

On March 9, 2020: CMS delivered guidance on the screening, treatment and transfer procedures healthcare workers must follow when interacting with patients to prevent the spread of COVID-19 in a hospice setting. CMS also issued additional guidance specific to nursing homes to help control and prevent the spread of the virus.

https://www.cms.gov/newsroom/press-releases/cms-issues-clear-actionable-guidance-providers-about-covid-19-virus

On March 9, 2020: CMS issued a press release highlighting the telehealth benefits in the agency’s Medicare program for use by patients and providers.  Expanded use of virtual care, such as virtual check-ins, are important tools for keeping beneficiaries healthy, while helping to contain the community spread of the COVID-19 virus.

https://www.cms.gov/newsroom/press-releases/telehealth-benefits-medicare-are-lifeline-patients-during-coronavirus-outbreak

On March 9, 2020:  CMS published guidance to hospitals with emergency departments (EDs) on patient screening, treatment and transfer requirements to prevent the spread of infectious disease and illness, including COVID-19. Medicare-participating hospitals are to follow both CDC guidance for infection control and Emergency Medical Treatment and Labor Act (EMTALA) requirements.

https://www.cms.gov/newsroom/press-releases/cms-issues-call-action-hospital-emergency-departments-screen-patients-coronavirus

March 6, 2020: CMS issued frequently asked questions and answers (FAQs) for healthcare providers regarding Medicare payment for laboratory test and other services related to the 2019-Novel Coronavirus (COVID-19). https://www.cms.gov/newsroom/press-releases/covid-19-response-news-alert-cms-issues-frequently-asked-questions-assist-medicare-providers

March 5, 2020: CMS issued a second Healthcare Common Procedure Coding System (HCPCS) code for certain COVID-19 laboratory tests, in addition to three fact sheets about coverage and benefits for medical services related to COVID-19 for CMS programs. https://www.cms.gov/newsroom/press-releases/cms-develops-additional-code-coronavirus-lab-tests

March 4, 2020: CMS issued a call to action to healthcare providers nationwide and offered important guidance to help State Survey Agencies and Accrediting Organizations prioritize their inspections of healthcare. https://www.cms.gov/newsroom/press-releases/cms-announces-actions-address-spread-coronavirus

February 13, 2020: CMS issued a new HCPCS code for providers and laboratories to test patients for COVID-19.  https://www.cms.gov/newsroom/press-releases/public-health-news-alert-cms-develops-new-code-coronavirus-lab-test

February 6, 2020: CMS gave CLIA-certified laboratories information about how they can test for SARS-CoV-2. https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/notification-surveyors-authorization-emergency-use-cdc-2019-novel-coronavirus-2019-ncov-real-time-rt

February 6, 2020: CMS issued a memo to help the nation’s healthcare facilities take critical steps to prepare for COVID-19.  https://www.cms.gov/medicareprovider-enrollment-and-certificationsurveycertificationgeninfopolicy-and-memos-states-and/information-healthcare-facilities-concerning-2019-novel-coronavirus-illness-2019-ncov

By: Ray

MMM-Inscríbase en el Portal de Inscripción de Proveedores del Programa Medicaid de Puerto Rico (PRMMIS)

In: Circulares, Noticias


Carta Circular 1 | 30/10/2019
Portal de Inscripción de Proveedores del Programa Medicaid de Puerto Rico (PRMMIS)


Carta Circular 2 | 1/14/2020
Portal de Inscripción de Proveedores del Programa Medicaid de Puerto Rico (PRMMIS)


Carta Circular 3 | 2/27/2020
Primera y Segunda Fase de Inscripción al Portal de Proveedores del Programa Medicaid de Puerto Rico (PRMMIS)

By: Ray

Medication Adherence: Key to Therapy Success

In: Circulares, Comunicados, Eventos, Noticias

 A todos los Proveedores de Salud del Plan VITAL les invitamos al evento educativo

 Medication Adherence: Key to Therapy Success

 Recurso: Larisa Nieves Alicea, BSPh, MPHE, CHES
3 horas créditos para médicos


miércoles, 18 de marzo de 2020
Caguas Country Club
5:00pm -Registro


 jueves, 26 de marzode 2020
Restaurante Mojito Grill -Salinas
5:00pm -Registro

 Incluye cena y estacionamiento
Para confirmarsuasistenciapuedecomunicarse:
787-735-4520 Ext. 5019  | providereducation@planmenonita.com

By: Ray

Proveedor de Humana : Periodo de emergencia

In: Circulares, Comunicados, Noticias

Durante el periodo de emergencia declarado quedan sin efectos los siguientes requisitos para Medicare:

  • Requisito de referido para servicios cubiertos de salud física y mental
  • Requisito de pre-autorización para servicios cubiertos de salud física y mental
  • “Refill too soon” para medicamentos

Durante el periodo de emergencia declarado quedan sin efectos los siguientes requisitos para Comercial:

  • Requisito de referido para servicios cubiertos de salud física y mental
  • Requisito de pre-autorización para servicios cubiertos de salud física y mental
  • “Refill too soon” para medicamentos
  • Requisito de pre-autorización para medicamentos, excluye medicamentos controlados (SOLO aplica Comercial)

NOTA: Estas exclusiones estarán vigentes mientras dure el estado de emergencia o que sean canceladas por las agencias pertinentes, lo que ocurra primero.

VER COMUNICADO

By: Ray

Cartas Circulares del Plan de Salud Menonita – Vital

In: Circulares

CIRCULARES

Carta Circular 19-00024

Manejo de Opioides

Carta Circular 19-00023

Cambios al Formulario de Medicamentos en Cubierta del Plan de Salud

Carta Circular 19-00022

Facilitación del medicamento Trogarzo®

Carta Circular 19-00019

Carta Circular 19-00019 Métodos Anticonceptivos

Carta Circular 19-00023

Carta Circular 19-00023 Cambios a Formulario Zytiga

Carta Circular 19-00022

Carta Circular 19-00022 CODIGO DE FACTURACION PARA LA ADMINISTRACION DE TROGARZO

Carta Circular 19-00021

Carta Circular 19-00021 Medicamentos para Hepatitis C

Carta Circular 19-00020

Carta Circular 19-00020 Cambios al Formulario de Medicamentos en Cubierta (FMC) del Plan de Salud Vital (PSV)

Carta Circular 19-00018

Carta Circular 19-00018 Formulario de Registro de Beneficiarios SMI’s / SED’s / Buprenorfina.

Carta Circular 19-00017

Carta Circular 19-00017 Cambio de Formulario de Medicamentos

Carta Circular 19-00016

Carta Circular 19-00016 Servicio de Ginecología

Carta Circular 19-00015

Carta Circular 19-00015 Medidas de calidad HEDIS 2019

Carta Circular 19-00014

Carta Circular 19-00014 Código J NDC Mandatorio 20190412

Carta Circular 19-00013

Carta Circular 19-00013| Anti-Discrimen Género

Carta Circular 19-00012

Carta Circular 19-00012 TARIFAS ANTIBIOTICOS INJECTABLES

Carta Circular 19-00011

Carta Circular 19-00011 CÓDIGOS DE ADMINISTRACIÓN PARA TRATAMIENTOS CÓDIGOS J

Carta Circular 19-00008

Carta Circular 19-00008 Certificación de Diagnóstico HCHN revisada

Carta Circular 19-00007

Carta Circular 19-00007 Extensión Periódo de Transición Vital

Carta Circular 19-00006

Carta Circular 19-00006 Diagnóstico y Tratamiento de Dengue, Chikungunya y Zika

Carta Circular 19-00005

Carta Circular 19-00005 Asunto: Programa de Revisión Intrahospitalaria

NORMATIVAS

OTROS DOCUMENTOS CIRCULARES

Comunicación Casos de Influenza 11/01/2019

Comunicación Carta Circular 19-00003

Comunicación Casos de Influenza 11/01/2019

Comunicación Formulario de Ajustes 27/12/2018

Formulario de Ajustes PSM – Vital 1.1

By: Ray

Medicare & Medicaid Services (CMS) conducts the MAC Satisfaction Indicator survey

In: Circulares, Comunicados, Noticias

First Coast Service Options, your Medicare Administrative Contractor (MAC) for the traditional Medicare program, would like to request your opinion of our service by taking the MAC Satisfaction Indicator (MSI) survey. Your feedback goes directly to the Centers for Medicare & Medicaid Services and helps us understand how we can better service you. This survey should only take about 10 minutes of your time. To take the survey, click on the link below:

 

https://www.surveygizmo.com/s3/4826847/?MAC_BRNC=9&MAC=JN-First_Coast

 

Also, thank you for your feedback in 2018. You may read about some of our changes here.

 

By: Ray
TRIPLE-S Business Partners

Triple-S | Carta a Proveedores PREPA 12/27/2018

In: Circulares, Noticias

Estimado Proveedor:

Reciba un cordial saludo de parte de Triple‑S Salud, Inc. (Triple-S).

Efectivo al 1 de enero de 2019, Triple-S administrará la cubierta de salud de los Empleados activos, jubilados y los dependientes elegibles de la Autoridad de Energía Eléctrica (PREPA). Nuestra organización fue seleccionada de entre varios proponentes al desarrollar una propuesta sólida enfocada en el acceso a servicios de la más alta calidad.

Triple-S se une a los esfuerzos de garantizar a los asegurados/afiliados acceso continuo a los servicios médicos-hospitalarios a través de la relación de negocios y la comunicación abierta que mantiene con su amplia red de proveedores. Es por ello que, mediante esta comunicación, Triple-S interesa orientarle en cuanto a temas relacionados al acceso y pagos por servicios prestados a partir de la fecha de efectividad de la cubierta. Leer más

By: Ray