Presbyterian: Provider Communications

PHP Communications

Recent Communications from Presbyterian Health Plan and Presbyterian Insurance Company, Inc.

In Brief Provider Newsletter - Information for Presbyterian Practitioners

Fall 2011 (PPC101105)
Summer 2011 (PPC091101)
Spring 2011 (PPC061108)
Winter 2010-2011 (PPC011108)
Fall 2010 (PPC101010)
Summer 2010 (PPC081015)
Spring 2010 (PPC041013)
Winter 2009/2010 (PPC021005)
Summer/Fall 2009 (PPC100918)
Spring 2009 (PPC070913)
Winter 2008-2009

Archived In Brief Issues

Provider Services

2011 HIV Screening Tests (PPC121107)
2011 Consultation Codes Eliminated (PPC121103)
2011 Presbyterian Senior Care Provider Directory Error (PPC101102)
2011 Dialysis Communication Provider Letter (PPC091102)
2011 Suboxone Communication To Providers (PPC091103)
2011 Suboxone/Subutex Form (PPC091103)
2011 Letter of Direction #41 (Correction of Letter of Direction #40) Coding Procedure Options for Opioid Addiction Treatment with Suboxone (State of NM Medical Assistance Div. Document)
2011 5010 Implementation Phase One Letter (PPCPPC081103)
2011 Electronic Claims Transmission Letter (PPC081101)
2011 Letter of Direction 40 Coding Procedure Options for Opioid Addiction Treatment with Suboxone (State of NM Medical Assistance Div. Document)
2011 Walgreen's Respiratory Termination Letter (PPC041106)
A 12/14/11 revision of the NDC Manual corrects instructions given with regards to correcting the omission of leading zeros in NDCs being entered on a claim form.
2011 Revised NDC Procedure Manual (PPC021104)
2011 Salud NDC Supplement 11-03 (State of NM Medical Assistance Div. Document)
2011 OIG Anti-Fraud Training, Additional Assistance (PPC021110)
2011 Non-Contracted Laboratory Letter (PPC011104)
2011 TriCore Reference Laboratories Patient Care Centers Listing
2011 Medicare Annual Wellness Visit (PPC121008)
2010 Office of Inspector General Anti-Fraud Training (PPC111009)
2010 SCI Podiatry Clarification Letter (PPC091015)
2010 Cancer Conference (PPC091010)
2010 Salud NDC Provider Letter (PPC081003)
2010 Salud NDC Supplement (State of NM Medical Assistance Div. Document)
2010 Emergency Department Initiative (PPC071007)
2010 SCI DME Letter (PPC061009)
2010 "My Care Family" Child Copay Reminder (PPC011004)
2009 Pres Online Status (PPC120910)
2009 Pres Online Enhancements Letter (PPC120908)
2009 Medicare Part C & D Fraud, Waste, and Abuse Training (2nd Notification) (PPC110905)
2009 Salud Notification Of Birth Form Letter (2nd Notification) (MPC090901)
2009 New Medicare Fraud, Waste, and Abuse Training Requirements (PPC090906)
2009 Medicare Fraud, Waste, and Abuse Training FAQ
2009 Medicare Fraud, Waste, and Abuse Training Helpful Web Links
2009 Notice of Non-Medicare Coverage Letter (PPC070904)
2009 Notice of Non-Medicare Coverage CMS Form (PPC070904)
2009 Autism Mandate (PPC060915)
2009 7 Day Behavioral Health Follow-Up Visit Copay Waived (PPC060911)
2009 Fluoride Varnish Pilot Program - Chaves County Providers Only (PPC060910)
2009 Revised Medicare ABN Form (ppc060901)
2009 Walgreens Purchases McKesson Specialty Pharmacy (PPC030904)
2009 Walgreens Specialty Drug Request Form (PPC030904F)

Archived Povider Services Communications to Providers

Reimbursement and Coding

2011 NDC Instructions Letter (PPC011101)
2010 Salud NDC Supplement 10-03 (State of NM Medical Assistance Div. Document)
2010 Salud NDC Requirements (PPC101014)
2010 In-Office Laboratory List (PPC041004)
2010 Coding Bulletin (PPC110904)
2010 2010 Fee Schedule Notification (PPC120913)
2009 Salud Fee Schedule Reduction Letter (PPC120907)
2009 A1c Notification (PPC050901)
2009 RBRVS Updates (PPC010901)

Archived Reimbursement and Coding Communications to Providers

Claims

2009 Medicare Medical Record Request Letter and Form (PPC040904)

Health Services

2012 HPV Gardasil Vaccine Age Limit Changed For Males (PPC011206)
2011 PT ST OT Prior Authorization Provider Letter (PPC101103)
2011 Mammogram Reminder Cards Provider Letter (PPC081118)
2011 Member Mammogram Reminder Card - English (MPC020908)
2011 Member Mammogram Reminder Card - Spanish (MPC020908)
2011 PT-OT-ST Letter (PPC071105)
2011 PT-OT-ST Letter on SCI Benefit (PPC061106)
2011 Update on Speech Therapy ICD-9 Codes Letter (PPC051103)
2011 Termination of RadOnc™ Radiation Therapy Benefit Program (PPC041105)
2011 PT-ST-OT Provider Letter (PPC031111)
2009 PCP Medical Records Audit Letter (PPC030912L)
2009 Medical Record Standards (PPC030912S)

Prior Authorization/Benefit Certification Changes
2011 Prior Authorization/Benefit Certification Changes (PPC031106)
2010 Benefit Certification Changes (PPC041003)

Healthy Solutions
2010 Healthy Solutions Disease Management Program Flyer (PPC100908)
2009 LifeMasters Provider Transition (MPC030913)

Provider Profiles

Asthma Provider Profiles
2011 3rd Quarter Asthma Provider Profile Letters (reporting period, 07/01/2010 through 09/23/2011)
Non-PMG Provider Profile Letter (PPC091109)
PMG Provider Profile Letter (PPC091110)
2011 Asthma Exclusion Form (PPC031115)
2011 Asthma Formulary
2011 Summary Of The National Asthma Education and Prevention Program's Expert Panel Report - 3 (PPC091111)

2010 4th Quarter Asthma Provider Profile Letter (PPC121003) (reporting period, 09/01/2009 through 12/01/2010)
4th Quarter Asthma Sample Member List (PPC061004L)

2010 3rd Quarter Asthma Provider Profile Letter (PPC061004) (reporting period, 06/30/2009 through 09/01/2010)

2010 2nd Quarter Asthma Provider Profile Letter (PPC061004) (reporting period, 03/01/2009 through 06/10/2010)
2nd Quarter Asthma Sample Member List (PPC050904)

Diabetes and Cardiovascular Conditions Provider Profiles
2011 2nd Quarter (reporting period, 04/01/2010 through 07/14/11)
Eligible for Salud/SCI Pay for Performance Incentive Cover Letter (PPC071104)
Not Eligible for Salud/SCI Pay for Performance Incentive Cover Letter (PPC071102)
Sample Profile/Glossary (PPC071103)
Evidence of No Diabetes Form (Diabetes Exclusion Form) (PPC071101)
Certified Diabetes Educators List (PPC071106)

2010 2nd Quarter (reporting period, 04/01/2009 through 07/18/2010)
Provider Cover Letter (PPC071008)
Diabetes and Cardiovascular Conditions Sample Profile/Glossary (PPC041012ML)
Practitioner Practice Profile Supplemental Data Form (PPC041012)
Evidence of No Diabetes Form (Diabetes Exclusion Form) (PPC041012F)
Certified Diabetes Educator List (PPC041010)

Emergency Room High Utilization Provider Profiles
2011 3rd Quarter Provider Letter - Non-PMG Providers (PPC071001)
Provider Letter - PMG Providers (PPC021105)
Sample Member List (PPC021106)

2011 2nd Quarter Provider Letter - Non-PMG Providers (PPC071001)
Provider Letter - PMG Providers (PPC021105)
Sample Member List (PPC021106)

2011 1st Quarter Provider Letter - Non-PMG Providers (PPC071001)
Provider Letter - PMG Providers (PPC021105)
Sample Member List (PPC021106)

2010 4th Quarter Provider Letter - Non-PMG Providers (PPC071001)
Provider Letter - PMG Providers (PPC021105)
Sample Member List (PPC021106)

2010 3rd Quarter Provider Letter - Non-PMG Providers (PPC071001)
Provider Letter - PMG Providers (PPC071001)
Sample Member List (PPC071001L)

Physician Performance Assessments (PPA)

2011 2nd Quarter PPA (reporting period, 07/01/2010 through 06/30/2011) (rural PPA reports are formatted the same as urban)
Provider Cover Letter (PPC071014)
PPA Family Medicine Urban Sample
PPA Internal Medicine Urban Sample
PPA Pediatric Medicine Urban Sample

2011 1st Quarter PPA (reporting period, 04/01/2010 through 03/31/2011) (rural PPA reports are formatted the same as urban)
Provider Cover Letter (PPC071014)
PPA Family Medicine Urban Sample
PPA Internal Medicine Urban Sample
PPA Pediatric Medicine Urban Sample

2010 4th Quarter PPA (reporting period, 01/01/2010 through 12/31/2010)
Provider Cover Letter (PPC071014) (PAAs Samples are the same as 2nd Quarter PPAs)

2010 2nd Quarter PPA (reporting period, 07/01/2009 through 06/30/2010) (rural PPA reports are formatted the same as urban)
Provider Cover Letter (PPC071014)
PPA Family Medicine Urban Sample
PPA Internal Medicine Urban Sample
PPA Pediatric Medicine Urban Sample

2010 1st Quarter PPA (reporting period, 04/01/2009 through 03/31/2010) (rural PPA reports are formatted the same as urban)
Provider Cover Letter (PPC071014)
Family Medicine Urban Sample
Internal Medicine Urban Sample
Pediatric Medicine Urban Sample

2010 PPA (PPC051006) (reporting period, 01/01/2009 through 12/31/2009)
Family Medicine (Rural)
Family Medicine (Urban)
Internal Medicine (Rural)
Internal Medicine (Urban)
Pediatric Medicine (Rural)
Pediatric Medicine (Urban)

PHP Communications

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