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Provider Training

Provider Services is dedicated to building stronger relationships with our contracted healthcare providers/practitioners.

 

NOTIFICATION
IMPORTANT INFORMATION: Chaves County Fluoride Varnish Project
July 1, 2009
 
Presbyterian Health Plan is committed to ensuring that our practitioners and providers are kept apprised of changes that affect the way in which health care is administered, and changes in the benefits that members are offered. At the request of the New Mexico Human Services Department (HSD), Presbyterian Salud is participating in the Chaves County Fluoride Varnish Project.
 
The majority of children between newborn and three years (0 to 3) of age do not visit a pediatric or general dentist. Intervention during young childhood is important because cavity-causing bacteria can be established in an infant’s mouth by the time his/her first tooth erupts. For children at high risk of oral disease, this infection can quickly progress into rampant decay that can destroy a child’s primary teeth soon after they emerge. 
 
The Chaves County Fluoride Varnish Project, a pilot program, is a value added service allowing coverage of fluoride varnish application by Presbyterian Salud contracted, non-dental Primary Care Practitioners (PCPs) and Pediatricians located in Chaves County. As part of a child’s Well Child visit, PCPs and Pediatricians are being asked to participate in this pilot program because they see children before the child’s third birthday more often than a pediatric or general dentist.
 
Effective Date of the Chaves County Fluoride Varnish Program:
July 1, 2009
 
Who is eligible to receive the fluoride varnish application?
The value added benefit will be available to Salud! members from newborn to a child’s third birthday (0 to 3 years of age).
 
Who is eligible to apply the fluoride varnish to members?
Chaves County PCPs, Pediatricians, and practitioners acting in the capacity of a PCP for children between the ages of zero and the child’s third birthday, who are contracted to see Salud! members.
 
Frequency of fluoride varnish application:
Non-dental providers will be allowed to bill up to six applications for the noted members’ age range.

Coding and Reimbursement Information:
  • Procedure Code: Please bill Presbyterian Salud for this service using procedure code D1206. 
  • Diagnosis Code: Please use diagnosis code V07.31 – Prophylactic Fluoride Administration, along with the appropriate Well Child diagnosis code.
  • Reimbursement: $15.00 per application.
Training:
Providers are strongly encouraged to view the training provided in the Web links below to learn how to apply fluoride varnish to eligible members. Continuing Medical Education hours are offered through some of the training resources.
 
Maine Oral Health Program – Information for Providers
http://www.maine.gov/dhhs/bohdcfh/odh/providers/fluoride-varnish.shtml
 
Dental Health Screening and Fluoride Varnish Application
http://www.meded.umn.edu/apps/pediatrics/FluorideVarnish/index.cfm
 
American Adamancy of Pediatrics – Oral Heath Initiative
http://www.aap.org/commpeds/dochs/oralhealth/index.cfm
http://www.aap.org/commpeds/dochs/oralhealth/cme/
 
Open Wide: Oral Health Training for Health Professionals http://www.mchoralhealth.org/OpenWide/index.htm
 
Oral Health Screening Online Training - Child & Teen Checkups (C&TC) program
 
Fluoride Varnish Training for Health-Care Professionals
 
Ordering fluoride varnish for your office:
NM HSD has offered the links below directing you to the companies that sell fluoride varnish:
 
 
Duraflor®:
 
(available in unit-dose package)
 
View the Fluoride Varnish Letter of Direction from NM HSD (.pdf)

Cultural Sensitivity Competencies Offered Online With Up To 9 Hours of Free CEUs
Presbyterian Health Plan, Inc. and Presbyterian Insurance Company, Inc. (Presbyterian) are pleased to offer our network practitioners, providers, and nurse practitioners educational opportunities to become even more culturally competent while earning up to nine hours of free Continuing Education Units (CEU).
“A Physician’s Practical Guide to Culturally Competent Care” is a continuing medical education activity. Supported by the Office of Minority Health at the United States Department of Health and Human Services, and accredited by Ciné-Med Inc., these online competencies are designed to assist healthcare professionals deliver culturally competent care to an ever increasing diverse population of members.
IMPORTANT REGISTRATION INFORMATION: When you log on to Pres Online, a Cultural Sensitivity Competencies link appears with other link options (Epocrates, HealthHelp, Pres Online), directing you to the registration page for “A Physician’s Practical Guide to Culturally Competent Care.” In order to participate, when registering on the website for the program, it is required to create your user name beginning with the letters “phs” and then the underscore symbol. The rest of your user name is unique, created by you (example, phs_upto9freeCEUs).
During registration, you will choose an appropriate program in which to earn up to nine free CME credits (Physicians and Physician Assistants) or nine contact hours (Nurse Practitioners).
The website provides a Frequently Asked Questions section, which addresses everything from computer requirements to receiving your CEUs. Since these competencies are made available on the Internet, you can earn free CEUs at your convenience, 24 hours a day, seven days a week.

New Product Information

Presbyterian Insurance Company Inc. introduced PresMetro, a new Individual Preferred Provider Organization benefit plan in September, 2007. Review enhancements to PresMetro, effective April 1, 2008.

UNM 2008 Custom Care

PresSolo

Pres Online Training for Physicians, Practice Managers and Staff

Pres Online Manual (.pdf)

View these animated Web demonstrations for instructions on using Pres Online for Providers:

Advanced Imaging Ordering Program

View a Web demonstration for submitting an online Advanced Imaging Order request   (Flash 7 MB)

Training Request Form

Please fill out the Training Request Form if you are interested in receiving specialized training from the Presbyterian Provider Services' Training Specialists. One of our Training Specialists will review your request and contact you within 5 to 7 days of its receipt.