February 2024 Newsletter

February

Open Positions:

Nephrologist

We are hiring full-time Nephrologists for our growing practice in the suburbs of Chicago and Indiana. We have multiple open positions. CLICK HERE to view our open physician roles.

Medical Assistant

We are looking for professional, reliable, patient-focused, and detail-oriented Medical Assistants to join our team. This is an opportunity for someone looking to get their start as a Medical Assistant or administrative professional. CLICK HERE to see all open MA positions.

If any of these positions spark your interest, please contact a member of our team for application requirements! Email: HR@nephdocs.com

Nurse Practitioner/APN

We are seeking a Nurse Practitioner to join our clinical team who understands the needs of our patients and will put care above everything else. CLICK HERE to view our open NP positions.

Radiology Technologist

We are seeking an experienced Radiologic Technologist for multiple locations. CLICK HERE to view these open roles.

EMPLOYEE BENEFITS OPEN ENROLLMENT

Will be open from March 4th - March 15th

You will be able to add, cancel or adjust your benefits plan

HR sent out the new benefits guide with instructions, it's also posted on our intranet.

Value-Based Care

Quality healthcare from quality people

Q1 Focus Areas

• PAM surveys - the first round of PAMs are due 3/31/24

• Administering PHQ-9

• Focus on Optimal Starts

• Focus on Risk Adjustment

The VBC Team Welcomes Daniela Ramirez! Daniela previously held an administrative role at our Crystal Lake office. We are excited to have her on the team, her in-office experience will help us improve VBC processes and quality metric tracking.

New Metric: Delayed Progression

Target population: CKD 4 patients with at least one CKD 4 diagnosis code in the preceding 15 months to the performance year, and at least one CKD 4 diagnosis code during the performance year

Aim: Slow the progression from CKD 4 through ESRD

Target: This is an observed-to-expected metric. The expected is based on the average performance of similar entities’ observed case mix.

Key takeaway: Documentation of both the severity of illness and accurate disease staging is going to help increase the case mix, which will in turn increase the number of expected

Q4 2023 Performance Excellence Award Winners!

As we continue to build and nurture our organizational culture, reinforcing our values and recognizing employees who embody our core values hold significant importance. One of the most effective ways to do so is by recognizing and supporting individuals within our team who consistently demonstrate these values in their actions and interactions. Therefore, we will grant a Performance Excellence Award to employees who characterize each of our 6 core values.

Service Excellence

We work together to deliver the highest level of service to each and every one of our patients. It’s not simply meeting our patient’s needs, but also taking that extra step to exceed expectations.

Elesa Moore, Practice Manager - Berwyn & North & South Chicago

Integrity

We do what’s right; we make good decisions and treat others with respect. To become the most trusted nephrology partner, it’s imperative that we uphold the highest standards.

Kristen Poat, Manager of Auditing & Compliance

Compassion

We approach patients, partners, and each other with compassion to promote a welcoming and caring environment. Caring about people medically and personally is the driving force behind eve

April Roy, Administrative Assistant - NIN

Continuous Improvement

We are committed to advancing the boundaries of patient care through shared expertise, clinical research and by expanding access to healthcare. A steady stream of improvement

Cynthia Wiersema, Clinical Director - NANI Vascular, Fort Wayne

Teamwork

We embrace collaboration because we are stronger when we work together.

Lynda Robinson, Revenue Cycle Supervisor

Fun

We are passionate about caring for others and have fun doing it. We strive for a positive and fulfilling workplace that supports wellbeing, inspires engagement, and celebrates successes.

Charlene Moyeno, Receptionist & MA - Crystal Lake

Condition Management Documentation (CMD)

in Acumen

Acumen will flag patient charts for diagnosis codes that have not been submitted in the current calendar year but may be pertinent to document and bill. Improving specificity of diagnosis codes on patient charts will help to create a more accurate Condition Management Documentation (CMD) for the patient. This helps payers stratify patients and is a significant component of the risk contracts associated with Medicare Advantage.

Compliance Uncomplicated – February 2024

NANI’s internal hub for quick and current compliance-related information, topics, and support.

False Claims Act

The False Claims Act (FCA) 31 U.S.C. 31 U.S.C. § 3729-3733, plays a crucial role in combating fraud within the healthcare sector. In general, false claims in healthcare often involve billing discrepancies, kickbacks, and other deceptive practices that result in financial losses for government healthcare programs like Medicare and Medicaid. Healthcare providers (such as NANI), pharmaceutical companies, and other entities involved in the industry must adhere to strict regulations to avoid violating the FCA. Violations can lead to severe consequences, including substantial fines and legal actions as detailed below.

Questions/comments/concerns? Please contact NANI's Auditing & Compliance Manager Kristen Poat (331) 216-1132, Ext. 1700, or at kpoat@nephdocs.com.

All cases of suspected or known FCA violations are to be reported without delay to your direct supervisor/manager, the Compliance Hotline (833) 551-1176, or to our Chief Compliance Officer/a member of the NANI Compliance Committee.

PLAY VIDEO

Documentation Standards

“Time is money”, that’s what they say. You may try to find shortcuts to make documentation quicker, and less burdensome. That’s ok if your documentation is accurate and compliant. NANI providers have been given different resources for HCC coding and documentation, you may be tempted to use an ICD-10 code in your note instead of a narrative diagnosis, see the example below:

Comments: N18.6/Z99.2 – Continue IHD TTHS, Challenge UF

I12.9 – Controlled with current regimen. Continue anti hypertensives. N25.81 – Calcium stable. PTH stable. No vitamin d analogs, calcimimetics at this time E11.22 – A1C 5.9 (12/12/23). On DM meds. Primary/endo to manage Z94.0/Z94.4 – On Lamivudine, Mcyophenolate, Tacrolimus, Bactrim

I50.22 – Continue current regimen. Follow up with cardiology. Challenge UF at HD. Patient is stable. Patient discussed with nursing.

Please keep in mind that the diagnosis code is assigned based on the provider’s diagnostic statement, an ICD-10 code is not the same as a diagnosis. The ICD-10 Guidelines state:

Code assignment and Clinical Criteria

The assignment of a diagnosis code is based on the provider’s diagnostic statement that the condition exists. The provider’s statement that the patient has a particular condition is sufficient.

The example above should specifically state the patient has:

• ESRD, on dialysis

• Hypertension

• Secondary hyperparathyroidism of renal origin

• Type 2 diabetes with CKD

• Kidney and liver transplant *add immunodeficiency due to drugs

• Chronic systolic heart failure

Document the appropriate M.E.A.T. after each diagnosis to be submitted on the claim.

Katy E. Rotroff, COC, CPC, CRC Revenue Cycle Manager

Krotroff@nephdocs.com

Find all past Pulse Of Documentation files HERE!

Tara Harrington

Nicholas Smith

Erin Collins

Crystal Oar

Veronica Dillahunty

Anna Gough

Trena Haneline

Leticia Sanchez

Rebecca Paez

Happy

1 year

Liza Chavez

Adam Paredes

Medical Assistant, SWNA

Registered Nurse, Indianapolis Vascular Medical Assistant, SWNA

Medical Assistant, Northwest Indiana/NIN Medical Assistant, Northwest Indiana

Administrative Assistant, Northwest Indiana

Front Desk Coordinator, Fort Wayne Medical Assistant, NEN

Medical Assistant, Bergen Kidney Center

anniversary

5 years

Kimberley Downey

Brandon Plavka

Mohammedadil Chandiya

Jennifer Werling

Joann Gonzalez

James Lyles

15 years

Gabrielle Panfil

20+ years

Suzanne Glosson