Nivano Physicians is dedicated to serving its members and providers during this tough time. Below are general resources and health options for members regarding the novel coronavirus.
How is Nivano Physicians Handling COVID-19?
- Since March 13th, Nivano Physicians has been operating at nearly 100% remote for all departments with the exception for clerical and accounting functions. So far, we have had zero interruptions in our company operations and processes. All departments are being monitored daily to ensure we are still keeping up with all expectations and utilizing resources in the additional capacities needed.
- We are reaching out to all of our offices constantly during this time to ensure that we have the latest information on who is providing Telemedicine services, who is closed, and if there are any other updates. We have also worked on educating and informing groups of how to properly bill for telemedicine services and in some instances, helping with the implementation of the technology. Lastly, we are redirecting members to alternative providers in situations where their provider has decided to close their doors temporarily.
- Given the call volume increase that we have already experience and anticipate continuing, we have shifted resources and added six additional staff to rotate in our Customer Service call queues. Despite a 50% increase in call volume, this has allowed us to maintain an average wait time of less than a minute!
- Nivano has rolled out a COVID-19 Hotline. This hotline will be available to members to get more information on symptoms, list resources for each health plan and more. A text message and call went out to all members this morning that gave them the details about the hotline and gave the option for them to request call backs from our member team.
- We have pulled reports for all members who have outstanding prescriptions and other vital open referrals so that we may reach out and coordinate as needed. We also have sent out text messages and are doing calls to our medicare and other elderily populations to check up on them, update them and to make sure they are aware we are still available.
- We utilized our text messaging platform to contact every Anthem member and notify them about Livehealth. We sent emails and faxes to all contracted groups about this and we published information about it on our site and social media pages.
- In order to ensure there are no delays in payments we made a concerted effort to reach out to all providers who are not on EFT to get them onto it as quickly as possible. In order to preemptively identify potential issues with offices we have also developed a report that tracks trending referrals from all groups. This has allowed us to identify any groups who may have been impacted during this recent crisis.
Reimbursements For Telemedicine Visits:
In an effort to ensure our providers can continue giving care during these hectic times, Nivano Physicians will be reimbursing all contracted providers who are seeing patients through telemedicine visits. Reimbursement rates will be based on your current contracted rates.
Telemedicine visits are defined by HR6074, Section 102 as having audio and video capabilities.
For Medi-Cal patients, you can bill an evaluation and/or management (E/M) code (for example, 99213, 99214) along with a Telehealth Place of Service (POS) code 2 and potentially a modifier, such as code "95". These can be billed and submitted directly to Nivano. The referral process will work the same, and most specialty visits will still require an initial authorization.
For Medicare members, please submit telemedicine visits directly to Anthem Blue Cross.
You can use the following codes:
99441-99443 - Physician via telephone
98966-98968 - Non-Physician via telephone
Add Modifier -GT to the appropriate E&M outpatient visit if via real-time Audiovisual telecommunication.
POS = Office (or facility where provider is present)
ACH Payments, Electronic Claims and Authorizations
As we continue to monitor the rapidly evolving situation around the novel coronavirus (COVID-19), our first thought is for the safety and well-being of everyone in our healthcare delivery system and members impacted by these difficult circumstances. In these unprecedented times, it is important that our community comes together to support the most vulnerable populations.
You can count on us to continue to do our best to serve you and keep you informed. Operations at our main office are temporarily suspended for visitors and we are operating in a remote environment.
We encourage you to use as many of our electronic offerings as possible during this time.
Using these capabilities is simple and free!
- Deposit capitation and claims payments directly into your checking account by enrolling in EFT (electronic funds transfer).
- Quickly request, receive, and view authorizations via the QuickCap portal.
- Send your claims electronically through your clearinghouse instead of mailing them. Please note, for most clearinghouses our payer ID is MBA01.
If a health center's regular distributors are unable to fulfill orders for critical medical supplies such as personal protective equipment, the first step is to contact your local or state public health department for immediate assistance. If the state is unable to provide supplies, you may request federal assistance from the U.S. Department of Health and Human Services.
If assistance is approved, the HHS Assistant Secretary for Preparedness and Response will direct deployment of supplies from the SNS to state public health officials. The state is then responsible for distributing the supplies to areas in need. We understand the difficulty of this situation, but the state department of health is your best option for assistance with needed supplies.
For more information, please visit the following links:
- California Regulators Issue Bulletins on COVID-19
- COVID-19 Memo to MCPs
- Live Health Online Provider Information
- Molina COVID-19 Information
- Telehealth Information
- State of Californa Executive Stay at Home Order
- Sacramento Public Health Order
- COVID19 Information from Anthem
- COVID-19 HCP Quest Information
- APL-COVID-19 Waiver Of Cost Share