The Premier HealthCare Network LLC
ACO Beneficiary Notification Process
Notification Purpose
All Medicare Shared Savings Program ACO’s are required to notify Medicare beneficiaries that:
· Your provider(s) are participating in the Premier ACO
· Your provider(s) are eligible for additional Medicare payments or may be financially responsible to Medicare for failing to provide efficient, cost-effective care
· Medicare claims data for your patients may be shared with our ACO at the ACO’s request
· They can “Opt Out” of this data sharing by completing a form or calling 1-800-MEDICARE
Notification Process
Your practice will need to notify your patients about your participation in the Premier ACO and about their participation, as well. Please notify your patients, by mail, by sending the attached letter on your practice letterhead. Add your practice information in the spaces provided but do not alter the letter. Medicare requires that this letter be used in this exact format and can NOT be modified.
Patient Responses
Once notified your patients may:
· Decide NOT to share their personal health information with our ACO (they must either notify Medicare directly or complete a form to opt out of data sharing-see attached)
· Offer to share confidential alcohol/drug treatment information
· Change their data sharing preferences at any time
Assignment of Medicare Beneficiaries
The Premier ACO will provide you with:
· A complete list of your assigned beneficiaries provided to us by Medicare (see attached list).
· Medicare beneficiary forms to provide your patients
· Posters to hang in your office ( will be provided at our first meetings on July 30th and 31st )
· Regular updates will be provided to you as we receive quarterly files from Medicare which include:
o Patients who decline to share personal health information
o New Medicare patients assigned to your providers
o Transferred/deceased Medicare patients
Practice Role
• Notify your Medicare patients on your “provider list” that your provider(s) are participating in our ACO. This is referred to as the “First Visit Notification” and is required by Medicare.
• Post the Medicare required posters within your practice (Premier will provide them to you)
• Become informed about the Premier ACO so that you can be prepared to answer patient questions
Suggested “First Visit” Medicare
In Office Beneficiary Notification Process:
1. Greet your Medicare patients
2. Check your spreadsheet for the patient’s name
3. Provide the following Medicare forms to the patient:
· Accountable Care Organizations and You:
o Frequently Asked Questions (FAQ) for People with Medicare
· Declining to Share Personal Health Information
· Consent for the Release of Confidential Alcohol or Drug Treatment Information
4. Document the date of the notification visit on your spreadsheet
5. If a patient turns in any completed forms please fax or mail to The Premier ACO
Sharing Patient Responses with PREMIER
Your Practice is responsible for forwarding any of the following forms should a patient decide to complete them:
· Declining to Share Personal Health Information
· Consent for the Release of Confidential Alcohol or Drug Treatment Information
· Consent to Change Personal Health Information Preference
· Practice send signed forms to The Premier HealthCare Network, LLC ACO on a regular basis (i.e., daily, weekly or monthly) via:
– Mail to P.O. Box 54157 Atlanta GA 30308 or
– Fax with cover sheet with name of practice to 770-270-9323
Premier will report all changes to Medicare
Resources
• Patients:
1-800-MEDICARE
• Providers/Staff
– Medicare Beneficiary Notification and Communication Guide
– Email:
– Phone: 770-270-5229 ext 234
– Website: www.premierhealthcareACO.com