Effective March 1, 2012, Absolute Total Care will discontinue the adult dental benefit which covers adult members ages 21 and older. The last day of coverage for the adult dental benefit will be Wednesday, February 29, 2012. This change will not affect any other Medicaid benefits. Members will continue to receive their other Medicaid benefits as usual. Please contact our Member Services department at 1-866-433-6041 with any questions about this change.

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Absolute Total Care has announced the addition of Paul Accardi as its new chief operating officer. In his newly acquired role, Accardi will serve as the lead of operations and strategic growth for the company and is responsible for several key areas, including medical management, quality, member and provider services, marketing and network development.

“Paul brings a strong operational background to Absolute Total Care and will be working with the leadership team to provide excellent service to members, providers and the State of South Carolina,” said Mark Eggert, interim chief executive officer, Absolute Total Care, and executive vice president of health plans, Centene Corporation.  “He is a seasoned healthcare executive whose experience and knowledge will help Absolute Total Care improve the quality of care and the health outcomes of our members, which is a top priority for our health plan.”

Accardi, a veteran healthcare professional, worked for both Liberty Health Advantage and MDNY Healthcare in New York. His experience includes multiple executive management positions in the healthcare sector, as well as the finance and accounting industry. 

Accardi earned a bachelor’s degree in business administration with a concentration in accounting from Hofstra University, a master of business administration degree in corporate finance and investment theory from Adelphi University and master of healthcare policy and management degree from Columbia University.  He holds several executive certifications, including negotiation from Harvard University School of Law and Six Sigma Quality Management from Villanova University.

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Absolute Total Care has announced the promotion of Bobbi Crimm to vice president of medical management and quality. Crimm oversees several key areas, including quality improvement, pharmacy, utilization management, case management and marketing and communications. Prior to her promotion, she served as senior director of quality.

Crimm joined Centene Corporation, Absolute Total Care’s parent company, in 2005 at its Georgia subsidiary, Peach State Health Plan, where she served as senior director of quality from December 2005 to January 2009. While there, she secured New Health Plan NCQA accreditation for Peach State Health Plan. Under Crimm’s guidance, Absolute Total Care obtained its highest score in company history from the National Committee for Quality Assurance (NCQA) New Health Plan accreditation as well.

Crimm’s healthcare career spans over 25 years with an emphasis in advancing quality initiatives. Her background includes leadership positions at top healthcare organizations — Emory University Hospital, Matria Healthcare and BlueCross BlueShield of Georgia. A registered nurse with clinical experience, Crimm is a graduate of St. Joseph’s College of Maine with a bachelor’s degree in healthcare administration. She earned a master’s degree in business administration from St. Joseph’s College of Maine, as well as Certification in Professional Healthcare Quality (CPHQ) and Six Sigma certification. Crimm is a member of NCQA’s Health Plan Advisory Council.

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Absolute Total Care will soon initiate the implementation of the Electronic Data Interchange (EDI) Version 5010 in accordance with the federal Health Insurance Portability and Accountability Act (HIPAA) rules for all EDI transactions.  HIPAA rules mandate that the implementation of EDI Version 5010 will begin January 1, 2012.  From October 1, 2011, through December 31, 2011, Absolute Total Care will support a dual-strategy approach to the implementation of EDI HIPAA Version 5010.  Trading partners will be able to submit version 4010 transactions through December 31, 2011; however, trading partners that have passed the EDI HIPAA Version 5010 testing and certification requirements may send version 5010 transactions beginning October 1, 2011. 

Absolute Total Care is working with Edifecs to ensure a successful transition to the new formats.  Trading partners are required to complete HIPAA Version 5010 testing and certification using the Centene Edifecs Ramp Management Testing Facility.  To obtain access to the HIPAA Version 5010 Companion Guides, sample files, and FAQs trading partners must enroll on the Centene Edifecs Ramp Management site: www.centene.com/edifecs

Additional information regarding HIPAA Version 5010 will be communicated on the Centene Edifecs Ramp Management site and distributed to trading partners that have enrolled for testing on the Centene Edifecs Ramp Management site.  

Questions? Contact the EDI Helpdesk at ediba@centene.com or 1-800-225-2573 X25525.

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Effective October 1, 2011, Absolute Total Care (ATC) will no longer be servicing members in Spartanburg, Cherokee and Union counties. Members will not lose their Medicaid benefits. Members’ benefits will not be interrupted.

ATC members affected by this change will receive letters via mail notifying them to choose another health plan available in their county. These members should call South Carolina Healthy Connections Choices (SCHCC) at 1.877.552.4642. ATC members are encouraged to have the names of their doctors and Medicaid ID number when they call. The choice period is from August 19 to September 20, 2011. Members who do not choose a new health plan will be assigned to another health plan effective October 1, 2011.

Additionally, Absolute Total Care members in Greenville, Laurens and Pickens counties will receive letters via mail notifying them of their option to select another health plan. Members can call SCHCC at 1.877.552.4642 to make this change. The choice period is from August 19 to December 20, 2011. If no selection is made, the member will remain an Absolute Total Care member. Absolute Total Care is committed to serving its members and appreciates the opportunity to serve them. We understand that both members and providers may have questions about this change. Please call Absolute Total Care at 1.866.433.6041 (TTY/TTD 1.866.912.3609) or SCHCC at 1.877.552.4642 for assistance.

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Columbia, S.C., February 10, 2011 – Absolute Total Care today announced the addition of Peter P. Bachini as vice president of network development and contracting. Bachini will be responsible for hospital and provider relationship management, network strategy and contract negotiations. He will report to Aaron Brace, president and chief executive officer.

“We are very proud to have Peter join our team, especially as we position Absolute Total Care for long-term growth. He has extensive experience in healthcare network development, including credentialing, contracting and provider relations. These particular areas are essential to having a strong provider network that allows our members access to quality care,” said Brace.

Bachini has more than 24 years of experience in the healthcare and health insurance industries. Most recently, he served as senior vice president of health plan services for Parkview Health System in Fort Wayne, Ind. before joining Absolute Total Care. Other previous experiences in healthcare include senior executive positions with four of the largest national payors – AETNA, Blue Cross and Blue Shield, United Healthcare and CIGNA.

Bachini earned a bachelor’s degree in physiology from State University of New York at Buffalo (SUNY). He is a member of several professional healthcare associations, including the National Association of Health Underwriters, the American College of Healthcare Executives, the Academy for Healthcare Management and the Healthcare Financial Management Association.

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Columbia, S.C., February 10, 2011 – Absolute Total Care today announced the addition of Stephen Moore as director of finance. Moore will provide leadership and oversight for all aspects of finance. He will report to Aaron Brace, president and chief executive officer.

 “Stephen brings exceptional knowledge and expertise to our company. His experience working for our parent company, Centene Corporation, as well his experience in the Medicaid market, will be instrumental in helping us grow stronger as a subsidiary,” said Brace.

Prior to joining Absolute Total Care, Moore served as health plan controller at Centene, with financial management responsibilities for Centene’s Wisconsin subsidiary and reinsurance program.  He joined the company in 2004 and since that time has achieved increasing roles of responsibility throughout his career. 

Moore is a graduate of Auburn University. He earned a bachelor of science degree in finance.

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Wednesday, February 16, 2011 – 2:00PM EASTERN STANDARD TIME  

https://www2.gotomeeting.com/register/541179770 

During the webinar, the following topics will be covered:  

• Viewing News & Alerts
• Working with New Payments
• Using the New Posting & Denial Reports
• How to Use Account & Payer Management
• Search for Remits using Document Archive Search
• User Administration
• Mailbox Management
• Questions & Answers

Wednesday, February 9, 2011 – 10:00AM EASTERN STANDARD TIME 
https://www2.gotomeeting.com/register/766959187

During the webinar, the following topics will be covered:  

• Define the PaySpan Health Mailbox
• Discuss Access Points
• Demonstrate Setup of Mailbox
• Routing Files to Data Exchange Partner
• Questions & Answers

To speak with one of our Provider Services Specialists, please call 1-877-331-7154. The Provider Services Team is available Monday through Friday, from 7am to 9pm Eastern Time.

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PaySpan Health Training Webinar Schedule – SIGN UP TODAY!!!

Sign up for a FREE PaySpan Health Training Webinar today!

During the webinar, the following topics will be covered:

·        Viewing News & Alerts

·        Working with New Payments

·        Using the New Posting & Denial Reports

·        How to Use Account & Payer Management

·        Search for Remits using Document Archive      Search

·        User Administration

·        Mailbox Management

·        Questions & Answers

Please click one of the links below to register for the meeting of your choice.

Space is limited!

***PLEASE NOTE ALL WEBINAR TIMES ARE EASTERN TIME***

Wednesday, January 12, 2011 – 10:00AM EASTERN STANDARD TIME 

https://www2.gotomeeting.com/register/998738035

Wednesday, January 26, 2011 – 2:00PM EASTERN STANDARD TIME

https://www2.gotomeeting.com/register/621430187

Click here or copy and paste this link into your browser window to view a list of all PaySpan Health Payers:

http://www.payformance.com/for-providers/participating-health-plans/

To speak with one of our Provider Services Specialists, please call 1-877-331-7154. The Provider Services Team is available Monday through Friday, from 7am to 9pm Eastern Time.

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Effective January 1, 2011, CentAccount funds cannot be used to buy over-the-counter medicines without a prescription. This change is being made as a part of the federal government’s Affordable Care Act. If you have any questions, please call Member Services at 1-866-433-6041 (TTY 1-866-912-3609).

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