Medical Status Visit (MSV)

The objective of the Medical Status Visit (MSV) 2010 project is to promote an annual preventive visit of all our members to their physicians.  That way, at the end of the year we will be able to have a complete summary of our member’s active acute and chronic medical conditions. It is important to emphasize that every January 1^st, CMS assumes that the patient is in “good health” regarding medical conditions and diagnostic information. This means that all providers will need to document existing acute and chronic medical conditions, every year and in the most specific way possible.  This practice is instrumental to preserve the integrity of the diagnostic accuracy of our members’ medical information.  

Reaching this goal conveys a systematic change respecting documentation and codifying practices within healthcare industry.  Today, more than ever, complete and accurate documentation of medical conditions, as well as precise diagnostic codification are key elements to provide quality medical services.  Therefore, we highly encourage your participation completing the MSV Form.

MSV completion benefits include the following:      

• Promotes medical costs coverage, reports precise mortality rates to better generate quality trends.

• Helps to evaluate and identify future medical problems, promoting the implementation of health and educational programs that encourage healthy lifestyles for our members. .

• Offers providers with an opportunity to precisely report the Risk Adjustment Factor (RAF) of their patients each year, justifying the utilization costs per member.

•  Entrusts Medicare Advantage Programs to receive fair and adequate revenues to cover patients medical needs and their utilization costs,  if complete medical data are being submitted precisely and updated. 

It’s important to document in detail the patient’s medical condition, treatment and follow-up plan to promote the highest quality standards.  Failure to document medical condition, treatment and follow-up plan will require submitting progress notes copies sustaining active medical conditions reflected in 2010 medical encounters.

Forms can be handed personally in our Headquarters, located at Chardón Tower, 350 Chardón Ave., Hato Rey or at the regional office closest to you.  Feel free to call your Provider Relations Representative to coordinate a pickup.  Email is also accessible to the following address: codingunit@mmmhc.com .  Forms could also be sent via fax to the following number; 787.625.2133; sending one (1) patient information at a time.  Regular mail is also available for sending material labeled as confidential, to the following address:

Claims Department

PO BOX 71305
SAN JUAN PR 00936-8405

If you are an InnovaMD user you will need to electronically attach a copy of the MSV Form or progress notes containing the detailed description and explanation of the medical condition.

Please note that MMM Healthcare, Inc. (MMM) and PMC Medicare Choice, Inc. (PMC) reserve the right to make any payment adjustments after the evaluation MSV document in case it is not in compliance with Medicare guidelines and the International Classification of Disease ICD 9-CM, and quality standards required by the insurance company.  

Thank you for your cooperation with this important project.