Click to view this email in a browser

July 3, 2018
spacer.gif
CCHAP Practice Manager Newsletter
Colorado Children's Healthcare
Access Program
CCHAPLogoFinal-500x107px
large_box_top.gif

Dear Subscriber,

See below for all the latest news and important updates for practices...


CCHAP Changes Coming Soon

For over 10 years, CCHAP’s mission has been to promote and support medical homes to improve health outcomes for children and advance health equity. Our work with community practices has served as a “mirror” reflecting back to CCHAP the ways we need to adapt and continually improve to better support practices. CCHAP is invested in the success of primary care practices that serve children and we are committed in advancing healthcare systems to meet the needs of families. 

I am excited to share some of the positive changes CCHAP is making to offer greater content, resources, user-friendly tool kits, technical assistance and coaching to community practices based on the feedback we have received from practices with whom we work. The following represents just a sampling of some of the exciting changes and improvements to better serve the practices that serve Colorado’s children: 

  • CCHAP Newsletter. CCHAP will continue to share updates regarding Colorado Medicaid that includes billing and coding, policy changes, contracting and value-based payment initiatives. We will also share our work in the policy and advocacy space as part of our collaboration with our community partners to create better systems of care for our families. Future newsletters also feature stories from the field highlighting the innovation and success stories of practices throughout the state. Over time, you will also notice a new look and feel to the CCHAP Newsletter. What won’t change is our commitment to providing you with the latest and most relevant information. 
  • CCHAP Practice Manager’s Meetings. Historically, CCHAP’s approach to hosting Practice Manager’s meetings has been to identify relevant organizations and speakers that can share information about a certain topic or initiative. We also recognize that we need to upgrade the technology platform so that there is an improved opportunity to participate and share information. Additionally, we plan to develop more substantive content that the practice managers can use and implement. For example, we are currently developing a unit for practice managers and clinicians on behavioral health integration. We are also hoping to adapt the materials to address issues specific to the geographical location of the practice, size of the practice, payer mix, and population served. 
  • CCHAP Website. CCHAP’s website will be undergoing a refresh over the coming months to reflect our current work and the resources available to community practices. 
  • Specialized Trainings and Consultation Services. CCHAP has learned that while practices share much in common, there is also great variation in terms of what a practice may need at a particular point in time. CCHAP is available to offer community practices a menu of specialized trainings and consultation services. A community practice identified a need for a customer service training and CCHAP will be working with that practice to develop and deliver a training that meets the needs of that practice. CCHAP also has available resources to help practices develop business plans, strategic frameworks, grant writing as well as consultation to support the practice’s delivery of services.
Dr. Steve Poole and the rest of the CCHAP team have created a body of work and a strong foundation over the past 10 years for the sole purpose of supporting practices and the families they serve. As the Executive Director of CCHAP, my aspiration is to continue this tradition of serving practices and families because the work of practices is not only important – it’s critical! In its policy and advocacy work, CCHAP will continue to champion policies that support pediatric primary care and support what is in the best interests of children and their families. Through its various initiatives and projects, CCHAP will turn innovation into action! 

As many wise people have pointed out, “there is nothing permanent except change.” CCHAP looks forward to continuing to walk on this path of change with our community practices, community partners, funders and families to make sure the voices of children and what they need to grow up to be healthy and thrive are always heard and represented. Feel free to reach out to me with any thoughts or ideas sue.williamson@cchap.org


CCHAP Welcomes Jodi Carpinello

CCHAP is pleased to introduce our new program coordinator, Jodi Carpinello to the CCHAP team. Jodi will be working to support our CCHAP Practice Manager’s Newsletter, Practice Manager’s Meetings as well as our Provider Engagement activities. Jodi brings tremendous expertise to CCHAP with respect to events planning, fundraising, communications and database management in the private and nonprofit sectors. Jodi can be contacted at Jodi.Carpinello@cchap.org


CCHAP Wants to Hear from Your Practice on Behavioral Health Integration

CCHAP is proud to be partnering with the Rose Community Foundation on an exciting new project to assist primary care pediatric practices in enhancing the behavioral health services your practice offers.  However, we need to hear from you to understand what barriers and challenges you are facing so we can be sure we are offering the support you need.   

Please take a moment to complete this brief survey. It should take less than 3 minutes and will help us as we prioritize areas of focus for this important work.  



Colorado Medicaid Timely Filing Period Extended to 365 Days - Effective 6/1/18

In May 2017, the Department of Health Care Policy & Financing (the Department) temporarily extended the timely filing period from 120 to 240 calendar days. Effective 6/1/18, the timely filing period will be extended to 365 days. This is a permanent change, not a temporary extension. 

Please note that this timely filing extension does not apply to dental claims submitted through DentaQuest or pharmacy (point of sale) claims submitted through Magellan; however, Durable Medical Equipment (DME) claims are subject to the updated 365-day timely filing policy.

For all updated timely filing policy details, reference the General Provider Information manual and the Timely Filing Frequently Asked Questions (FAQs), located on the Provider FAQ Central web page.


ACC Phase II: July 1, 2018 Implementation

The next iteration of the Accountable Care Collaborative (ACC) will begin July 1, 2018. The goals of the next phase are to improve member health and reduce costs. 

The contact information, proposals and contracts for each of the new seven Regional Accountable Entities are available on CO.gov/HCPF/ACCPhase2.  

Key Milestone Updates 
Attribution & Enrollment Letters 
Health First Colorado members began receiving letters indicating a member's attribution and enrollment. The majority of letters will be mailed between June 26 and mid-July.  
  • Members should contact Health First Colorado Enrollment if they have any questions regarding their letter at 1-888-367-6557. State Relay: 711 for callers with hearing or speech disabilities. Call Monday to Friday, 8 a.m. to 5 p.m. 
  • Providers should contact their RAE for information about the attribution process or if they have questions about their list of assigned members. 
Payment for Physical Health Services 
Physical health services will continue to be reimbursed fee-for-service. Member assignment to a primary care medical provider (PCMP) does not affect fee-for-service payments to providers

While the ACC program promotes member utilization of the assigned PCMP and use of referrals for specialty care, the ACC does not lock members into a PCMP or require referrals for health services.   
  • A member's assignment to a PCMP does affect the administrative payments made by the RAE to the PCMP, so providers should encourage members to change their PCMP by contacting Health First Colorado Enrollment.
Providing Behavioral Health Services During Transition to Regional Accountable Entities 
Behavioral health providers who are working with the RAEs to finalize contracts may continue providing services to meet members' needs. The Department has a Transition of Care policy that requires their managed care entities to honor a member's ongoing course of treatment for 60 days following a change in a member's managed care entity. 

For more information, contact the RAE in your region.

Member Communications 
The Department has developed a Member Messaging Resource Center for their partners on  CO.gov/HCPF/ACCPhase2. This resource center has the latest information and messaging for Health First Colorado members related to the ACC. Some of the following resources are included below: 
Submitting Questions  
At this time, Health First Colorado is requesting that members, providers and other interested parties start by contacting their RAE if they have questions. In addition, interested parties can submit their questions to the Department using this form.  

The Department has shared that they will not be able to respond directly to all inquiries but will direct questions to the appropriate entity while we work closely with the RAEs and other contractors to address critical issues. The Department will continue to use the questions submitted to tailor upcoming communications and resources. 

Also see these links for more contracting information: 


ACC Phase II Webinars

Previously Recorded Webinars: 
Please access this web page for links to all previously recorded webinars including: 
  • Overview of Key Concepts 
  • Implementation Process Overview 
  • Provider Contracting - What Providers Need to Know 
  • Attribution 
  • Short Term Behavioral Health Services in the Primary Care Setting 
  • Performance Measurement
Additionally, interested parties can submit questions using the ACC Phase II Question Form on the ACC Phase 2 web page.


Pediatricians Planning Child Health Programs Supported

American Academy of Pediatrics: Community Access to Child Health Program 
The Community Access to Child Health (CATCH) Program, a national initiative of the American Academy of Pediatrics, is designed to improve access to healthcare by supporting pediatricians who are involved in community-based efforts to enhance the health of children. CATCH Planning and Implementation Grants of up to $10,000 are awarded to pediatricians and fellowship trainees to plan innovative community-based child health programs that will ensure all children have medical homes, are properly immunized, and have access to healthcare services not otherwise available in their community. (Grants of up to $2,000 are awarded to pediatric residents addressing the same issues.) The application period will close on July 31, 2018. Visit the American Academy of Pediatrics’ website to learn more about the CATCH Program.


Quality Improvement Facilitation and Opportunity to Earn MOC or CME

Assuring Better Child Health and Development (ABCD) invites medical providers to earn MOC or CME with free Quality Improvement facilitation delivered to your practice. Partner with ABCD on a unique project to improve developmental and/or maternal depression screening and referral in your practice. On average, practices who participate see screening rates increase from 9% to 91% over the course of the project. These projects make it easier for practices to simplify and improve referral processes, meet best practice standards for screening and referral processes, and administer standardized screening tools that meet American Academy of Pediatrics’ and American College of Obstetrics and Gynecology recommendations.  

ABCD is a statewide nonprofit focused on improving the lives of Colorado children through early identification of developmental needs. ABCD brings the lifelong benefits of early identification and intervention to Colorado children by strengthening the primary care, early childhood and community agencies who serve them. ABCD partners with frontline providers to make it easier for Colorado families to access maternal mental health and/or developmental screenings, referrals and support. 

Practices will work on screening and referral activities with ABCD’s guidance in addition to support from local public health, community centered boards, and school districts as appropriate. Practices will develop close relationships with community organizations, learn about new referral resources and strengthen referral processes. 

Participating communities may include Adams, Arapahoe, Boulder, Denver, Douglas, Jefferson, Larimer and Pueblo. Participation is dependent on the specific project and county where the practice is located. Practices that participate may earn both CME (up to 20 credits) and MOC Part IV credits (depending on project and board certification). 

By working together, we can improve early childhood outcomes and give all Colorado children an equal opportunity to thrive! Contact Claire Ulrickson, ABCD Manager of Quality Improvement to learn more! claire@coloradoabcd.org


Medicaid Beginning Billing Workshop Materials

Now Available - Beginning Billing Workshop Training Materials by Provider Specialty New training materials for specific provider specialties are now available on the Provider Training web page under the Billing and Training Workshops drop-down section. Of particular interest are training materials for Pediatric Personal Care Benefit, Practitioner, and Women's Health.

Preventive Care Billing 
Billing for Preventive Service exams (99385-99387 or 99395-99397) is limited to one annual visit each year for adults 21 years or older. To prevent claim denials for exceeding this annual limit, primary and specialty care providers should communicate and coordinate provision of annual exam services when billing with these specific preventive service codes. If similar annual exams are provided (although exams may differ in anatomical focus), other service codes, such as the E/M codes (99201–99205 or 99211–99215), are available for billing for these annual exams. 

When date of service time-frames potentially overlap an annual coverage time limit, providers should coordinate their provision of these services. Providers should notify Health First Colorado members when a preventive service annual exam is being provided. Clear communication with Health First Colorado members assists providers in identifying whether a prevention service code could be billed. 

Medical service coding on claims is determined by each practitioner or practitioner group. However, by communicating intent of care with other providers who may provide overlapping services to an individual Health First Colorado member, providers may be able to prevent claim denials for exceeding the annual limit. Contact the Provider Services Call Center at 1-844-235-2387 with questions.

Medicaid Passive Enrollment Process for Denver County 
The Department of Health Care Policy and Financing (HCPF) hosted a webinar presentation on the history of Colorado Medicaid’s passive enrollment process in Denver County, the rules, current issues, and workarounds. This presentation also touched on the eligibility policy updates and the attribution process for Accountable Care Collaborative members. Here are the links to access the recorded webinar, slides, and FAQs: 


Medicaid Fee Schedules 
Colorado Medicaid recently updated their rates & fee schedules. Here are the links to the most common fee schedules: 

Reminder: Medicaid Members May Not be Billed for Services 
It is important that all health care providers know that Health First Colorado (Colorado Medicaid) members cannot be billed for services covered by Health First Colorado. Questions regarding whether or not a service is covered by Health First Colorado may be referred to the Provider Services Call Center at 1-844-235-2387. For more information about this policy, visit the Policy Statement: Billing Health First Colorado Members for Services web page.

Medicaid FAQs - Charging for Missed Appointments 
Question: Can we charge Medicaid patients for missed appointments ("no shows") Answer: While missed appointments can result in administrative and cost burden to practices, charging a fee to Health First Colorado members who do not have other health plan coverage is not permitted. Fees may be charged, in some circumstances, to Health First Colorado members who have Medicare or a commercial health insurance plan as the primary payer. See this policy statement for complete details

Colorado interChange Common Questions 
Based on the provider questions most frequently submitted to Medicaid and DXC Technology (DXC), they have published this special bulletin as a helpful resource. In addition to answering the most frequently-asked provider questions, this bulletin also serves as a collection of previously published important information, with links to the original sources. Click here for this special bulletin

Fingerprint - Federal Criminal Background Check Beginning May 1, 2018, DXC Technology (DXC), on behalf of HCPF, will be mailing official requests for Fingerprint submissions to providers considered high risk. Read the details here...

Medicaid Provider Call Center 

Until further notice, the Provider Services call center (1-844-235-2387) hours will be: 
  • 7:00 a.m. - 5:00 p.m. MST Monday, Tuesday, & Thursday 
  • 10:00 a.m. - 5:00 p.m. MST Wednesday & Friday
The Provider Services call center will be utilizing the time between 8 a.m. and 10 a.m. on Wednesdays and Fridays to return calls to providers.

Important Medicaid Links 

Psychiatric Consultations
Child psychiatrists available to provide consultation to Medicaid providers. The service includes phone or email consultations for providers to optimize pharmacotherapy. Please contact Nila Mahyari, PharmD, DUR Clinical Specialist at Nila.Mahyari@state.co.us for additional information or to be connected with a child psychiatrist.

Mental Health Referrals 
Regional Accountable Entities (effective July 1, 2018) 

Preventive Screening Table with ICD-10 Codes 
(updated with new rates, policies & resources) 
Medicaid policies and coding requirements have changed for some of the recommended well visit screenings. We have created a simple easy to read two-page summary table for you to use as a reference guide that includes the new ICD-10 diagnosis codes.

Medicaid Provider Training 
See the Provider Training section of the Medicaid website.

Medicaid Provider Help
Provider resource contacts are available online: Medicaid Provider Help. 

Provider Relations staff are also available to help with provider concerns, policy questions, and complex issues that have not been resolved using established channels: 

Marceil Case, Provider Relations Manager 
Meghan DeLisle, Operations Specialist 

Medicaid Provider Bulletin 
JUNE 2018 Click here for the latest Medicaid provider news

2018 HCPCS Fee Schedule - Click here

Medicaid Fee Schedules 2017-2018 - Click here

Medicaid Immunization Rate Schedule 2017-2018 - Click here

VFC Program FAQs - Click here

Vaccine Resources for Providers 

ColoradoPAR Resources 
ColoradoPAR process resources are available online on the Medicaid Provider Services website and the ColoradoPAR Provider website.


CCHAPLogoFinal-500x107px 2

Sign Up to Receive Our CCHAP Newsletters!


Our Medical Director, Steve Poole, M.D. publishes a CCHAP Clinical Newsletter geared toward providers. Please make sure we have your provider emails so they can receive this clinically focused information. And... all past CCHAP manager and provider newsletters are available here.


large_box_bottom.gif
spacer.gif
50 South Steele Street
Suite 250
Denver, CO 80209
Email: jodi.carpinello@cchap.org



Click here to forward this email to a friend

Non-Profits Email Free with VerticalResponse!