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July 9th, 2014
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CCHAP Practice Manager Newsletter
Colorado Children's Healthcare
Access Program
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Dear Subscriber,

The Colorado Children's Healthcare Access Program (CCHAP) is actively considering a partnership role as part of Colorado's application for a State Innovation Model (SIM) grant. The State Innovation Models initiative is a project of the federal government designed to provide financial support to states for the development and testing of multi-payer health care delivery system, public health, and payment transformation plans. The goal is improving health system performance and population health. In order to successfully implement the SIM, the state needs engagement and participation from health care providers, health plans, public health agencies, community programs and residents.

The objective of SIM is to ensure that by 2018, eighty (80) percent of Coloradans will have access to comprehensive care that integrates physical and behavioral health. To reach that goal, the state must adopt specific strategies to meet the needs of children and support the health care providers that serve kids and their families. Colorado’s SIM proposal recognizes this and provides specific components to address the needs of children and families.

Your support in helping to structure and implement these initiatives to ensure that the needs of Colorado’s children are met is very important. Letters of support from pediatric and family practices are invited and encouraged.

If you have a few minutes, please contact kevin.heckman@childrenscolorado.org for an example letter of support that will make this quick and easy for you. Thank you!


For more detailed information on the SIM grant:SIM
Q&A for Children’s Advocates
Colorado SIM: The Road Ahead




Billing and Reimbursement for After Hours Visits

Beginning July 1, 2014, Colorado Medicaid will allow after-hours office visits as a covered benefit. Procedure code 99050 will be reimbursed at a rate of $7.00 per visit. This code may only be billed for a patient weekday visit that starts before 7:30 a.m. or after 5:30 p.m., as well as any time during the weekend. The reimbursement is only available to providers billing fee schedule services.

In order for a claim to process correctly, procedure code 99050 also requires an accompanying procedure code for covered Evaluation and Management (E&M) services (procedure codes 99201-99217, 99341-99350, and 99381-99397) and a place of service rendered outside of a hospital setting. Only one unit of the after-hours service can be reimbursed per member visit.

To bill the after-hours procedure code for weekday visits only, providers must include a notation in the remarks field of the claim stating that the visit started before 7:30 a.m. or after 5:30 p.m.
Providers able to bill for these services include Physicians, Osteopaths, Family/Pediatric Nurse Practitioners, Nurse Midwifes, and Physician Assistants.

Please contact Richard Delaney at Richard.Delaney@state.co.us or 303-866-3436 with questions.


CCHAP Practice Manager Meeting - Friday July 18th

Meeting Agenda:
     Comprehensive Behavioral Health Screening for Children and Adolescents
  • Periodicity Schedule
  • Rationale for Screening
  • Recommended Screening Tools
  • Coding, Billing & Reimbursement
  • Referrals
     Presentation by Patrece Hairston, PsyD
     Director of Behavioral Health Programs
     Colorado Children's Healthcare Access Program

RSVP to joanie.muzzulin@childrenscolorado.org. Invitations and instructions for attending the meeting will also be sent via email.


Teen Depression Screening

by Patrece Hairston, PsyD

Click here to download the entire article in a .pdf file
teen_screening
Rationale
The lifetime prevalence of Major Depressive Disorder among adolescents may be as high as 20%. If not addressed and left untreated, adolescents that experience major mood disturbances are at significant risk for the following by young adulthood: early pregnancy (for girls); decreased school performance; impaired work, social, and family functioning;suicide attempts;  increased risk of death by suicide; and recurrence of major depression in adulthood (U.S. Preventative Services Task Force, 2009). Additionally, adolescents with behavioral health disorders (attention-deficit hyperactivity disorder (ADHD), oppositional defiant disorder, and conduct problems, as well as depression and anxiety) are more likely to abuse substances (National Institute of Drug Abuse, 2009).

Many parents and caregivers turn to their trusted primary care providers to ask questions about their adolescent’s behavior and “moodiness.” This puts medical providers in an excellent position to facilitate screening, deliver education and guidance, and provide referrals (if necessary) for behavioral health care and substance abuse.

Recommended Screening Tools
PHQ 9 Modified for Adolescents (PHQ-A) is a 13-item adolescent self-report designed to detect symptoms of depression, including suicide risk. It takes about 5 minutes to complete and score. Scoring is relatively straightforward and can be done by any trained member of the medical staff.  The PHQ 9 is the most widely used depression screening tool in primary care nation-wide and is well-standardized and validated.
•    English version:
•    Spanish version and supporting documents:

To read more in-depth information about each screening tool, including scoring information:
•    PHQ-9 Modified for Adolescents

Click here to read more...


Medicaid Fee For Service Provider Rate Increases

Medicaid provider rate increases were approved during the 2013-2014 legislative session and are effective for dates of service beginning July 1, 2014. The fee schedule located at the bottom of the Provider Services web page of the Medicaid website will be updated to reflect the increases. There is a 2% increase for most of the fee-for-service benefits including, but not limited to:

 

          • Physician and clinic services

          • Early and Periodic Screening, Diagnosis, and Treatment (EPSDT) services

          • Laboratory & x-ray services

          • Durable Medical Equipment (DME), supplies, and prosthetics

                    Click here to read more...


Notification of Changes to BHOs

Through a competitive Request for Proposal (RFP) process, Colorado Access won the behavioral health contract for northeastern Colorado, which takes effect July 1, 2014. Colorado Access will be doing business as Access Behavioral Care (ABC). Effective July 1, 2014, Northeast Behavioral Health Partnership (NBHP) will no longer manage behavioral health services for northeastern Colorado. The northeast region includes Larimer, Weld, Morgan, Logan, Sedgwick, Phillips, Washington, Yuma, Elbert, Lincoln, Kit Carson, and Cheyenne counties.

 

For more information contact:

Access Behavioral Care at 844-880-8508, or visit coaccess.com

Northeast Behavioral Health Partnership at 888-296-5827, or visit nbhpartnership.com

Frequently Asked Questions (FAQs) can be found here.

Click here for a list of all BHO Contacts


School Based Health Centers (SBHC) Billing Change Alert

Effective July 1, 2014, all non-FQHC providers are required to submit claims for services provided in School Based Health Centers with a place of service code of “03”. School Based Health Centers that are sponsored by FQHCs may use place of service code “03”, but the code is not required as all FQHCs are assigned a unique Medicaid provider ID for each service location.

Please contact Meredith.Henry@state.co.us or 303-866-4538 with questions.


Accountable Care Collaborative

Behavioral Health Integration Clinical Discussions

Colorado Access (RCCO for Regions 3 and 5) is hosting their Best Practices and Clinical Transformation Meeting on July 30, 2014 at COPIC. Clinical discussion sessions will include "Myth Busting", "Integration Innovation", and face-to-face roundtable discussions with behavioral health professionals in your area. Pediatricians are especially encouraged to attend and participate!

See this flyer for more information:
RCCO Region 3/5 Best Practices & Clinical Transformation Meeting Flyer



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MEDICAID PROVIDER BULLETIN
JULY 2014



AFFORDABLE CARE ACT NEWS AND RESOURCES


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CROSS-CULTURAL CONSIDERATIONS IN PRESCRIBING MEDICATION
It is important for both physical and mental health providers to examine culturally based concepts and expectations of medication. Some people from some cultures place a lot of faith in western medications. They may feel that if drugs aren’t prescribed, they aren’t getting adequate care. People from other cultures may be afraid that western medicines are addictive... read more



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Tel: (720) 777-6309
Fax: (720) 777-7338
Email: kevin.heckman@childrenscolorado.org



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