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Provider Association Newsletter
June 2020
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Message from the Executive Director
Please Help Us Keep Colorado Covered and Enroll New Care Providers
As Coloradans struggle with record unemployment in the fallout of the coronavirus (COVID-19) pandemic, the Department of Health Care Policy & Financing (HCPF) is projecting a surge of more than 500,000 Coloradans between April 1 and Dec. 31, reflecting a 40%+ increase in Medicaid and CHP+ members. During this difficult time, the passionate staff at HCPF is working hard to keep Colorado covered!
Given this goal, it is critical that we help Coloradans easily navigate their way to the right health coverage solution. That means providing clear guidance on what Health First Colorado (Colorado's Medicaid program) and Child Health Plan Plus (CHP+) cover, how to apply, how to find a doctor and who to call with questions. To that end, we have developed a coverage guidance tool that answers these questions and ultimately helps Coloradans stay covered during this economic downturn. We appreciate your help sharing this tool broadly so we can reach the Coloradans who need this support. Please post this link on your organization's website, share it via social media and forward it to your customers, associates or constituents. In tandem, we are sharing this tool via our social media channels. You could further help us keep Colorado covered by "following us" and sharing our posts on Facebook and Twitter.
We would also appreciate your help recruiting care providers to serve our Health First Colorado members. Many physicians and other providers want to continue serving their patients who transition from commercial coverage to our coverage; at the same time, our new members often want to continue to see their preferred providers for care. To accomplish those shared goals, we need to "enroll" new providers into Health First Colorado. Providers can enroll at this
join us now
link. Feel free to share this link on your website, as well.
Currently, the Department is offering incentives to increase provider enrollment, including:
- Allowing temporary enrollment for providers during the federally designated COVID-19 emergency.
- Waiving the application fee and fingerprinting process for applicable providers.
- Waiving site surveys for applicable providers.
Last, we appreciate your collaboration in thoughtfully balancing the state budget, given the tremendous reduction in available funding. HCPF represents 26% of the state's general fund and 33% of total funds, so it is critical that our Department do our part, despite our projected 40%+ membership surge. Your attendance at our many webinars, your shared suggestions for budget cut alternatives and your engagement throughout this difficult process is very much appreciated by me, our leadership team and our staff. Thank you for all you are doing to be part of the solution!
Kim
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Resources for Coloradans Impacted by COVID-19
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Onwardco.org
can help connect Coloradans with services, funds and jobs during the COVID-19 pandemic. This resource is the result of collaboration with the Governor's Office,
S
tate agencies, community partners and Bitwise Industries. Please visit the website and share with anyone who is struggling, or may need the help:
onwardco.org
.
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ConnectToCareJobs.com Connects Health Care Facilities with Potential Workers
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Many health care providers have experienced significant disruptions due to the COVID-19 pandemic. To support both employers and health care workers, The Department of Health Care Policy & Financing,
ADvancing States
and
Centene Corporation
have created a website that helps connect residential care facilities and health care workers looking for a new position.
ConnectToCareJobs.com
provides facilities and job seekers with an easy way to connect. The online tool pairs licensed and/or trained health care workers or support staff with facilities that need their specific skills.
Registration
If you are a representative of a licensed residential care facility in Colorado, you must take additional steps prior to registering on the site. Licensed residential care facilities have received a message in their CDPHE provider portal with a link to complete a survey. Facility representatives must complete the survey before attempting to register on the Connect To Care Jobs site. After completing the survey, you will receive an email inviting you to register on the site. The email invitation will be sent to the email address submitted on the survey.
The only licensed facilities that are able to access the site now are: Skilled Nursing Facilities, Assisted Living Residences, Intermediate Care Facilities and Residential Care Facilities.
Job seekers may go directly to the site and register now.
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Sign-up for HCPF's COVID-19 Weekly Update
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The Department has created a weekly update for providers, stakeholders, community partners and staff about COVID-19. If you'd like to opt-in to receive this newsletter, please go to the Department's
newsletter sign-up webpage
, complete the form with your contact information, click "COVID-19 Weekly Update" and then the "Sign-Up" button.
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Non-Emergent Medical Transportation (NEMT) Update
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A contract has been awarded to the vendor, IntelliRide, to begin managing the Non-Emergent Medical Transportation (NEMT) benefit for all counties in Colorado.
Expanding management of the NEMT benefit to one statewide broker will help us improve customer service to both our members and our county partners. By moving to a single statewide vendor, the state is better able to ensure more consistent, streamlined operations and infrastructure, including improved access for members and reduced administrative burden for counties. We are not changing or terminating the NEMT benefit. This is only a change to NEMT administration.
IntelliRide already operates in nine counties, and is working to expand its network to the rest of the state as quickly as possible. Although the contract is effective July 1, 2020, IntelliRide may experience delays in credentialing providers in some counties because of logistical constraints due to COVID-19. Because of this, counties will continue to provide NEMT services to members until IntelliRide is fully operational in their county. The timeline for this transition will vary from county to county to ensure no interruption to members' NEMT benefit.
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Hospital Transformation Program Update
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HQIP Update
The Hospital Quality Incentive Payment (HQIP) Program Data Collection Tool (DCT)) opened to users May 1. In light of COVID-19, the data collection period has been extended an additional 30 days until June 30. We held a Data Collection Tool training webinar April 29 that was recorded and can be found along with additional information on the Department
HQIP website
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Community Advisory Council
A Community Advisory Council meeting was held April 24. Council members used the time to talk about the best ways to continue community engagement during the COVID-19 pandemic. Meeting notes can be found on the
Community Advisory Council website
next week. The council plans to meet again in late June and details will be forthcoming in this newsletter.
For additional information, we encourage stakeholders to visit
the HTP website,
as well as read past editions of the HTP Newsletter and HTP communications in
our online archives
.
Please contact
Courtney Ronner
, Hospital Relations and Communication Manager, with any questions.
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Clinicians are encouraged to prioritize in-person newborn care, well-child visits and immunization of infants and young children whenever possible. Well-child care should occur within the child's medical home where continuity of care may be established and maintained.
Work with parents and caretakers to help families catch up on any immunizations they missed in line with CDC recommendations. Health First Colorado and CHP+ have designed coloring sheets to get the message out to families. Please use the coloring sheets as a tool by printing them out and disseminating them at your practice. The coloring sheets are online at
https://www.healthfirstcolorado.com/2020/05/be-a-public-health-hero/.
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Prior Authorization Requests for Long-Term Home Health and Private Duty Nursing Providers
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Prior Authorization Requests (PARs) for Pediatric Long-Term Home Health and Private Duty Nursing services must be submitted for dates of service on or after July 1.
These PARs may be placed on administrative hold to accommodate system changes. PARs placed on administrative hold will be reviewed in sufficient time for members and providers to review the PAR determination prior to the start date of service.
Contact eQHealth Solutions customer service at 888-801-9355. Email
[email protected]
for any unresolved issues.
Additionally, this is a reminder that prior authorization requests for long-term home health and private duty nursing received administrative approval through June 30. A new PAR must be submitted through the
eQSuite PAR portal
if a member needs medically necessary services beyond June 30.
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Upcoming Improvements to Claims Review
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In accordance with Senate Bill 18-266, the Department is implementing a new claims payment solution, ClaimsXten, and improvements to the existing 3M EAPG system to improve payment accuracy. This will help align Health First Colorado (Colorado's Medicaid program) claims processing with commercial payers.
For outpatient hospital payments, the Department and its contractor, DXC Technologies is working to map 3M EAPG return codes to edits in the Colorado interChange.
For other professional and outpatient claim types, the Department and DXC are working with Change Healthcare to implement the ClaimsXten tool to automatically review claims for appropriate billing practices. The first phase of ClaimsXten implementation will exclude home and community-based services (HCBS) claims.
Both solutions are scheduled for implementation in late fall 2020. For more information and timely updates, visit our web page. Questions or concerns can be sent to [email protected].
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