Navigator - Provider Newsletter from Colorado Access

Welcome to the latest edition of the Navigator! I am new to Colorado Access and very excited to join this team that cares so much about the communities we serve. In my first three weeks with Colorado Access, I am feeling extremely lucky to be surrounded by a team with such talent, commitment, and a sense of urgency to constantly improve provider engagement and quality outcomes.

As vice president of provider engagement, I will be partnering with our leaders to develop, lead and align the execution of both short-term tactical initiatives and long-term strategies which result in optimal provider relationships and mutual success. Specifically, I have responsibility for the departments of quality improvement, provider affairs, provider contracting, and provider services & support. I have an extensive health care background, including experience in health plans and health systems focusing on Medicaid, accountable care, value-based payment models, and population health. My work with providers over the past 15 years has involved a constant evolution of different types of payment models, quality improvement programs, and data/analytic platforms. While improvements in care delivery and health outcomes are a result of that evolution it is only through provider partnerships that we continue to discover best practices to build future programs.

Looking forward to our work together!

Sincerely,
Dana G Pepper, RN, MPA
Vice President of Provider Engagement
Colorado Access

In October in the United States, we celebrate Indigenous People's Day, a holiday only formally recognized in 2021. According to the White House website, it’s a day to honor “America’s first inhabitants and the Tribal Nations that continue to thrive today.” But it’s probably not completely out of line to say that our country’s indigenous population has had a history of being overlooked. It drives home the importance of recognizing this community and making sure it receives the right resources and care. It’s a need that was recognized by AccessCare (a subsidiary of Colorado Access) when they teamed up with Denver Indian Health and Family Services (DIHFS).

DIHFS, which has been around since 1978, is a health program that provides services to the American Indian/Alaska Native community in the Denver area. Many of the people seeking services through DIHFS live in a more urban setting, meaning they have left the more rural setting that their parents, grandparents, or ancestors traditionally lived in. At times, this can mean building a new community in their urban setting and DIHFS can help them do this. It provides them with a place to seek that community and accommodations they may be looking for to help them become established in their surroundings and seek services such as behavioral health. It also provides them with a walk-in clinic setting where they can see people who look like them and where they know important spiritual and cultural aspects will be upheld.

In August of 2017, AccessCare and its Virtual Care Collaboration and Integration (VCCI) Program joined forces with DIHFS. VCCI helps to support and manage behavioral health conditions through collaboration and consultation. One of the biggest ways VCCI can help is through telehealth services, something that DIHFS staff says is important to the community they help. As Stephanie Lefthand, an integrated care clinician with DIHFS, explains, the option for online behavioral health services is important to people, primarily ages 20 to 40. This age group became very used to doing things online during the COVID-19 pandemic, and now they may be more comfortable staying virtual. She explains that it makes things easier to be able to refer them to Colorado Access services because it is a vetted organization they know they can trust. Another important aspect is that VCCI gives DIHFS community members the chance to participate in virtual therapy in their homes or in the DIHFS offices if that makes them feel more comfortable.

In President Biden’s 2021 proclamation declaring Indigenous People’s Day a U.S. holiday, he acknowledged the unfortunate circumstances that the Native American population has endured in our country, “For generations, Federal policies systematically sought to assimilate and displace Native people and eradicate Native cultures,” President Biden wrote. “Today, we recognize Indigenous peoples’ resilience and strength as well as the immeasurable positive impact that they have made on every aspect of American society. We also recommit to supporting a new, brighter future of promise and equity for Tribal Nations — a future grounded in Tribal sovereignty and respect for the human rights of Indigenous people in the Americas and around the world. “

Lefthand explains that the community sometimes experiences behavioral health issues due to historical trauma. This community has faced a history of relocations, services that eventually lapse, substance use issues, and violence. Having consistent services is important, such as the services received through AccessCare.

“It is truly a pleasure to work with DIHFS, they are a highly collaborative partner that has grown and evolved with us through the VCCI Program these past five years, and their outstanding staff shares our commitment to increasing access to care and prioritizing the needs, care and safety, of our shared patients,” says George Roupas, director of telehealth for AccessCare.

But Lefthand wants to note that even though partnerships, services, and care are very important, the community itself deserves a lot of recognition for how they handle and overcome challenges. “Even though I’m very cognizant, and I think people should be cognizant of the experience of urban Indians, I think we can look at the social ails that urban Indians struggle with, but we also have to take into account the incredible resilience of urban Indigenous communities as well,” Lefthand reminds us. “DIHFS is the only urban Indian organization in the entire state of Colorado providing services alongside with only, I believe, maybe two other tribal health facilities. Indigenous people make it work wherever they are, they make it work.”

Colorado Access knows that its work would not be possible without the partnerships it maintains with more than 10,000 providers. And the organization is always looking for new partners and ways to build existing partnerships. If you have a story about a Colorado Access partnership to share with us, please email us at stories@coaccess.com.

In Colorado, when it comes to behavioral health services, there is not a one-size-fits-all model. There are populations and cultures with different challenges and dynamics. Servicios de la Raza (Servicios), a specialty clinic serving the Denver area for the past 50 years, was formed to make sure that the low-income, Spanish-speaking population received linguistically and culturally responsive social services. Colorado Access, recognizing the importance of their work, wanted to help make that happen. This past spring, the organization offered its support through an impactful partnership.

The COVID-19 pandemic hit the Latino community hard, as it did in many other communities. Not only did they face struggles with issues like depression, anxiety, and isolation, but the Latino population in Colorado also faced disproportionate health and economic impacts. That included a higher risk of being infected with COVID-19, being hospitalized due to COVID-19, and death due to COVID-19, according to the Centers for Disease Control and Prevention. All things that can also increase anxiety and depression within the community as well.

“Given the increase in symptomology due to the impacts of the pandemic: loss of employment, grief, health concerns, trauma, and more, our communities continue to need spaces where their mental health is being attended to,” explains Anaísa Lúa, a bilingual therapist with Servicios, “As we know, the residual effects of these experiences could have long-lasting impacts on our communities, and so, it is important that we are providing access to services that directly help individuals navigate, heal, and process difficult experiences now not a few years from now.”

Not only did Colorado Access want to help with health care related to COVID-19, but the organization also wanted to focus on treating the whole person.

First, addressing the health care needs, Colorado Access helped to fund an effort spearheaded by consultant Julissa Soto to host “vaccine parties” complete with music, games, and other entertainment. These events were held at community venues, such as churches, where large numbers of people could be reached at once.

But, in order to continue to address all needs, Colorado Access felt its next focus was the behavioral health needs of the community. And that’s where Servicios came into play. Colorado Access worked with Servicios to fund two therapists that are Spanish-speaking and reflect the cultural backgrounds of the people Servicios serves. The partnership has been going on for six months now.

As the work of Colorado Access and Servicios continues, and the nation continues to work towards pandemic recovery, there is hope for the future of this partnership. “More than ever, our people are communicating their need for mental health services and it is imperative that we not only destigmatize mental health in our communities, but actually provide pathways to engage in affordable care that meets the community’s cultural and linguistic needs,” say Lúa.

Colorado Access knows that its work would not be possible without the partnerships it maintains with more than 10,000 providers. And the organization is always looking for new partners and ways to build existing partnerships. If you have a story about a Colorado Access partnership to share with us, please email us at stories@coaccess.com.

Life in the health care world can be demanding. Juggling patients, billing, appointments, staff, and other office responsibilities can be challenging for any provider. The last thing a provider needs is to spend time on the phone asking countless questions. Burnout is a real concern for providers in Colorado and beyond, an issue that has only gotten worse over time. While providers want to spend their time on patients and health care, often there are so many other tasks and items to attend to. It doesn’t leave any time to recharge and it’s not good for anyone involved. According to the United States Department of Health and Human Services (HHS), worker burnout can be caused by things like excessive workloads and administrative burdens.

Colorado Access has a helpful tool that some providers may not be aware of, which could save a lot of time, effort, and headaches. It’s called…the Provider Portal! We spoke to a few members of the Colorado Access team that developed it to learn more about how to use it, why it’s so important, and what features are underutilized by providers.

“The Provider Portal is an online tool that allows providers to see their information related to Colorado Access,” explains Nicholas Ambrose with the Provider Portal support team at Colorado Access. “They can view items like claims, contact information, patient eligibility, and other information that help our providers,” he adds.

The portal is a user-friendly tool that is easily accessible from the Colorado Access website. When you go to the homepage, there are two blue buttons in the top right corner. One says “Find a Provider” and the other says “Provider Portal.”

Point blank - it saves time, something that is precious to any busy provider who is more focused on the care of their patients than on paperwork and other time-consuming tasks. “The Provider Portal offers a self-service alternative for providers to look up information instead of needing to call Colorado Access for information,” says Ambrose, “one of the instant benefits is allowing people to check eligibility and claims immediately through this tool. They do not need to call and wait for answers.”

It also keeps providers better informed about their patients and other pertinent information, without having to do extra legwork or research. As Valerie Joyner, a provider network manager with Colorado Access, explains, “providers are able to stay in the know with any updates that are related to their patients’ overall care, along with Colorado Department of Health Care Policy & Financing (HCPF) updates that could affect health care services to our Medicaid population.”

In addition to the features listed above, there are many other benefits new and experienced users should take advantage of by using the portal.

For example, analytics indicate that an appeals section in the portal is highly underutilized. In fact, what providers may not realize is that they can appeal claims directly in the provider portal. In addition, many don’t realize the ability to submit a form to confirm a member’s eligibility exists. The form sends a request to the Colorado Access eligibility team for further research, and they will then send a response.

If a provider isn’t using the portal but wants to sign up, registration is simple. All a provider needs are their tax ID number and a valid claim number from the past 180 days to complete the registration process. The National Provider Identifier (NPI) number must match what is on file with Colorado Access. The provider will also need to use Internet Explorer 11.0 or higher or the latest version of Google Chrome, Firefox, or Safari.

If providers encounter an issue, they can always contact technical support. They are also able to reach the Provider Portal support team at either ProviderPortal.Support@coaccess.com or contact Colorado Access at 720-744-5224 or Toll-Free at 888-844-3710. They can also reach out to provider network services at ProviderRelations@coaccess.com.