Navigator - Provider Newsletter from Colorado Access

To my colleagues,

We are all in pain right now. We have all been stunned by a flood of bad news and losses; COVID-19 illness and death, economic shutdown, health disparities, a renewed public wave of murders of Black Americans, and resulting violent protests.

On CNN, I recently saw Terrence Floyd, George Floyd’s brother, lead an impromptu vigil. Many of the events of the last several weeks have saddened me, but watching Terrence and his supporters brought tears of hope to my eyes. In the peaceful protest tradition of the great Martin Luther King Jr., Terrence taught us all how to honor the memory of George Floyd and the many other American souls that we lose every day as a result of prejudice and unequal treatment in its many forms.

Those closest to the ones who have been lost have the right to speak first. Many others have a right to be heard before I, as a white man, speak up. But as a human being and as a leader in this company I want to say; this kind of unequal, dehumanizing, and deadly treatment must stop or it will destroy the soul of this country.

Racial and economic injustice has been going on for too long. It will not stop until we all (including those of us who have been advantaged in this regard) stand together and demand a better world for all. I hope you will join me in a personal vow to redouble my efforts to listen better, understand more, and act in a way that creates a more just and kind community.

There are many resources out there, but here are two that I find to be helpful. The first has many good ideas and the second talks about being allies. As health care providers, now is not the time to be silent. Those we serve are often the most underserved communities in our cities.

In the words of Martin Luther King Jr., “Now is the time to make real the promise of democracy and transform our pending national elegy into a creative psalm of brotherhood. Now is the time to lift our national policy from the quicksand of racial injustice to the solid rock of human dignity.”

Sincerely,
Marshall Thomas, MD
President & CEO
Colorado Access

At Colorado Access, caring for you and your health is our top priority. This includes the health of our providers.

Telehealth Survey: The success of our provider network during the COVID-19 pandemic is a top concern and we understand that the utilization of telehealth services has been crucial to maintaining the care of your patients. In an effort to better support your telehealth efforts we invite you to complete a short survey about how you use telehealth in your practice here. The results will help us better understand the challenges you face and help us support your telehealth efforts.

COVID-19 and Telehealth: In June, The Medicaid and CHIP Payment and Access Commission (MACPAC) produced a report that tracks the Changes in Medicaid Telehealth Policies Due to COVID-19 in all 50 states and territories. All data included in the report are considered current as of May 1, 2020. You can access that information here.

COVID-19 and Health Care: The Center for Connected Health Policy (CCHP) is also tracking COVID-19 state actions through an interactive webpage, that include links to source documents regarding Medicaid, private payers, licensing and prescribing and is updated on a continual basis.

COVID-19 and Rural Health Clinics/Federally Qualified Health Centers: The Medicare Learning Network has issued guidance around New and Expanded Flexibilities for Rural Health Clinics (RHCs) and Federally Qualified Health Centers (FQHCs) During the COVID-19 Public Health Emergency (PHE). Please read this information here.

COVID-19 and Face Masks: Governor Polis continues to advocate for wearing face masks when we can, to help slow the spread of COVID-19 in our communities. However, in some cities and counties wearing a face mask is required. Not sure where? Check out this information here.

COVID-19 and Racial Inequity: The Colorado Department of Public Health and Environment has a Violence and Injury Prevention – Mental Health Promotion Branch that has released a statement and created an action plan to dismantle racism. If you wish to be involved, you can give feedback through this Google Form. You can also read more about the statement and plan of action here.

We’ve also put together a webpage of COVID-19 resources and information. Visit coaccess.com/covid19 for the most current information. If you have any questions, please contact your provider relations representative directly, or send an email to providerrelations@coaccess.com.

As of July 1, 2020, we are no longer the Single Entry Point for Adams, Arapahoe, Denver, Douglas and Elbert counties. The new Single Entry Point will be Rocky Mountain Human Services.

Current Single Entry Point
Colorado Access
11100 E Bethany Dr.
Aurora, CO 80014
800-511-5010
customer.service@coaccess.com
www.coaccess.com

NEW Single Entry Point
Rocky Mountain Human Services                       
9900 E Iliff Ave.
Denver, CO 80231
844-790-RMHS (7647)
SEPquestions@rmhumanservices.org
www.rmhumanservices.org

We are collaborating with Rocky Mountain Human Services to make this transition as smooth as possible for you.

Updated DRG weights and DRG base rates went into effect on July 1, 2020.
Inpatient Hospital Providers - DRG billing changes for newborn claims. This information was also provided in the June 2020 HCPF Provider Bulletin

Separation of Mother’s Delivery & Newborn Birth Claims
The Colorado Medical Services Board (MSB) adopted a change into rule on May 8, 2020. Inpatient claims with a To Date of Service (TDOS) of July 1, 2020, and later will no longer require hospitals to bill a mother’s delivery and services provided to newborns during the mother’s inpatient stay under a single combined claim. These services will need to be billed on separate claims starting with July 1, 2020 DOS. For more information on reasons for the change, please see the meeting materials on the Hospital Stakeholder Engagement Meeting web page.

All Patients Refined Diagnosis Related Groups (APR-DRG) Weight Table Changes Related to Separation of Mom/Baby Available for Review:
The Department of Health Care Policy and Financing (HCPF) presented the budget neutral change to the APR-DRG Weight Table and table of estimated changes in expected payments for all in-state hospitals. All are available for review under the Friday, March 6, 2020, Hospital Stakeholder Engagement Meeting’s section on the Hospital Stakeholder Engagement Meeting web page. A recording of the meeting and summary of the meeting are also available for review.

If you have any questions or need any additional information, please contact Diana Lambe at diana.lambe@state.co.us.

Community Events

Volunteers Needed!

The Need: The Adams County Response and Recovery Teams are engaged in critical efforts to ensure Adams County community members are supported during this time.

These teams have identified opportunities for additional support in meeting key community needs, including volunteers. Organizations need additional volunteers to help with key response and recovery efforts.

The Opportunity: The Response and Recovery Teams need your help with critical gaps in volunteers in order to meet the needs of Adams County community members during this time. You can help by serving as a volunteer, or sharing the opportunity with people you know who might be able to volunteer.

Call to Action: There is still a growing need for volunteer support.

About Rocky Mountain Cradle to Career Partnership (RMC2C)

The Rocky Mountain Cradle to Career Partnership (RMC2C) Backbone team is working to support network partners in their efforts to navigate through the COVID-19 pandemic. The Backbone continues to be in a position to bring people together to work collectively, specifically around emergency response and recovery related to COVID-19.

If you have an upcoming community event that you'd like us to share, please email us.

Behavioral Health Documentation Quality Standards and Review

As published in the April Navigator, our quality department regularly monitors provider documentation to ensure all participating providers who deliver behavioral health services meet quality documentation standards.

Did you know:
The top two measures that providers most commonly meet are:

Assessment: Date of Service is documented
General Documentation: Chart is legible

The top five measures that providers most commonly miss are:

Assessment: Mode of treatment is present
Assessment: Barriers to treatment are present
Assessment: Place of service is present
Treatment: Goals are measurable
Treatment Plan: Treatment plan is strength based

How can you improve your own chart documentation?

Review the “Quality Improvement Behavioral Health Documentation Training” found on our Provider Training page.
Conduct a peer or self-audit a few of your behavioral health charts to ensure your documentation meets standards.

If you have any questions, please contact your provider relations representative directly, or send an email to ProviderRelations@coaccess.com.

In our commitment to supporting our RAE network providers, we are continuously expanding the data reports made available through the Colorado Access provider portal. New this month, we have developed the KPI Performance Report for PCMPs. This report is designed to be more time-sensitive with current wellness and dental visit key performance indicator (KPI) rate data based on two-month-old claims. The KPI Performance Report also provides both provider site- and RAE-level KPI statuses, with how many more qualifying claims are needed to reach the current Tier 1 and/or Tier 2 goals. We are excited to share this new report with PCMP providers and have these data updated on a monthly basis. If you have any questions, please contact your provider relations representative.

Performance Based Payments

We recently sent out amendments to your Regional Accountable Entity (RAE) PCMP contract that extends your current key performance indicator (KPI) methodology. Please note that there was language in the amendment that referenced accreditation to be considered a patient centered medical home (PCMH). This is not a requirement in order to be a PCMP, but it does represent one of four components that will contribute toward earning the administrative payment in the our next PCMP Value Based Payment (VBP) amendment. A decision was made to delay the VBP amendment that was due to go into effect on July 1, 2020 due to the COVID-19 outbreak. We anticipate that the VBP amendment will instead be released later this year.

If you have any questions, please contact your provider relations representative directly. You can also send an email to providerrelations@coaccess.com.

Barbara Blair recently joined Colorado Access, and brings 30 years of health care industry experience with her. She loves the variety of hats she gets to wear as a provider relations representative, and her “being in the field” hat is her favorite to wear. Building trusted relationships with providers and staff is a highlight of the job for her, especially when she can help support their patients and our members.

Barbara was born and raised in New Jersey but is an avid fan of both the Broncos and Rockies. Outside of work, she loves spending time with her friends and her three children; Tarryn, Cameron, and Cody; as well as her dog, Roxy, and her turtle, Winston. Barbara loves going for walks, biking, planting flowering pots, and dancing. Food is also a big part of her life; Barbara is an avid cook and baker, and loves going out to eat.