Share
Preview
JUNE  2021

Dear Health Community Colleague,

Welcome to the first issue of the Navigator for June. In this issue, you’ll find important information about a telehealth survey for you to take, information about the new telemedicine bill Governor Polis signed into law, and important information about the Child Health Plan Plus (CHP+) State Managed Care Network.

Be on the lookout later this month for the second issue of the June Navigator, where we’ll continue our deeper dive into social determinants of health, offer more COVID-19 resources, and highlight another provider partnership in the community.

If you want to learn more about anything in this issue of the Navigator or just have a question, please contact us. You can also connect with us on any of our social media channels using the links below.

In good health,
Colorado Access

NEED TO KNOW
 
 
 
Take This Telehealth Survey
Because there is no statewide dataset nor single source of information about all the telehealth happenings in Colorado, the Office of eHealth Innovation and Prime Health have launched the Regional Telehealth Learning Collaboratives (RTLCs) to collect input from a diverse group of community leaders in health care that will inform a set of strategies and recommendations for statewide telehealth infrastructure. Click here to access the survey.
Telemedicine Bill Signed into Law
Governor Polis signed HB21-1256 into law, which directs the Department of Health Care Policy and Financing (HCPF) to create rules that regulate providers who offer health care services in Colorado predominantly through telemedicine. Click here for more information.

State Managed Care Network Ends June 30, 2021
On July 1, 2021, all members who are eligible for Child Health Plan Plus (CHP+) will be automatically enrolled into a CHP+ Managed Care Organization (MCO). As a result, if you do not have an active contract with a CHP+ MCO, you will not be eligible for reimbursement for services delivered to CHP+ members after June 30, 2021.

The CHP+ State Managed Care Network (SMCN) will no longer be available to pay for health care services delivered to CHP+ members after June 30, 2021. Contract with CHP+ MCO(s) now to ensure continuity of care for members and timely reimbursement.

We will continue to participate in the CHP+ program as an MCO. If you are an SMCN provider, we encourage you to contract with CHP+ offered by Colorado Access for continued participation in the CHP+ program.  If you are not currently contracted with an MCO, you should contact other participating CHP+ MCOs to contract to be eligible for reimbursement for providing health care services to CHP+ members beginning July 1, 2021.

Please see the attached letter for more information. If you have any questions, please contact our provider relations team at providerrelations@coaccess.com.

Protect Me, You, Us - Provider Brief
COVID-19 vaccine hesitancy is highest among the very populations most disproportionally affected by the pandemic. This includes communities of color as well as groups who are economically and socially disadvantaged. Perceptions and concerns regarding patients’ responses to getting the vaccine may discourage engagement in conversations that are essential to increasing vaccination rates. Outside of patients’ values, fears, and social norms, they have valid concerns and real barriers to getting the vaccine. Read more here.

Chat on the Colorado Access Website
Coming soon! We are implementing a new chat feature on our website. You will be able to ask questions and get answers on a variety of topics. These topics include: where to call or email to find out who your provider relations representative is, links to resources to check member eligibility, and where to find provider training, among other things. Look for more information soon!

Trainings
Discovering & Leveraging the Creativity Within
The issue of healthcare professional wellbeing has become an even more important issue during the COVID-19 pandemic. Learn more and register here.

Past the Pandemic: Mental Well-being for You and Your Patients
This ECHO series offers strategies to navigate, normalize and hold space for worries and experiences during this pandemic. Each session provides helpful, tangible tools in a psychoeducational, didactic format. By understanding stress along a continuum, you will learn how to manage stress and loss, increase capacity to prevent burnout, elevate connectedness and mindfulness, and promote quality patient care. There will be six weekly sessions, held virtually from 12:00 p.m. to 1:00 p.m., starting Tuesday, June 29th and continuing through Tuesday, August 3rd. Learn more and register here.

Trauma Informed Care
Register now for upcoming free webinars offered in July and August on Trauma Informed Care: The Basics of the Brain. These are offered by Denver Children’s Advocacy Center (DCAC). A donation is welcome but not required. Learn more and register here.
Community Events

Park Hill Area Free Food Resources

Please see the flyer here for more information about food resources in the Park Hill area.

Invitation to Apply for Funding Summer/Fall 2021: Youth Engagement Pop-Up Event Series

The Youth Violence Prevention Program is a newly funded initiative to implement a public health approach and intervention level efforts that are based on national models and best practices to prevent and address the youth violence crisis occurring in the City of Aurora. Both intervention and prevention level strategies will be implemented through a multi-disciplinary approach to include community-based efforts such as youth engagement pop-up events to increase neighborhood protective factors. The grant period is from June 20,2021 to October 31, 2021. Learn more here.

The City of Aurora has created a new economic development program to connect people in the community who are experiencing food insecurity with free meals at local restaurants. If you work with people or groups that could benefit from this program, please contact Frank for more information at 303-739-7272 or email fbutz@auroragov.org.


If you have an upcoming community event that you'd like us to share, please email us.
COVID-19 Resources

For COVID-19 utilization management information, click here.

For COVID-19 pharmacy information, click here.

For COVID-19 administrative information, click here.

For COVID-19 training information, click here.

For COVID-19 practice support information, click here.


HEALTH EQUITY
 
 
 
Diabetes Empowerment Virtual Education Program
Free virtual and in-person monthly classes will help patients develop the tools needed to better control diabetes. This program is being offered by Tri-County Health Department, in partnership with The Center for African American Health. Click here for more information and to register.

Connecting the Dots: Social Determinants of Health
Be sure to check out our article series in the second issue of the Navigator. This new series will illuminate social factors that lead to health inequalities and disparities, or help to decrease them. We hope this monthly series will support your existing efforts by providing resources and educational opportunities while exploring current trends and best practices.

 
PROGRAMS
 
 
 
Training Opportunity: Assessing Your Ability to Pass a Claims Audit
Have your claims ever been audited by a Medicaid Health Plan? Does the thought of a claims audit make your nervous or are you confident you’ll pass with no issues? Our compliance team is offering a training for behavioral health providers to help assess how you might do in a claims audit. This one-hour training, with a follow-up Q&A session, will help you develop a plan to assess your readiness for a claims audit. We’ll cover the following topics:

  • The Colorado Access Audit Program
  • Assessing your documentation and claims (building your audit plan and tool)
  • Common audit findings
  • Where to get help/resources

Please join our compliance team for this informative training on Tuesday, June 29th from 12:00 p.m. to 1:30 p.m. Click here to register. If you have any questions, please email our compliance team at compliance@coaccess.com.
Behavioral Health RAE: Audit Observations and Important
Claims Reminders

During recent audits, we have found many documentation errors when billing for outpatient therapy services. All documentation must be legibly signed, dated, and include the providers’ credentials/license as part of the signature. The credentialed signature is what validates the claim for payment and must be completed before you submit a claim for payment. 

Audited records that reveal signatures added after the payment date or with inadequate provider signatures will fail an audit and lead to recoupment of the overpayment. It is critical that those who bill for outpatient therapy are familiar with the technical documentation requirements listed in the Uniform Service Coding Standards Manual maintained by HCPF. You can find the latest version of this manual here.
Billing Pattern Problems
We recently reviewed 90791 and H0001 assessment claims and noticed billing patterns that may be outside of billing compliance standards. Please note the following billing standards for 90791 and H0001 codes:

  1. Only ONE 90791 or H0001 can be billed per assessment, even if it takes two sessions to complete an assessment
  2. Assessments should be reviewed and updated when there is a change in the patient's level of care or functioning, and should not be billed more frequently

It is important to ensure billing compliance. If you have any questions, please email our quality improvement team at qualityimprovement@coaccess.com.

Substance Use Disorder Documentation (SUD) Training
We regularly monitor provider documentation to ensure all participating providers who deliver substance use services meet quality documentation standards. Quality audit criteria is based on regulations, billing manuals, industry best practices, and other sources that support quality documentation. We developed a comprehensive training on the most up-to-date SUD documentation standards that includes:

  • General documentation
  • Assessment
  • Treatment planning
  • Psychotherapy progress notes
  • Case management

This training is titled “Quality Improvement Substance Use Disorder Documentation Training” and can be found in our Learning Management System. Please contact your provider relations representative or send an email to providerrelations@coaccess.com if you have not yet signed up for access to the Learning Management System. If you have questions about the training, please send an email to our quality improvement team at qualityimprovement@coaccess.com.

Time to Heal Toolkit
The "Time to Heal” COVID-19 song and toolkit is a guide to help self-reflect on mental health and learn how to cope after a traumatic experience, such as living through a pandemic. You can find resources such as a weekly mental health check-in plan, a guide for self-care planning, healing plans, an emotional healing map, support group outlines, real stories, song lyrics, and fact sheets related to mental health. Find more information here.
Behavioral Health Copays
Starting July 1, 2021, there will no longer be cost sharing for outpatient behavioral health services for Child Health Plan Plus (CHP+) offered by Colorado Access. Members at all income levels will pay $0 copay for these services. If you have any questions, please contact your provider relations representative or send an email to providerrelations@coaccess.com if you have questions.

Adolescent Reproductive Health For Primary Care Providers
This ECHO series offers clinically relevant topics for primary care providers who provide or are looking to build, expand, and improve care to preteens through young adults. Once completed, you will be able to evaluate and manage common conditions in adolescent reproductive health. Over the course of six sessions, the series will include an overview of adolescent reproductive health issues, best practices in adolescent contraception and common adolescent gynecology concerns. Six weekly ECHO sessions will be held virtually on Thursdays from 7:00 a.m. to 8:00 a.m. starting July 22nd and continuing through August 26th. Click here to register.
Provider Learning Opportunity
Register now for our Provider Learning Collaborative focused on emergency department (ED) utilization by members with uncontrolled chronic conditions. The event takes place on Thursday, July 22nd and from 12:30 p.m. to 2:00 p.m. It is designed to support primary care medical providers (PCMPs) that are participating with our Controlled Chronic Conditions: ED Reduction Program (C3EDR) in their intervention design. The event will include member perspectives as well as a Q&A session with an ED physician in order to give various perspectives about the utilization practices of Medicaid members with uncontrolled chronic conditions. We will also feature success stories with network providers that have launched effective interventions. Attendance will be counted toward participating providers’ two required learning opportunities. Click here to register.
Oncology Resources
If you do not already have an oncology resource, Western States Cancer Research NCORP can help you or your patient find oncology practices that specialize in the possible cancer type they have. In a time of duress, a seamless referral for a patient can be of help. Click here for more information.
 
 
 
 
 
11100 E. Bethany Dr.
Aurora, CO 80014

Email Marketing by ActiveCampaign