EOCCO Clinics & Staff,
Welcome to the April issue of the EOCCO Monthly Newsletter. Below is a preview of the articles you will find in this month’s issue:
- BOOST Oregon COVID-19 Vaccine Community Workshop
- The EOCCO Health Equity Plan
- Assertive Community Treatment (ACT) Referral Website
- Unite Us Platform Demonstration - Community Feedback Needed
- Upcoming Events
- Identifying Fee-for-Service ("Open Card") Members and CCO/Plan Members
- Elective Procedure Practice Guidelines: Smoking Cessation
- Place of Service Code 19
- Reminders: OHA Enrollment, ICC Services, & Timely Access to Care
Please let us know if you have any questions, concerns or recommendations. We would love to hear from you!
Please contact: Kelly Watanabe at kelly.watanabe@eocco.com
Thank you,
Your EOCCO Team
BOOST Oregon COVID-19 Vaccine Community Workshop
EOCCO is excited to announce that we are once again partnering with BOOST Oregon to offer three patient-facing community workshops to increase confidence in the COVID-19 vaccine. These events are *free* to attend and are open to anyone in Eastern Oregon who wants to learn more about the COVID-19 vaccine.
Unlike the provider training on April 9th, these workshops are designed for members of the public. Sessions will be presented in English and Spanish and will give attendees an opportunity to learn more about the COVID-19 vaccines and talk to a medical educator.
Spanish Speakers
Wednesday April 28th, 2021, from 6pm – 7pm PDT
Register here for the Spanish Zoom Webinar Hosted by Medical Educator and family physician Rima Chamie, M.D. (registration page is presented in Spanish)
English Speakers Option 1
Thursday April 29th, from 6pm – 7pm PDT
Register here for the first Zoom webinar Hosted by Medical Educator and pediatrician Ryan Hassan, M.D.
English Speakers Option 2
Friday April 30th, 2021, from 12pm – 1pm PDT
Register here for the second Zoom webinar hosted by Medical Educator and family physician Rima Chamie, M.D.
For more information about the COVID-19 Vaccine, please visit our COVID-19 Vaccine Info page. Members and providers can learn more about:
- Frequently asked questions
- COVID-19 vaccine events by county
- COVID-19 vaccine pharmacy locations in your county
- Contact information for your county
The EOCCO Health Equity Plan
EOCCO is committed to creating an organization that values and prioritizes building an equitable health plan that serves the unique challenges of our 12 rural and frontier communities. In accordance with a framework provided by the Oregon Health Authority, EOCCO has identified opportunities to leverage technology and data to enhance identification and monitoring of key items such as linguistic needs and completion of cultural responsiveness trainings, and to illustrate the level of alignment and representation between EOCCO’s membership and workforce demographics.
These projects and initiatives will be instrumental in continuing to solidify an equitable and community-informed foundation to promote and achieve health equity.
Additional information about EOCCO’s health equity action plan can be found here.
Assertive Community Treatment (ACT) Referral Website
GOBHI will now host the Assertive Community Treatment (ACT) Referral website which provides access to ACT Referral Forms for Eastern Oregon in Baker, Gilliam, Grant, Harney, Malheur, Morrow, Sherman, Umatilla, Union, Wallowa, and Wheeler counties. Assertive Community Treatment (ACT) is a specialized model of treatment and service delivery designed to provide comprehensive community-based mental health services to persons with serious and persistent mental illness (SPMI) who are at least 18 years of age, have severe functional impairments, and who have not responded to traditional psychiatric outpatient treatment or less intensive non-standard levels of outpatient mental health treatment.
The primary goal of ACT is recovery through community treatment and habilitation through long-term clinical, rehabilitation, recovery, supportive and case management services provided directly by a multidisciplinary team in the individual's natural environment. ACT serves as the primary provider of services and is in some cases available 24 hours a day, 7 days a week. ACT is for a relatively small group of members who are diagnosed with serious mental illness, experience the most intractable symptoms, and, consequently, have the most serious problems living independently in the community.
If you want to refer a person with serious mental illness to the services described above, you must complete the online referral form by visiting https://gobhi.org/act-referral/ *Once the referral is submitted, the referral application will be sent to the ACT provider of the members county of origin. For more information about the ACT Referral process, please email actreferrals@gobhi.org , or go to the OHA website to learn more about ACT Program admission criteria.
Unite Us Platform Demonstration - Community Feedback Needed
EOCCO is exploring the option of implementing Unite Us, a Community Information Exchange (CIE) tool that facilitates closed-loop referrals for social needs. Unite Us works to instantly connect members to a network of community resources and increase transparency by allowing all members of the care team to view the status of the referral. However, the success of Unite Us is largely dependent on the number of partners who participate in the platform.
EOCCO is seeking feedback from community-based organizations, clinics, and other community partners regarding the Unite Us platform over a series of four community engagement presentations at the end of April. The 12 EOCCO counties have been divided into four regions and each have their own session. EOCCO will be polling participants for interest in the platform at the end of the session.
Umatilla & Morrow register here
Tuesday, April 27, from 12-1pm PDT
Baker, Union, Wallowa, & Malheur register here
Wednesday, April 28 from 12-1pm PDT
Grant, Harney, & Lake register here
Thursday, April 29, from 12-1pm PDT
Gilliam, Sherman, & Wheeler register here
Friday, April 30, from 12-1pm PDT
Please email EOCCOmetrics@modahealth.com with any questions.
Elective Procedure Practice Guidelines: Smoking Cessation
The Prioritized List practice guidelines indicate that smoking cessation is required before elective surgical procedures for all active tobacco users. The individual must abstain from smoking for at least 4 weeks prior to the procedure and will be tested to ensure evidence of cessation. As a reminder, EOCCO will deny prior authorization requests if the patient is an active smoker and no evidence of smoking cessation is provided. We understand that the denial can cause a delay in scheduling elective procedures and ask that the guidelines are followed to prevent unnecessary denials and administrative burden on your staff.
Prioritized List of Covered Services & Practice Guidelines can be found here.
Click here to access the EOCCO Smoking Cessation Flyer for members.
We have several additional tools and resources available to EOCCO members that can assist with smoking/tobacco cessation on our website as well as free health coaching that can assist with smoking/ tobacco cessation:
EOCCO Health Promotion and Wellness
1-877-277-7281
Email: careprograms@modahealth.com
Hours: Monday through Friday, 7:30 a.m. to 5:30 p.m. PST
TTY users, please call 711
Place of Service Code 19
Place of Service (POS) codes specify the location where the item was used, or the service was performed. POS 19 Outpatient Hospital – Off Campus is defined as a portion of an off-campus hospital provider based department which provides diagnostic, therapeutic (both surgical and non-surgical), and rehabilitation services to sick or injured persons who do not require hospitalization or institutionalization. CMS indicates POS 19 should have a facility-based payment rate.
Effective with processing dates of June 1, 2021 and after (regardless of the date of service), EOCCO will be reimbursing POS 19 at the facility rate. For more information regarding Place of Service codes, see Noridian’s website.
Reminders
DMAP/Oregon Health Authority - Health Systems Division Enrollment
To be reimbursed for the services provided to EOCCO members, please remember that all rendering and prescribing providers, groups and facilities must be registered and active with the Oregon Health Authority – Health Systems Division (OHA-HSD).
Need to verify if your provider or group NPI is active?
Please use OHA’s verification tool.
Please visit our Become a Provider page to register and learn more.
Intensive Care Coordination (ICC) Services
EOCCO's Intensive Care Coordination (ICC) services is a program to eliminate barriers to remove gaps in care for members identified with high complexity or comorbidities including for members in Prioritized Populations. ICC services is a collaborative process of assessment, planning, facilitation and advocacy for options and services to assist members with complex conditions and help them access needed resources. Providers, community support staff, members and their representatives can make referrals to ICC services via any verbal or written means.
Providers can refer EOCCO members for ICC services by using the referral form available on our website.
Timely Access to Care
Participating providers must provide timely access to medically appropriate and culturally responsive covered services. EOCCO members should be seen, treated or referred within the following time frames:
Physical Health:
- Emergency Care: Immediately or referred to an emergency department depending on member’s condition
- Urgent Care: Within 72 hours or as indicated in initial screening
- Well Care: Within four weeks, or as otherwise required by applicable care coordination rules, including OAR 410-141-3860 through 410-141-3870
Upcoming Events
Payment Reform Focus Groups
The Oregon Rural Practice Research Network (ORPRN) is leading a series of focus groups to better understand provider perceptions of value-based payments. Open to all behavioral health, physical health/medical or dental providers in Oregon.
Choose from one of seven 60-minute virtual focus groups offered in April or May of 2021. Participants will receive a gift card for their time.
Click here to register or contact Caitlin Dickinson at summerca@ohsu.edu or (503) 830-7983 for more information.
Virtual learning collaborative: COVID vaccines for clinics
The OHA Transformation Center and OHA Vaccine Planning Unit are hosting a learning collaborative for clinics newer to COVID immunizations. This will cover topics such as operational workflows, allocations, targeting high risk populations, vaccine hesitancy and more.
Every other Friday beginning April 16, from 12pm-1pm
Register here or contact Bernadette Nativo (Bernadette.Nativo@dhsoha.state.or.us) with any questions.
Questions?
- Questions related to incentive measures, health equity, traditional health workers, SDoH, and HIT - Please email EOCCOMetrics@modahealth.com
- Questions related to claims and payment information - Please email EOCCOProviderInquiry@modahealth.com
- Need to verify if your provider or group NPI is active? Please use OHA’s verification tool
- Need to register your practitioner, group or facility? You can find forms on EOCCO.com/Providers/becomeaprovider
- If you would like to be added or removed from this email list, please let us know at EOCCOProviderInquiry@modahealth.com
