Providers

EOCCO March Provider Newsletter

EOCCO Clinics & Staff,

Welcome to the March issue of the EOCCO Monthly Newsletter. Below is a preview of the articles you will find in this month’s issue:

Cut-off for Incentive Measure Data Approaching
New Traditional Health Worker Reporting Requirement
Upcoming Trainings
Community Health Worker Billing Reminders
EOCCO Clinic and Provider Survey - Member Access
COVID-19 Vaccine Updates
Correction to eviCore Update

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

Cut-off for Incentive Measure Data Approaching

Clinical Quality Measures
If your clinic intends on reporting any data related to the 2020 EHR-based incentive measures, and have not returned your data submission template, please do so as soon as possible. EOCCO must submit our performance data to the state by Monday, April 1st, 2021. Templates may be returned securely to EOCCOmetrics@modahealth.com. The EHR-based measures include Diabetes HbA1c Poor Control, Depression Screening, Cigarette Smoking Prevalence, Drug and Alcohol Screening (SBIRT), Controlling High Blood Pressure, and Weight Assessment and Counseling.

Chart Review Measures

EOCCO has worked to validate a number of patients for the chart review measures using a combination of claims data from our system and EHR data provided by our clinics. Individual clinics may have been contacted with a reporting template as needed for additional assistance. If your clinic received a request for charts please return your completed template securely to EOCCOmetrics@modahealth.com by Wednesday, March 17th for Prenatal and Postpartum Care, and Friday, March 19th for Colorectal Cancer Screening data.

New Traditional Health Worker Reporting Requirement

The Oregon Health Authority has set new contract requirements asking CCOs to collect data on Traditional Health Worker (THW) utilization in their service area. This information will be used to strengthen several THW functions including listing THWs within the Provider Search tool on the EOCCO website, connecting THWs with EOCCO communications and resources, and supporting proficient billing practices. The first THW utilization request was emailed in January 2021, and has an approaching due date of Wednesday, March 31st, 2021. For clinics with completed templates, or if your clinic needs to request a reporting template, contact EOCCOmetrics@modahealth.com. We ask that organizations return this information securely on a quarterly basis moving forward.

Upcoming Trainings

BOOST Oregon COVID-19 Vaccine Provider Training

EOCCO is excited to announce that we are partnering with BOOST Oregon to offer a provider training on increasing COVID-19 vaccine confidence. This training is *free* to attend and will be beneficial for any providers or organizational staff that interact with patients.

Medical Educator Max Cohen, N.D., will discuss root causes for vaccine hesitancy in some BIPOC communities, background on mRNA vaccine function and safety, and tactics on how to communicate effectively with individuals on the COVID-19 vaccines. Please see attached flyer for more details.

Friday, April 9th from 12pm – 1pm PDT
Zoom Webinar (link to be shared after registration)
Click here to register

First Tooth Training

Advantage Dental is hosting a live First Tooth certification for medical and dental providers seeking to implement preventive oral health services for infants and toddlers ages three and under. This training is intended for those who provide care to pregnant women, young children, and adolescents.

Wednesday, April 7th
Morning Session (7:30-9 am)
Afternoon Session (12-1:30pm)

Thursday, April 8th
Morning Session (7:30 - 9am)
Afternoon Session (12-1:30pm)

To register, click the desired session above.
Contact EOCCOmetrics@modahealth.com for more details.

SBIRT Webinar Training Series

A webinar series focused on addressing moderate to severe Alcohol Use Disorder (AUD) using Screening and Brief Intervention (SBI) and Medication Assisted Treatment (MAT).

Wednesday, May 12th, or August 11th, 12pm – 1pm
Click here to register or contact: antecedent@ohsu.edu for more information.

Critical Access Hospitals Quality 101 Training Program

This two-part series is aimed at teaching best practices in quality improvement, data abstracting, data reporting, and process improvement.

Wednesday, April 7th, and April 28th from 10am – 11am.
Visit the Oregon Office of Rural Health's website to register.

Patient-Centered Counseling Trainings

A full-day training focused on strengthening motivational interviewing and other patient-centered counseling skills.

June 29th, from 9am – 4pm.
Follow this link to register or add yourself to a waitlist.

Community Health Worker (CHW) Billing Reminders

The EOCCO will reimburse for Community Health Worker (CHW) services when a state certified CHW provides the services. CHWs will be enrolled as non-payable rendering providers and must work and bill under a licensed provider's supervision. When the CHW is the rendering provider, and the clinic or supervising medical provider is the billing provider, the Oregon Health Authority (OHA) will allow the code to pay. To qualify for reimbursement under the Oregon Health Plan, CHW's must be certified by the OHA by completing an approved training program and enrolled in the state's central registry. To learn more about becoming a certified and registered CHW and how to bill for services, visit: EOCCO Become a Provider webpage to download the enrollment and reimbursement instructions.

EOCCO Clinic and Provider Survey - Member Access

EOCCO Provider Inquiry sent out on email on March 3rd that included a survey to collect information for required reporting by the Oregon Health Authority. This survey will help EOCCO gather information regarding telehealth availability, office hours, interpreter services and ADA accommodations to assess and improve network adequacy as well as access to care. We appreciate your participation in this survey. If we have questions about your responses, we may contact you.

Click here to complete the survey.

Please complete by Wednesday, March 31st, 2021.

COVID-19 Vaccine Update

As of March 17th, 2021, the vaccine is available to those who are in Phase 1A and Groups 1-5 in Phase 1B. Please visit the COVID-19 Vaccine Information for Providers page for updated billing information that includes the Johnson & Johnson vaccine.

Vaccine events and clinics in Eastern Oregon can be found on the COVID-19 Vaccine Events by County page.

Additional resources from OHA regarding vaccine billing, sequencing, and other information can be found in following links:

Correction to eviCore Update

Please note the correction to the effective date. Beginning March 26th, 2021, eviCore will separate EOCCO from Moda Health business on the prior authorization portal. EOCCO will now be added to the list of Health Plan drop-downs to choose from when requesting a prior authorization in the eviCore portal.

If you choose Moda Health as the health plan option for a member on EOCCO you will receive a message “member not found / ineligible member”.

EOCCO will host eviCore prior authorization trainings in the near future and we will communicate the dates and times of these sessions as soon as we have more information.

Claims Explanation Code (E/X) Corner

751 - Capitation applied. This is not a denial; this explanation code is used for PCPCH clinics that are enrolled with our primary care claims capitation. Certain PCP services are paid on a capitated basis where clinics receive monthly per member per member (PMPM) based on the members demographics.

CDD - This service is a duplicate of a previously processed service or is currently in process. Please check your records. This is a common denial that is applied when we are billed the exact same services twice on the same day. Proper modifier placement will waive this denial if there are same services on the same day. Often providers will also bill the claim again if they have received no payment. A provider should only bill a second time if they are correcting their original billing and mark it as a “corrected claim”.

10M - A signed, valid consent form is required. Please submit with claim. This denial is due to the member having a sterilization or hysterectomy and the required consent form was not submitted with the claim. We are unable to pay a claim without a signed consent form as required by the Oregon Health Authority (OHA) Oregon Administrative Rules (OAR) 410-130-0580.

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