EOCCO Clinics & Staff,
Welcome to the April 2025 issue of the EOCCO monthly newsletter. Below is a preview of the articles you will find in this month's email:
News from EOCCO:
- Help for EOCCO members affected by Harney County flooding
- Medical record standards reminder
- Updated EOCCO clinical practice guidelines
- Provider reconsiderations update
- Provider directory data accuracy
- EOCCO car seat resource guide
- EOCCO 2025 Quality Improvement (QI) team office hours
- April 2025 IET learning collaborative
- IET technical assistance drop-in hours
From our partners:
- New OHA-Certified/Qualified Health Care Interpreter (HCI) Registry file posted
- Responsive Practice Training: accessibility and care for individuals with disabilities training
- Innovative approach: collaborative development of CHWs in health centers
Plese let us know if you have any questions, concerns or recommendations. We would love to hear from you!
Please contact: EOCCO Provider Inquiry
Thank you,
Your EOCCO Team
Help for EOCCO members affected by Harney County flooding
With the recent flooding that has impacted Harney County, EOCCO members may request assistance with replacing medical equipment, supplies, prescription medications or dentures. Please share these resources with your patients for help obtaining replacements:
- Durable medical equipment (DME) or supplies: Call EOCCO Customer Service at 888-788-9821 (TTY: 711)
- Prescription drugs: Call EOCCO Pharmacy Customer Service at 888-474-8539 (TTY: 711)
- Full or partial dentures: Call ODS Community Dental at 800-342-0526 (TTY: 711)
EOCCO will work to provide replacements as quickly as possible. For more information, please contact EOCCOproviderinquiry@modahealth.com
Medical record standards reminder
As a reminder, providers are responsible for complying with medical and treatment record-keeping as part of the contract between Moda Health (on behalf of EOCCO) and the provider.
All medical record-keeping systems must follow these standards:
- The practice has a documented HIPAA-compliant policy on the security, privacy, storage and transport of patient data
- The practice uses methods of storing and transporting all patient data that complies with applicable privacy and security laws, such as encrypting all backup data before transport, or storing data at a secure off-site facility (bank vault), or in a fireproof safe on premises
- Medical records and patient information are not accessible by non-authorized individuals
- Written procedures dictate release of patient information, and these procedures include a system for tracking to whom medical records are released and which staff members have access to the medical records
For a list of the standards for paper-based medical records and electronic medical records systems, please refer to the EOCCO Provider Manual on page 70.
Updated EOCCO clinical practice guidelines
Updated clinical practice guidelines have been posted to the EOCCO website. To find clinical practice guidelines for physical health, oral health and behavioral health, please visit the Clinical Practice Guidelines section of the EOCCO website. If you have any questions regarding these updates, please email EOCCOproviderinquiry@modahealth.com.
Provider reconsiderations update
With the change of provider reconsiderations underway for over a year, EOCCO wanted to share our most recent updated process and procedures. If at any time there are questions, we are here to help. Don't hesitate to get in touch with us at 503-243-3962 or toll-free at 877-605-3229. We can also be reached by email at medical@modahealth.com. Please review the following regarding this updated process to ensure a smooth transition.
- Any denial of service not yet received (pre-service) will need member consent before an appeal can be started and reviewed. Remember, a provider’s rights to appeal only pertain to denied, post-service claims.
- Peer-to-peer (P2P) consultations can only be conducted for advice and not with the intent of changing the initial determination. Once an adverse determination has been made, the appropriate process to follow is to work with the member for consent to file an appeal.
- If the initial decision results in a denial of services, a Notice of Adverse Benefit Determination (NOABD) will be mailed to the member and service provider. The member must initiate the appeal or provide consent for a provider to submit an appeal on their behalf.
- EOCCO encourages providers to make use of the appeal process (working with members for appropriate consent) instead of submitting duplicative requests for prior authorizations in response to an adverse benefit determination to avoid the appeals process. Submitting duplicative requests can lead to delays.
- If there is additional information you would like us to consider after NOABD has been issued, member consent will need to be obtained, and an appeal will need to be initiated. You may submit additional information by faxing it to 503-412-4003.
- To prevent delays in the review process, please ensure that all relevant information is included with the request to facilitate a smooth process for all parties. Do not send a duplicate prior authorization request.
- If a member initiates an appeal, the EOCCO appeals staff will contact you to request any additional information needed for the review. Please respond promptly, as this request is time-sensitive.
- If a member decides not to file an appeal, EOCCO encourages providers to discuss this decision with the member. Providers can request an appeal on the members’ behalf if they have written consent.
Provider directory data accuracy
Accurate provider directory information allows members to find you, helps members receive timely access to care, and helps to ensure accurate and timely payment for your services.
Effective July 1, 2024, EOCCO uses Quest Analytics' BetterDoctor tool to verify your provider directory information. BetterDoctor will reach out to you on a quarterly basis to confirm or update your information. You must complete a quarterly review to remain listed in our provider directory.
You will be contacted by BetterDoctor every 90 days by fax, mail, email and/or telephone to verify your provider directory information. Please respond and attest or provide changes when you receive outreach. Providers are required to validate the accuracy of their information every 90 days, even if there are no changes to the information.
Providers are responsible for reporting necessary information within the following timeframes to ensure accurate information is available to members and providers:
- Notify EOCCO within ten (10) business days of all changes to the list of Group Providers, the services it/they provide, and all contact and billing information for Provider and Group Providers
- As requested by EOCCO, provider roster requests must be completed and returned no later than 30 days upon receipt
Provider directory accuracy validation process
BetterDoctor will contact you quarterly by email, fax, telephone and/or U.S. mail. Their outreach will indicate Moda Health as a participating health plan.
You'll be asked to visit betterdoctor.com/validate and enter the access code given to you by BetterDoctor. (It is an eight-character alphanumeric code and is not case sensitive.)
Verify and update your information using the online tool via the BetterDoctor portal.
BetterDoctor verifies information for each practicing location and providers, so you may receive more than one verification request. Access codes provided on communications are specific to the providers and locations listed.
If your group includes 20 or more practitioners, you can register to participate in the BetterDoctor roster process designed for large groups and health systems.
Updates captured by BetterDoctor will be provided to EOCCO for processing.
If you need help, please contact support@BetterDoctor.com for assistance.
EOCCO car seat resource guide
EOCCO has developed a Car Seat Resource Guide that includes local car seat resources in Eastern Oregon counties. Resources include free or discounted car seats, as well as information on free car seat safety checks.
Please note that not every county in EOCCO’s service area is listed in this guide as not every county has car seat resources available. If this is the case for your county, please navigate to the "More Resources" section of the Car Seat guide on page 10.
This guide will be updated regularly with new resources as they become available. If you know of a resource that should be added, or if you notice any changes that need to be made, please email us at EOCCOmetrics@modahealth.com.
EOCCO 2025 Quality Improvement (QI) team office hours
EOCCO’s Quality Improvement team is hosting a series of virtual office hours for clinical partners during 2025!
While each office hour session will be loosely focused on a CCO incentive measure or reporting requirement, this is an open space for partners to come peer-share and ask questions about any topic in the quality improvement realm.
- Date and time: 2nd Tuesday of every month, from 11:00 a.m. – 12:00 p.m. PST
Please click here to register for EOCCO’s QI office hours.
April 2025 IET learning collaborative
EOCCO is excited to present a learning collaborative on Initiation and Engagement of Substance Use Disorder Treatment (IET). Please join us on Tuesday, April 22, 2025, for a virtual learning opportunity on the IET incentive measure. Providers and staff at any EOCCO-contracted physical and behavioral health practices are welcome.
Agenda items will include (but are not strictly limited to) a discussion of EOCCO IET data trends, the utility of process mapping, and opportunities for peer-sharing! To register, please click here to complete the IET learning collaborative registration form.
Please reach out to EOCCOmetrics@modahealth.com with any questions or concerns, or if you/your organization has any ideas for agenda items.
IET technical assistance drop-in hours
Starting in mid-March 2025, EOCCO will be offering weekly technical assistance sessions for any physical or behavioral health provider looking for assistance or information on the Initiation and Engagement in Substance Use Disorder Treatment (IET) incentive measure. This will be a set time for drop-in hours each week, co-lead by Tasha Robinson (tasha.robinson@modahealth.com) with EOCCO, and Kati Jokinen (kjokinen@gobhi.org) with GOBHI. We are aiming to address any concerns related to IET cases and the technical specifications of the measure.
The IET technical assistance office hours will be held on Thursdays, from 10:00 – 11:00 a.m. PST. Click here to register for these hours. Please reach out to EOCCOmetrics@modahealth.com with any questions or concerns.
New OHA-certified Health Care Interpreter Registry file posted
The February 2025 OHA Health Care Interpreter (HCI) Registry file has been posted to the EOCCO Incentive Measure webpage under “Meaningful Language Access”. This file contains a list of all active OHA-Certified or Qualified Health Care Interpreters in the state of Oregon. This file can be downloaded for your reference and records.
You can also search for OHA-Certified or Qualified Health Care Interpreters on the Health Care Interpreter Registry webpage.
Responsive Practice Training: accessibility and care for individuals with disabilities training
Improve your understanding of accessibility and provide inclusive care. The Oregon Office on Disability and Health (OODH) is offering two free virtual training courses designed for anyone working in healthcare with an interest in building skills to provide care to individuals with mobility, developmental and intellectual disabilities.
The modules and training materials were developed by the New Hampshire Disability and Health Program and offer the following:
- Free professional development credits
- Self-guided modules
- 35 minutes to complete
- Relevant for anyone working in a clinical healthcare setting
Please click here for a step-by-step guide for completing the training modules. For general questions or to request accommodations for successful training completion, please contact the Oregon Office on Disability and Health at oodh@ohsu.edu.
Innovative approach: collaborative development of CHWs in health centers
Northwest Regional Primary Care Association (NWRPCA) is excited to partner with MHP Salud for an upcoming webinar designed for health centers.
Join MHP Salud and NWRPCA for a webinar workshop to explore CHW career development and integration into health center teams. After just an hour, you’ll walk away with key insights to use apprenticeship programs and training and development to advance learning opportunities and professional growth for CHWs—all to help improve outcomes for your center and your community.
- Date: Wednesday, May 7, 2025
- Time: 12:00 p.m. PST
- Place: Online, via Zoom
If you’re part of a health center, then this workshop is for you! Please click here to register for this event.
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 the email list, please let us know at finn.gornick@modahealth.com
