Providers

EOCCO October 2023 Provider Newsletter

EOCCO Clinics & Staff,

Welcome to the October 2023 issue of the EOCCO monthly newsletter. Below is a preview of the articles you will find in this month's email:

COVID-19 Vaccine Commercialization
24/7 Suicide Prevention Hotline for Agricultural Workers
Responsive Practice Training
Updates to Provider Manual
EOCCO Clinic Spotlight
Technical Assistance for Social Needs Screening & Referral Incentive Measure
Social Emotional Health Community Learning Session
Colorectal Cancer Screening for Rural Communities ECHO
Free CHW Training for CAHs, RHCs and Rural Public Health
Travel and Non-Routine Adult Vaccines Updates
Reminders

Please 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

COVID-19 Vaccine Commercialization Effective Date; Impact on CCO Members Underage 19

EOCCO is providing notice to providers of the effective date for COVID-19 commercialization and to remind providers how this change affects Oregon Health Plan (OHP) coverage for COVID vaccines for children under the age of 19.

COVID-19 commercialization means the transition of COVID vaccines to the established pathways of procurement, distribution, and payment for vaccines. For OHP children under the age of 19, the established pathway is through the Vaccines for Children (VFC) program by VFC-enrolled providers.

Through October 31, 2023, children under the age of 19 can continue to get COVID-19 vaccines at Non-VFC providers during the commercialization transition period.

Effective 11/1/2023, children under the age of 19 will need to get COVID-19 vaccines from eligible VFC providers.

Children who are CCO members can receive COVID vaccines from any Oregon VFC provider, regardless of whether the provider has a contract with the CCO.

If the provider is not contracted by the CCO, then they can bill OHA for the vaccine administration. (VFC providers do not bill for the vaccine because it is provided to them at no cost).

Change in Referral and Prior Authorization Submission Process for Morrow and Umatilla Counties

This notice is to provide information regarding a process change for submitting referral and prior authorization requests for all EOCCO members.

Currently, all prior authorization service and referral requests for EOCCO members are submitted through the Eastern Oregon Independent Practitioner Association (EOIPA) for members residing in Morrow and Umatilla counties only.

As of October 1st, 2023, all referral and prior authorization requests for EOCCO members will be processed by the EOCCO referral and authorization team.

Referral and prior authorization requests can be faxed to

(833)-949-1886.

You can find more information and request forms on our website at EOCCO referrals & authorizations.

We appreciate the service and care you continuously provide to our members. If you have any questions, please reach out to us at (503)-265-2940 or toll free at (888)-474-8540.

EOCCO helps fund a 24/7 suicide prevention hotline geared specifically for agricultural workers

EOCCO helps fund the new AgriStress Helpline.

Agricultural workers in crisis can now call or text the AgriStress Helpline at 833-897-2474 to speak with a trained support specialist. Calls are free and confidential.

View full article here.

Responsive Practice Training: Accessibility and Care for Individuals with Disabilities

Improve your understanding of accessibility and provide inclusive care. The Oregon Office on Disability and Health (OODH) is offering two free virtual trainings designed for anyone working in healthcare with interest in building skills to provide care to individuals with mobility, developmental, and intellectual disabilities.

Free professional development credits
Self-guided modules
35 minutes to complete
Relevant for anyone working in a clinical healthcare setting

Click here for more information about each training module, CME/CEU accreditation information, and a step-by-step guide for completing the trainings. Links to the trainings are included below.

Responsive Practice: Providing Health Care and Screenings to Individuals with Disabilities
Access the training

Responsive Practice: Accessible and Adaptive Communication
Access the training

These trainings were developed by The New Hampshire Disability and Health Program. For general questions or to request accommodation for successful training completion, please contact the Oregon Office on Disability and Health.

Updates to Provider Manual

EOCCO has made some mid-year updates to the following topics:

Language removed that any member or authorized representative (with member consent) who files a verbal appeal with our customer service must follow up with a written appeal. No follow-up with a written appeal is required.
The language pertaining to “formal” appeals will be removed.
Any appeal for denied services that is being filed by anyone other than the member, thus including providers, needs to have member consent before the appeal can be processed.
Peer-to-Peer (P2P) reviews cannot be considered or conducted if an NOABD (Notice of Adverse Benefit Determination) was already issued (mailed out). While EOCCO is considering a new process in the future, it is still recommended that all providers follow the appeal process, or the instructions included in the denial letter. If you have any questions we are here to help, please contact us at 503-243-3962 or toll-free 877-605-3229. You can also contact us via email at medical@modahealth.com

EOCCO Clinic Spotlight

EOCCO is pleased to announce our new Clinic Spotlight!

The purpose of this Clinic Spotlight is to highlight a clinic and/or an organization's hard work to reach each incentive measure targets in our Monthly EOCCO Newsletter!

If you or someone in your organization has an innovative approach / system / workflow used to better serve our community and reach our targets, we'd love to hear it!

If your clinic is interested in being a part of our monthly Clinic Spotlight, please take your time filling out this form.

**Note that you have the option to submit anonymously**

Please keep in mind that by clicking the link below, you will be directed to a third-party website (Smartsheet) to complete the survey. Smartsheet may retain the data you submit to complete the survey.

You can view Smartsheet’s Privacy Policy Smartsheet Privacy Notice | Smartsheet information entered into this survey will be shared with EOCCO. You can view EOCCO’s privacy policy.

If you prefer to share this information directly with EOCCO, please call Customer Service at 1-888-788-9821 to complete the survey over the phone.

ORPRN is offering Technical Assistance for the Social Needs Screening & Referral Incentive Measure

The Oregon Rural Practice Based Research Network (ORPRN) is offering technical assistance opportunities for the new Social Determinants of Health (SDoH): Social Needs Screening & Referral Incentive Measure.

Please see the information below for TA session topics and registration for their Café Connect series:

Café Connect Event Series:

Café Connect events are an opportunity to hear from experts and allow for CCOs (Coordinated Care Organizations), CBOs (Community Based Organizations) and providers to engage in dialogue to strengthen partnerships and support successful Social Needs Screening & Referral metric implementation.

September 18, 2023 -- Café Connect Orientation* This open house orientation offers an overview of metric requirements for those that are new to the metric or would benefit from a review of the basics.
October 24, 2023 – Health & Social Care Integration: Sustainable Partnerships
January 23, 2024 – Payment Arrangements for Social Needs Screening and Referral
March 18, 2024 – Establishing Data Sharing Approaches and Agreements
May 23, 2024 – Optimizing Data Sharing Systems

Please reach out to Claire Londagin directly with any questions about the Café Connect SDoH Incentive Measure TA sessions.

Social Emotional Health Community Learning Session

Please join EOCCO for our second annual Social Emotional Health Community Learning Session on November 8th from 1-2:30pm. This learning session will be held virtually.

What is the Social Emotional Learning Session about:

Addressing the needs of our youth aged 0-5 and their families.
The learning session will provide an overview of the development of the SEH metric including vision, purpose, and activities. The focus of the metric is children birth to age 5, and their families, having equitable access to services that support their social-emotional health and are the best match for their needs.

Activities related to this metric include:

Building capacity within CCOs for enhanced services, integration of services, cross-sector collaboration, and future measurement opportunities.
Reviewing CCO aggregate social emotional/behavioral health screening and assessment performance for children ages 0-5 and Social Emotional Health Reach Metric Data
Using child-level data to guide and inform SEH metric efforts.
Conducting asset mapping for contracted behavioral health services summarizing the capacity and characteristics of Social-emotional health services, specific to therapy services and assignments/screenings.
Engaging in meaningful conversations with cross-sector community partners and families from communities experiencing historical and contemporary injustices. Identify barriers and opportunities to improve SEH service that can inform the CCO’s Action Plan to address service capacity and access.

Who should attend:

Primary care practices and providers
Behavioral health programs/providers that serve children
Early Learning Hubs
Tribal governments and/or the Urban Indian Health Program
Regional Education Service Districts, including the Early Intervention and Early Childhood Special Education program
Culturally specific organizations serving children birth to age 5 and their families
Local DHS programs, including the office of child welfare and self-sufficiency
Other behavioral health programs/providers serving children birth to age 5 and their families
Local criminal justice agencies
Early care and education programs, including preschool and childcare programs
Local public health programs serving children birth to age 5 and their families (e.g. WIC, home visiting)
Regional health equity coalitions
Faith based organizations

What Next?

EOCCO will use the reflections from conversations with cross-sector community partners and families to create a CCO Action Plan-- addressing barriers that impact equitable access to social-emotional/behavioral health services for children ages 0-5 and their families.
We will strategize ways to continue building capacity within EOCCO for enhanced services, integration of services, cross-sector collaboration, and future measurement opportunities.
Thank you for your participation in this event and we look forward to learning from you.
Please register for the Social Emotional Health Community Learning Session

Free CHW Training for CAHs, RHCs and Rural Public Health

NEON/Oregon Office of Rural Health is offering free CHW training to CAHs, RCH and rural public health departments!

ORH received a second year of funding for the CHW training grant and will train 27 more Community Health Workers (CHWs) free of charge to your organization through NEON.

This program will train someone, identified by your facility, to become a CHW to be employed by your CAH, RHC, your public health department, or shared between organizations. *This opportunity is limited to Oregon CAHs, RHCs and rural public health departments.

This person could be anyone you feel would make a great CHW – no experience required, except for a high school diploma. ORH will fund and organize their 11-week training (starting in Jan. 2024) through an Oregon-accredited online CHW program, and help, if applicable, to facilitate sharing the newly certified CHW between your hospital, RHC, or your local public health department. For more information on this grant, please see the attached document.

APPLY HERE

Deadline to apply is Oct. 27, 2023

If you have questions about this initiative, please feel free to reach out to Stepha Dragoon.

The Oregon Health Plan covers travel and non-routine adult vaccines effective October 1st, 2023

Starting October 1st, 2023, the Oregon Health Plan now covers the following codes:

90473: Immunization administration by intranasal or oral route; 1 vaccine (single or combination vaccine/toxoid)
90474: Immunization administration by intranasal or oral route; each additional vaccine (single or combination vaccine/toxoid)
90581: Anthrax vaccine, for subcutaneous or intramuscular use
90584: Dengue vaccine, quadrivalent, live, 2 dose schedule, for subcutaneous use
90586: Bacillus Calmette-Guerin vaccine (BCG) for bladder cancer, live, for intravesical use
90587: Dengue vaccine, quadrivalent, live, 3 dose schedule, for subcutaneous use
90625: Cholera vaccine, live, adult dosage, 1 dose schedule, for oral use
90690: Typhoid vaccine, live, oral
90691: Typhoid vaccine, Vi capsular polysaccharide (ViCPs), for intramuscular use
90717: Yellow fever vaccine, live, for subcutaneous use
90738: Japanese encephalitis virus vaccine, inactivated, for intramuscular use
90758: Zaire ebolavirus vaccine, live, for intramuscular use

ACIP recommends these vaccines for adults due to underlying health conditions, occupation, or travel. This change follows federal guidelines to cover recommended vaccines for adults as required by section 11405 of the Inflation Reduction Act.

Reminders

Timely Access to Care Survey

Please be on the lookout for an email in November for the biannual Timely Access to Care Survey. As a reminder, this helps EOCCO monitor the network to ensure all members are receiving care in a timely manner. This survey is for primary care, urgent care and specialty clinics. If you have not received this survey before, please reach out to Elizabeth Baird to be added to the distribution list.

Join EOCCO for our annual Workshop 2023

Join us as we conduct multiple annual workshops catered for around office and billing managers, referral, and authorization managers and/or front office staff. We will spend this time covering topics such as Member Eligibility and Plan Types, Prioritized List of Covered Services, Referral & Authorizations, Claims, Incentive Measures, Behavioral Health, Compliance & any future updates to our program.

We will also discuss Summit Health’s Medicare Advantage plan at the completion of the EOCCO presentation. **Food and refreshments will be served**

View the schedule and sign up here!

Need help or have questions?

Noah Pietz
503-265-4786
noah.pietz@modahealth.com

Change in Referral and Prior Authorization Submission Process for Morrow and Umatilla Counties

This notice is to provide information regarding a process change for submitting referral and prior authorization requests for all EOCCO members.

As of October 1st, 2023, all referral and prior authorization requests for EOCCO members will be processed by the EOCCO referral and authorization team.

Referral and prior authorization requests can be faxed to

(833)-949-1886.

You can find more information and request forms on our website at EOCCO referrals & authorizations.

We appreciate the service and care you continuously provide to our members. If you have any questions, please reach out to us at (503)-265-2940 or toll free at (888)-474-8540.

Members with Medicare and Medicaid

EOCCO full-benefit dual eligible (FBDE) members are those that have Medicare as their primary coverage and EOCCO as their secondary. These members have access to both health related services (also known as flexible services) and non-emergent medical transportation (NEMT) through their EOCCO benefit.

EOCCO Offers Interpreter Services

EOCCO offers two interpreter services to help remove language barriers for members seeking care. Passport to Languages and Linguava are available to service partners free of charge.

Instructions for connecting to a Passport to Languages phone interpreter are attached. Please note that clinics must sign a letter of understanding before using Linguava for the first time.

EOCCO members also have access to free translation services.

Link to the flyer: Interpreter resources

Health related services

Health related services are non-covered services under the Oregon Health Plan (OHP) with goals to improve the way members can get care and improve their health. Members can start the request, but providers will need to approve and submit the request to EOCCO. For more information, please see the flexible services request form.

Free Rides to Appointments

EOCCO members can receive free rides to appointments through NEMT services. Rides are available for covered services under OHP. Members can call 877-875-4657, Monday-Friday 8:00am – 5:00pm PT to request a ride. Please visit EOCCO’s NEMT page for the Free Ride Guide, a list of local phone numbers and list of FAQs.

2023 Colorectal Cancer Screening for Rural Communities ECHO

The Oregon ECHO Network is excited to offer the Colorectal Cancer (CRC) Screening Outreach for Rural Communities ECHO program again this fall. This 6-session ECHO will share evidenced-based approaches for clinical practices or regional health care organizations to improve colorectal cancer screening rates.

The sessions will cover topics such as how to identify patients for screening, implementing a program that fits local needs and unique barriers, and providing patient navigation throughout the screening process. ECHO is recruiting program champions from health care or community organizations (health plans, health systems, or clinical practices) interested in improving CRC screening rates using population outreach.

Event Date(s):

This ECHO will be held via videoconference on 2nd and 4th Thursdays from noon - 1 p.m., from September 14, 2023 - November 30, 2023.

Registration Link:

Training and Events

Child Physical Abuse Training for Primary Care Providers

Build and sharpen your clinical skills in child physical abuse identification and reporting alongside a virtual cohort of Oregon primary care providers. During this four-session training, board certified, Oregon-based child abuse pediatricians will combine lectures with case presentations and group discussions designed to help learners:

Identify the signs of child physical abuse, including types of bruises/skin injuries, abdominal injuries, burns, sentinel injuries, head trauma, and fractures
Conduct an exam and identify patient and familial history elements that are concerning for child physical abuse
Understand the roles and responsibilities associated with Oregon’s county-based Designated Medical Providers and Children’s Advocacy Centers, Karly’s Law, the Oregon Child Abuse Hotline, and Child Protective Services when there are concerns of abuse.

Questions? Contact Kat Hendrix.

Event Date(s):

September 20, 12:00pm – 2:00pm

October 18, 12:00pm – 2:00pm

November 12, 12:00pm – 1:30pm

December 13, 12:00pm – 1:00pm

Registration closes on Monday, September 11

Learn more and Register

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 kelly.watanabe@eocco.com