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Provider Matters

Provider Matters is an email communication that gives Oregon Health Plan providers timely updates, tips and resources related to fee-for-service benefit coverage, criteria, policies and procedures.

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Current issue

In this issue
ACA 1557 and OHP coverage of gender transition services; fee-for-service claim processing updates; COVID-19 provider resources; new Independent and Qualified Agent for Medicaid-covered behavioral health services effective July 1, 2020; recent rule revisions


In this issue
6/12/2020Financial supports for providers during COVID-19
Apply now for next round of federal Provider Relief Fund General Distribution; bill HHS for COVID-19 testing and treatment of uninsured individuals; OHP coverage of COVID-19 testing;  full-day virtual training on motivational interviewing and patient-centered counseling (no-cost CME available)
5/22/2020Questions about telemedicine/telehealth?
Questions about telemedicine/telehealth? OHP COVID-19 updates - April 17 webinar Q and A, updated COVID-19 Provider Guide and how to provide culturally and linguistically appropriate services during the COVID-19 emergency; additional COVID-19 updates for all providers from OHA, FDA and HHS
5/8/2020Corrections to behavioral health fee schedule
Corrections to behavioral health fee schedule; how to adjust claims paid by OHA; temporary expansion of CAWEM-only coverage during the COVID-19 emergency; Oregon Medicaid COVID-19 provider guide; guidance for resumption of non-emergent and elective procedures; OHSU Connected Care Center hotline for managing patients with COVID-19; HHS Office of Civil Rights updates;  temporary eligibility policy changes related to the COVID-19 emergency period
4/24/2020OHA launches OHA en Español Facebook page
OHA launches OHA en Español Facebook page; COVID-19 provider resources and updates; Governor Brown and OHA launch Safe + Strong outreach campaign in 12 languages; non-urgent medical procedures to resume May 1 with safeguards in place; recent rule revisions
4/10/2020New secure email options for OHP providers; updated COVID-19 provider resources
New secure email options for OHP providers; updated COVID-19 provider resources; alert from federal Office of Civil Rights - Individual Posing as OCR Investigator; recent rule revisions
3/20/2020Fee-for-service prior authorization updates; more COVID-19 and CCO 2.0 provider resources;
Use the current Prior Authorization Request form with coversheet; visit the new COVID-19 (novel coronavirus) resources page for OHP providers and plans; questions and answers from OHA's 2020 CCO 2.0 webinar now availableOHA Transformation Center Offers free, quick online Tobacco Cessation Counseling Training (with CME); recent rule revisions
3/6/2020March 2020 due dates, language access policies, COVID-19 and CCO 2.0 provider resources
Nominate topics for HERC evidence-based reports and coverage guidanes by Mar. 30; Medicaid EHR Program Year 2019 attestations due Mar. 31; all Medicaid providers must offer language access services; COVID-19 page and updates; Lane County CCO 2.0 webinar; diabetes prevention webinar; recent rule revisions
2/21/2020Lane County and Census 101 webinars, billing updates and reminders
Lane County providers: Join OHA and your local CCOs at a Feb. 25 webinar; 2019-2020 claims to be selected for upcoming Payment Error Rate Measurement review; provider reimbursement updates; reminders for submitting paper claims and prior authorization requests; more OHA provider training opportunities (Census 101; online tobacco cessation counseling training with CME)
2/7/2020Billing resources, updates and reminders
CCO 2.0 provider resource updates; do not bill members for services approved by the member's 2019 CCO; expanded orthodontia coverage effective Jan. 1, 2020; speech and therapy claims no longer require prior authorization; Rules Advisory Committee invitation for Administrative Examinations program
1/24/2020New - Resources for working with Jackson County CCOs, billing OHP and more
Jackson County webinar recording, materials now available; fee-for-service billing reminders;  when billing for maternity care using global codes, bill OHA or the CCO based on the mother’s enrollment status on the day of delivery; OR-ESSENCE in action: How complete coding at discharge helps inform Oregon's public health surveillance system; no-cost technical assistance opportunities; recent rule revisions
1/10/2020CCO 2.0 updates: Jackson County provider webinar, web updates
CCO 2.0 updates: Jackson County provider webinar, web updates; starting the conversation about tobacco cessation; Transformation Center Updates – No-cost technical assistance opportunities
12/20/2019CCO 2.0 - Provider questions and answers, CCO rule revisions
CCO 2.0 updates: Webinar questions and answers now available; recent rule revisions
12/13/2019CCO 2.0 - December member letters, pharmacy fact sheet, more 5-year CCOs
CCO 2.0 updates: Member letters and fact sheet updates; OHA approves AllCare, Cascade Health Alliance, Umpqua Health Alliance and Yamhill Community Care for full five-year CCO contracts; January 1, 2020 Prioritized List of Health Services; fee-for-service billing updates and reminders; recent rule revisions
11/22/2019CCO 2.0 - Nov. 21 webinar video and slides now available
Free technical assistance for clinics: Alcohol & Opioid Management; from CMS: Medicare claims using Health Insurance Claim Numbers will reject starting Jan. 1, 2020; recent rule revisions
11/8/2019CCO 2.0 - Join OHA's Nov. 21 provider webinar
OHA to host CCO 2.0 provider webinar; CCO changes by county; fee-for-service prior authorization tips and resources; updated National Diabetes Prevention Program billing guidance
11/1/2019CCO 2.0 - Affected members and upcoming plan close notices
Clarification about members who will have 2020 CCO changes; communicating to patients about CCO affiliations; CCO closure notices to PrimaryHealth and Willamette Valley Community Health members mail Nov. 1, 2019; recent rule revisions
10/23/2019Updates to CCO 2.0, vaping and public charge provider resources
CCO 2.0 updates - Continuity of care, member communication fact sheets; fee-for-service hospice rates effective Oct. 1, 2019; clarification about state-supplied vaccine coverage; public charge webinar for Oregon service providers; Transformation Center learning opportunities; vaping cessation resources
10/11/2019CCO 2.0 communications: Member letters begin mailing Oct. 15
CCO 2.0 member communications and resources for October and November: Mailings, material, provider page and more
9/23/2019CCO 2.0 updates: New provider, member resources
MS-DRG and LTC-DRG implementation status; reminder about payable procedure code/modifier combinations; recent rule revision
9/13/2019EDI System Maintenance 9/15/2019
Free online tobacco cessation counseling training with CME; fee-for-service prior authorization tips and resources; recent rule revisions
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