Provider Newsletter March 2020

Practice Tactics

Updates on Prior Authorizations

Deadline:  UHA will no longer accept prior authorization requests via fax from in-network providers as of 04/01/2020. Providers need to electronically submit your prior authorizations (PA) online through our CIM provider portal. Click here to sign up for this online access.

Determination Letters for PAs are now uploaded to the Attached Documents link within the authorization request and providers are notified of the final status via CIM email.

Multiline:  CIM, UHA’s prior authorization (PA) processing platform, has recently launched a new enhancement for submitting PAs. This will increase the efficiency of your offices by allowing you to submit a single PA request for office visits/referrals and procedures if the delivering provider is the same for all requested services. Click here for more details.

Announcing UHA’s Contract with Linguava Interpreter Services

As we strive to provide the highest quality services possible, UHA is excited to announce that we have completed our contract with Linguava Interpreter Services.

We want to ensure that our members receive services that meet and are respectful of their cultural and linguistic needs.

Effective immediately Linguava representatives will be available to our contracted providers to provide telephonic and video relay interpretation (VRI) service in any language required for patient appointments.  Please click here for more information on how to utilize this free service or contact our Member Services department at 541-229-4842 Monday through Friday 8:00 AM – 5:00 PM. 

Updated Claims Appeal Process

UHA now has an updated claims appeal process! Along with an updated Provider Handbook section 6 that includes a detailed explanation, a few other notable changes are:

  • A Provider Request for Reconsideration and Claim Dispute form will be required for all second level appeals, this can be found here
  • You can now upload your appeals electronically through the claim in CIM, click here for a tutorial

This change is effective on 4/1/2020 for claim appeals.   You can find more information on our website here: https://www.umpquahealth.com/claims/

Clinical Corner

Behavioral Health Access

We recently engaged UHA contracted Behavioral Health Providers to collect specific information on each practice. Our goal was to create a referral matrix in an effort to improve information to our network and to assist the referrals of our members to mental health providers that best match their needs. The referral matrix is a tool that illustrates current access and availability for each provider. There is also general information such as practice location, ages accepted, services provided and cultural and linguistic characteristics of the providers. It is our commitment to deliver a weekly access report with updates.

If you are not on this email list, send your request to Carlos Gomez, Manager Provider Network Operations (CGomez@umpquahealth.com).

OHA has begun regular updates on COVID-19 activity

The Oregon Health Authority offers weekly updates on persons confirmed, under monitoring and persons under investigation for novel coronavirus, COVID-19, as state epidemiologists, local public health officials and federal partners continue their investigation of the disease that has sickened tens of thousands of people worldwide.

Every Tuesday, OHA will post data on persons confirmed, under monitoring (PUMs) and persons under investigation (PUI) on its website, http://healthoregon.org/coronavirus.

PUMs are individuals who do not have COVID-19 symptoms such as fever, cough or difficulty breathing, but who may have been exposed through a close contact with a confirmed case or travel to world areas of high activity. PUIs are individuals with COVID-19 symptoms — but not necessarily the virus — who have had one of these exposures.

On The Lookout

Coronavirus Update (COVID-19)

The message this month from the Douglas County Public Health Network is extensive and a must-read for all clinicians and their staff.  Since it is lengthy, use this link to access the information.  Note that this was written last week, but still contains relevant info.

We may provide interim newsletter updates before next month’s regular edition if the situation warrants.

Information in this section is provided by Douglas Public Health Network. If you have any questions about the content, please contact the DPHN office at (541) 440-3571.

CME For Thee

Coronavirus Education for Clinicians

Colleagues, I am happy to forward the following CME educational activity offered by Dr. Michael Fordis, Senior Associate Dean for Continuing Professional Development and the National School of Tropical Medicine at Baylor College of Medicine.

The novel Coronavirus SARS-CoV-2, the agent responsible for coronavirus disease 2019 (COVID-19), is producing a public health emergency in China and elsewhere in the world.

Baylor College of Medicine’s National School of Tropical Medicine provides a continuing medical education update and resources for physicians across the College and the CommonSpirit Health System.

The educational activity is available at https://coronavirus.baylorcme.org/

Thank you,
Jason F. Gray, M.D.
Chief Medical Officer
Mercy Medical Center

Technical Assistance for Clinics: Alcohol & Opioid Management

The OHA Transformation Center is partnering with the Oregon Rural-based Practice Research Network (ORPRN) for the screening, brief intervention and referral to treatment (SBIRT) CCO incentive metric. This technical assistance, designed for clinics, is a 3-year study funded through the Agency for Healthcare Quality and Research. The project, referred to as ANTECEDENT (pArtNership To Enhance alcohol screening, treatment anD intervention) is designed to address unhealthy alcohol use in primary care. Additionally, the PINPOINT Collaborative is a separate technical assistance opportunity supporting clinics to address chronic pain management and opioid prescribing. Clinics are invited to participate in free technical assistance (see flier: https://www.oregon.gov/oha/HPA/dsi-tc/Documents/ORPRN-SBIRT-Antecedent-Pinpoint.pdf).

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