Value-Based Care Incentive Program Partial Funds Release

Umpqua Health Alliance (UHA) recognizes how the COVID-19 pandemic is impacting how care is being delivered to your patients and UHA members. This pandemic is causing hardship within our local healthcare system, economy and to many of our community members. In response to the emergency and to show support of our local healthcare delivery system, UHA has decided to issue partial payouts of its Value-Based Care Incentive Programs, where UHA has confidence that those particular goals have been met.

Typically, funds are distributed in July to ensure adequate claims runout, UHA’s Value-Based Care Incentive Programs are designed to incentivize practices to provide high quality and efficient care. This early release of funds is UHA’s response to assist in the stabilization of the economic impact COVID-19 has had on the healthcare delivery system. UHA will verify the outcome of remaining metrics and issue final payment of any unpaid funds in July 2020.

UHA’s Provider Relations Department will be visiting eligible practices in the coming days. Our intent is to deliver the checks and to discuss your specific incentives. If we are unable to connect in-person, we will mail the packet out and a phone call will follow from our Provider Relations Department.

Prior Authorization Approvals

Umpqua Health Alliance has extended the end date an additional 120 days for all* previously approved prior authorization requests that were set to term between March 1, 2020 and June 30, 2020. This change will allow extra time to provide these services and avoid the need to resubmit these requests.

*Notable exceptions:

• Inpatient, SNF, residential rehabilitation, for physical health, behavioral/mental health, or SUD, including detox;
• DME/orthotics/prosthetics;
• pharmacy, injectable/infusion drugs.

For future updates, please sign up for our provider newsletter and visit our website at umpquahealth.com/providers

COVID-19 updates for telemedicine and telehealth webinar

Webinar: Oregon Health Plan Telemedicine Billing Guidance for CCOs and Providers

When: April 17, 12-1 p.m.

Registration link: https://attendee.gotowebinar.com/register/5095726627610411278

Intended audience: OHP Providers (physical health, behavioral health and oral health) and billing staff, Coordinated Care Organizations. Please register early as registration is limited.

This webinar will provide updated OHA guidance on coverage and billing standards for telemedicine services during the COVID-19 emergency. Subject matter experts will address questions that have arisen since the April 6 webinar. Topics will include methods for billing provider-to-provider consultations and services provided by synchronous audio/video, telephone or online patient portals. The presentation will include detailed billing information related to fee for service Medicaid as well as information about OHP expectations for CCO coverage.

There will be a hosted Q&A session during the webinar using the chat function on your computer.  You will need to use your computer’s audio for sound and everyone will be muted during the webinar.  There is no call in option.

This webinar will be recorded and will be available on OHA’s COVID-19 Health care partner resource page for viewing if you are not able to attend the live webinar.  The slides will be sent out to registered participants prior to the webinar beginning at Noon.