Q4 2022 PROVIDER NEWSLETTER

Date: 11/28/22

Helping you care for your patients is our top priority:

Strong communication and trust between you and your patients will help ensure they’re satisfied and have good outcomes. You can rely on Ambetter of North Carolina Inc. for information and support to help you keep those patient relationships strong.

• Annual CAHPS Survey

The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey is an opportunity for your patients to share their healthcare experiences with you as their provider and with their health plan. Your patients are asked specific questions, which include how well their doctor communicates, if they felt their doctor listened to them, and if their doctor explained things in a way that was easy to understand. Also included are questions on how well different healthcare providers are communicating about care coordination and a (0-10) rating of the patient’s overall satisfaction with their healthcare, personal doctor and specialists.

• Annual Provider Satisfaction Survey

You are essential to providing the highest quality healthcare possible for our members, and your satisfaction is very important to us, too. We assess your experience with the health plan through an annual Provider Satisfaction Survey and use the results to guide operational improvement activities.

• Support Doesn’t Stop There

Our provider website contains essential information, including your rights and other sources of support for you. Read more here: https://www.ambetterofnorthcarolina.com/provider-resources/manuals-and-forms.html. If you have additional questions or need specific support, call Provider Services at 1-833-863-1310.

Flu Prevention

You have a key role to play in recommending your patients get the flu shot, and Ambetter of NC is here to help. Members can get a free Flu or COVID vaccine at their local pharmacy or with their doctor.
 
Remember, you can help stop the flu! Strongly recommend to all of your patients to get their annual flu shot.

• Make a strong recommendation to your patients to get their flu shot. Research shows that patients are more likely to get a flu shot if their doctor recommends it.
• Follow-up is important! If your patient did not get the flu shot during their visit, there’s a chance they didn’t get it at all. Talk to your patients about where and when they’ll get their flu shot, and make a note to confirm during their next visit.
• Talk with your patient about any questions or concerns — and be sure to repeat your strong recommendation. Most people know the flu shot is important. They may just need your reminder!

Flu Prevention Is a Win-Win
There are many advantages to promoting flu prevention:

• Healthier patients
• Decreased severity of illness for those who do get sick
• Reduced community spread

For more information visit:

• Ambetter of NC Inc Flu Shot Resources
• NC Respiratory Virus Surveillance Data

Incentivizing Providers for Your Hard Work!

Continuity of Care (CoC) Agendas

With 4^th Quarter upon us, we have less than 3 months to schedule member visits and qualify for the CoC Agenda Provider Incentives.

• Incentive potential

  Incentive payments for each agenda, is based on the below thresholds completed of total volume. (*based on total volume of 100 agendas)	Tiered incentives payments for each threshold completed
  <50% (*agendas 1-49)	$100 per agenda
  ≥50% to <80% (*agendas 50-79)	$200 per agenda
  ≥80% (*agendas 80 -100)	$300 per agenda

• Requirements to qualify for agenda incentive
  • Schedule your member for a visit by 12/31/2022
  • Assess/Address ALL existing conditions and document in your progress note
  • Submit a claim with ALL existing conditions
  • Complete the online or paper agenda form by checking a box for each diagnosis (Current existing or non-existing/resolved)
  • Submit your agenda via provider portal (Preferred method - real time submission) or fax/email your agenda to the contact info on the form

• Deadlines
  • Visits to be completed by 12/31/2022
  • Agenda submissions have to be done by 01/01/2023

Q1 and Q2 Payments

For providers and groups that are participating in the CoC Agenda program, you should have received your Q1 payments. Your Q2 payments are on their way.  Detailed reports are available if you would like more information regarding your payments.

We will communicate out Q3 payments before the end of 4^th Quarter.

If you are not participating in the program at this time, we are happy to show your potential incentives on the work you have already done.  It may require minimal steps to qualify for the incentive that you deserve.  Contact your Provider Engagement Coordinator and setup a short meeting to discuss.

If you have any questions on CoC agendas, please feel free to reach out to your Provider Engagement Coordinator.
 
Thank You for Taking Care of Our Members

Withdrawing from Caring for a Member

Providers may withdraw from caring for a member. Upon reasonable notice and after stabilization of the member’s condition, the provider must send a certified letter to Ambetter Member Services detailing the intent to withdraw care. The letter must include information on the transfer of medical records as well as emergency and interim care. For more information, review the Provider Manual.

The current address is:

Ambetter of North Carolina Inc.
Attn: Member Services Dept./CA21281-02-526
21281 Burbank Blvd.
Woodland Hills, CA 91367 

Beginning January 2023, the address will change to:

Ambetter of North Carolina Inc.
10101 David Taylor Drive, Suite 300
Charlotte, NC 28262

FREE Centene supported suicide prevention training for providers: Preventing Suicide in Healthcare Professionals/Staff

Thursday December 8, 2022
1:00PM-2:00PM EST
Register in advance

Healthcare professionals are significantly more likely to end their lives by suicide than the general population. The COVID-19 pandemic and other events have only exacerbated the stress, moral injury, and fatigue already felt by many healthcare professionals balancing caring for patients with concerns for their own wellbeing. And when healers end their lives by suicide, these tragic incidences can also have a “ripple effect,” increasing the vulnerability of other professionals, patients, and family members.

Join our webinar to understand the dynamics of the crisis and learn concrete strategies to help support primary care providers and teams, address suicide risk and prevent deaths by suicide in staff, and implement effective postvention strategies. This training will also provide tips from the Association of Clinicians for the Underserved on how organizations can self-assess their readiness to prevent and respond to provider suicide.

Presenter:

• Dr. Virna Little, PSyD, LCSW-r, SAP, CCM, Chief Clinical Officer and Co-Founder of Concert Health, Co-Founder of Zero Overdose

This webinar is made possible by the generous support of the Centene Corporation and draws from resources developed by ACU in partnership with Concert Health.

Have you Completed your New Provider Orientation?

During the New Provider Orientation, we will discuss the following:

• Ambetter benefits
• Verification of Eligibility and benefits
• Accessing the public website and secure web portal
• Prior Authorizations
• Claims
• Provider Billing Manual and Provider Tool kit

Ambetter of North Carolina Inc. holds New Provider Orientations monthly on the third Tuesday at 12PM.

• Register in advance for this meeting

After registering, you will receive a confirmation email containing information about joining the meeting.

Ambetter of North Carolina Inc. also has an on-demand option for your New Provider Orientation.

• View the recording

Once you complete an orientation, please submit your attestation.