Here is a reminder of the EHP deadlines for establishing the data flow from your clinic to EHP:
By Aug. 1, you should have:
- All providers trained on using CPTII/HCPCS codes
- All providers have begun submitting CPTII/HCPCS codes on claims
- Participating provider is regularly reviewing quality data in the Dimensional Insight (DI) dashboard, or administrative personnel are reviewing and notifying provider of necessary follow-up.
The Data Transfer Status sheet shows where your clinic stands regarding the Aug. 1 deadlines. If you see a date in the Received Claims in July column, that indicates the last time we received either data or CPTII/HCPCS codes from your practice.
We’ve added a new category of “Testing” in order to show clinics that have yet to send a claim, but are actively engaged in testing the data flow.
As we create a bonus pool as a result of gainsharing contracts, the Board of Managers will be approving a distribution methodology. To be eligible for a distribution in 2015, should a pool be available, participant members need to meet these requirements:
- You must be submitting your claims data to the quality program with CPTII code by some time in the 4th quarter (if you are an outpatient provider). This data is needed to support the quality program.
- Attend a 4th quarter training that will likely be focused on coding and documentation to support billing in an era of accountable care. This training will be made available to all providers who are members of EHP. Those who attend will be eligible for reimbursement, subject to the availability of a gainsharing distribution pool.