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Provider Digest | Volume 94

Date: 09/13/23

Effective 9/15/23: New Prior Authorization Timelines for Trillium Medicaid Behavioral Health SUD Providers

Trillium Community Health Plan is committed to partnering with you to provide high-quality behavioral health services to Trillium Medicaid members.

Effective Friday, September 15, 2023, Trillium has updated its prior authorization timelines for Behavioral Health Substance Use Disorder (SUD) residential providers as detailed below:

  • Providers: Trillium Medicaid-contracted providers offering SUD residential 3.5 ASAM level of care
  • Prior Authorization (PA) Timelines for 3.5 SUD res
    • Initial PA: 30 days
    • Concurrent PA: 14 days
  • Effective Date: 9/15/23

Thank you for your partnership in helping our members stay healthy. If you have any questions, please contact your assigned Provider Relations Representative.

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Register by 9/21/23: Early Childhood Social Emotional Health Community Conversation

Join Trillium Community Health Plan and PacificSource for a conversation to guide the future of our work supporting the Social Emotional Health of children ages 0-5 years old in our community. 

View this Early Childhood Social Emotional Health Community Conversation flyer (PDF) for more information. We hope to see you there!

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Clinical Documentation Improvement Best Practices: Documentation Integrity

We appreciate your partnership in maintaining accurate medical records. Below are some helpful Clinical Documentation Improvement (CDI) best practices for documentation integrity.

Documentation Integrity
Most EHRs have features that can help providers cut down on the time needed to document the medical record. These techniques, such as copy/paste, can save time. However, they also pose a risk to the integrity of the document.

Copy/Paste
When using this function, please ensure the information copied is updated and accurate. Inappropriate use of the copy/paste feature can result in the following:

  • Over-documentation: irrelevant information included in the medical record without additional support.
  • EHR cloning: inaccurate information placed in the patient’s medical record.
    • EHR cloning also makes it difficult to parse out new relevant patient information.
    • Avoid conflicting documentation between different parts of the progress note.
  • Jeopardizing patient safety by receiving inadequate medical care if medical decision making is based on inaccurate information.

References

CMS Electronic Health Records Provider Fact Sheet (PDF)

Thank you for your attention to these CDI best practices. If you have any questions, please contact Deqala Tripp.

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Reminder: Lane County Trillium Medicaid Behavioral Health Provider Availability Survey

In the Lane County CCO region, Trillium Behavioral Health has transitioned from monthly phone calls to an online survey to assess provider availability and your program openings. This will streamline the process for you as well as ensure we are able to provide members with the most accurate provider information. You should expect to receive the survey link via email on the first Monday of every month.

As always, we deeply appreciate the valuable work that you are doing for our Trillium members and our community at large. At the top of each survey, you will find contact information for Emma St. Clair and Erinn Stevens. Please reach out to both of them directly if you have any questions or concerns. We look forward to partnering with you on this new process!

Complete the Lane County Trillium Behavioral Health Provider Availability Survey

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Wellcare By Trillium Advantage Providers: Special Needs Plan Model of Care Self-Study Program

The Centers for Medicare & Medicaid Services (CMS) requires health plans to provide annual education and training on Wellcare’s Model of Care to providers who treat our Special Needs Plan (SNP) members. This applies to our Dual Eligible Special Needs Plan (D-SNP) members, who are eligible for both Medicare and Medicaid.

The annually updated training is available for download and self-study at our Model of Care Training webpage.

We appreciate the quality care you provide to our members and your support of our efforts to meet CMS regulations.

If you have any questions, please contact your assigned health plan Provider Relations Representative.

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Resources for National Suicide Prevention Month

September is recognized as National Suicide Prevention Month, shining light on the need to strengthen access to suicide care to save lives. The launch of the National 988 Suicide & Crisis Lifeline was a significant step toward breaking down barriers to accessing care by providing text, online, and telephonic crisis support 24/7. Month over month, the 988 Lifeline continues to see increases in overall volume of individuals engaged.

In observance of Suicide Prevention Month, we wanted to take the opportunity to highlight some resources:

  • Our provider focused, free, accredited continuing education training Suicide Risk Prevention and Assessment supplies first contact healthcare clinicians with enhanced suicide prevention awareness, incorporating special risk populations. Login and create an account with the Centene Institute for Advanced Health Education to take this training.
  • The 988 Partner Toolkit offers a variety of awareness and educational materials that are regularly updated. The toolkit provides a 988 fact sheet (PDF), 988 FAQs, and more information about 988. You are able to order many educational and awareness materials free of charge for your office through the Substance Abuse and Mental Health Services Administration (SAMHSA) store.

We look forward to working with you to encourage use of this critical service to our community. Thank you for your partnership in supporting our members. Together, we can transform the health of communities – one person at a time.

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