Gaps in Service Update: Consultative Services for Behavior Plans Survey Results on Network Providers Qualified to Complete Behavior Plans Two (2) emails were sent to all network providers requesting them to submit information on individuals in the Network qualified to do Behavior Plans. Three (3) providers responded Recommendation: Continue to reach out to those providers in our network. Target the eight (8) in our catchment area and reach them by phone so we will know why they would not be interested. B3 Waiver: Concern of billing trends of two providers: Further review of the specifics of billing and any issues. QOC’s Committee Highlights Top Significant Accomplishments Identified Accomplishment Factors That Supported Success Documented MD initial credentialing information that thoroughly assisted in the re-credentialing process. Re-Credentialing Mailing Notification: Timely mailing and consistent process Enhanced oversight process with Network manager, MD and QM NC Projects in Assistance in Transition from Homelessness Program (PATH) awarded to RFP released and provider awarded contract. provider B3 Services Implementation: Respite, Community Guide, Peer Support, SE/MH, SE/IDD, Personal Care, Physician Network Development support and collaboration with Consult SHC departments and community stakeholders/providers Pending: One Time Transitional Cost and NC Innovations Services NC TOPPS: Have met state performance Coordination with QM Department and Credentialing standard of 90% for Three consecutive quarters. monitoring and reminders to providers. Will request to terminate this QIP. Identified Areas of Need and Possible Solutions Item/Area of Need Identified Recommended Solutions Review and revision of procedure and sanction grid. Sanction and dispute process Procedure QM 36a Continue to enhance the contract process via the QIP 100% Execution of contracts Goals Re-Credentialing and Shaping the Network: Establish billing requirement and/or evaluate current Providers who to contract requirements. haven’t billed. But decline voluntarily terminate or amend their Data reports that identify actual needs per contract. catchment zip code
Gaps in Service Update: Consultative Services for Behavior Plans Survey Results on Network Providers Qualified to Complete Behavior Plans Two (2) emails were sent to all network providers requesting them to submit information on individuals in the Network qualified to do Behavior Plans. Three (3) providers responded Recommendation: Continue to reach out to those providers in our network. Target the eight (8) in our catchment area and reach them by phone so we will know why they would not be interested. B3 Waiver: Concern of billing trends of two providers: Further review of the specifics of billing and any QOC’s issues. Committee Highlights Top Significant Accomplishments Identified Accomplishment Factors That Supported Success Re-Credentialing Mailing Notification: Timely mailing and consistent process Documented MD initial credentialing information that thoroughly assisted in the re-credentialing process. Enhanced oversight process with Network manager, MD and QM NC Projects in Assistance in Transition from Homelessness Program (PATH) awarded to provider RFP released and provider awarded contract. B3 Services Implementation: Respite, Community Guide, Peer Support, SE/MH, SE/IDD, Personal Care, Physician Consult Pending: One Time Transitional Cost and NC Innovations Services Network Development support and collaboration with SHC departments and community stakeholders/providers NC TOPPS: Have met state performance standard of 90% for Three consecutive quarters. Will request to terminate this QIP. Coordination with QM Department and Credentialing monitoring and reminders to providers. Identified Areas of Need and Possible Solutions Item/Area of Need Identified Recommended Solutions Sanction and dispute process Review and revision of procedure and sanction grid. Procedure QM 36a 100% Execution of contracts Continue to enhance the contract process via the QIP Goals Re-Credentialing and Shaping the Network: Providers who haven’t billed. But decline to voluntarily terminate or amend their contract. Establish billing requirement and/or evaluate current contract requirements. Data reports that identify actual needs per catchment zip code
QMC-Exec-Summary-April-June-2015-6-22-15.docx