private hospital directed payment (phdp) check-in call · l.a. care health plan (l.a. care) will be...
TRANSCRIPT
Private Hospital Directed Payment (PHDP)Check-In Call
Thursday, July 11th, 2019
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Agenda
1. Introduction & Meeting PurposeJames Alvarez, Program Manager, Enterprise Quality Management
2. Plan Partner Meeting James Alvarez, Program Manager, Enterprise Quality Management
3. SurveyMonkeyJames Alvarez, Program Manager, Enterprise Quality Management
4. Encounter Remediation James Alvarez, Program Manager, Enterprise Quality Management
5. Contract Flagging Schedule Updates James Alvarez, Program Manager, Enterprise Quality Management
6. General Updates and Reminders James Alvarez, Program Manager, Enterprise Quality Management
7. Questions & Answers (Q&A)
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Plan Partner Meeting James Alvarez, Program Manager, Enterprise Quality Management
Plan Partner Meeting
L.A. Care Health Plan (L.A. Care) will be hosting an on-site meeting for Hospitals and Plan Partners on 8/22/19 from 1:30 p.m. to 3:30 p.m.
• The purpose of the meeting is to facilitate discussions between Hospitals and Plan Partners regarding Encounter Remediation and Contract Flagging.
• Further details regarding logistics and attendance for the meeting will be sent out as we approach the meeting date.
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Plan Partner Meeting
Possible Agenda Topics:
• For any agenda topics that you would like to be discussed at the coming meeting, please email them to [email protected].
•We will be taking a look at all suggested topics and choosing the ones impacting the majority of hospitals.
• Once the agenda has been finalized we will be providing that to you prior to the meeting date.
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SurveyMonkey
James Alvarez, Program Manager, Enterprise Quality Management
SurveyMonkey
• We are in the process of developing a SurveyMonkey regarding L.A. Care’s PHDP program in order to identify successes, concerns and issues within the program.
• The survey will be distributed in early August and we hope to provide feedback regarding the results at the 8/22 Plan Partner meeting.
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Encounter Remediation James Alvarez, Program Manager, Enterprise Quality Management
Encounter Remediation
• At this time L.A. Care is still in the process of completing its Edifecsimplementation.
- We do not anticipate distributing Encounter data for the service period of 07/01/2018 to 12/31/2018 until mid-August.
• Tentative scheduling includes:
- Submitting FFS claims until around the end of October
- Submitting Remediated Encounter Data by the end of November
• We will publish a definitive schedule when we distribute the Encounter Data files in August.
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Contract Flagging Schedule UpdatesJames Alvarez, Program Manager, Enterprise Quality Management
Contract Flagging Schedule Updates
• The Plan Partners requested additional time to flag the records in the 6/14/19 Volume Chart.
• We are now revising our schedule to include the following dates:
Activities Start Date End Date
Create files for Partners and Distribute 07/08/19 07/09/19
Receive files from Partners 07/17/19
L.A. Care prepares files for Hospitals and Distributes
07/18/19 07/19/19
Hospitals review period 07/22/19 07/26/19
L.A. Care performs updates and needed 07/22/19 07/26/19
L.A. Care prepares master file 07/29/19 07/30/19
L.A. Care submits file to DHCS 07/31/19
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General Updates and RemindersJames Alvarez, Program Manager, Enterprise Quality Management
General Updates and Reminders
• In order to receive any files for either Contract Flagging or Encounter Data you will need to have an sFTP site setup with L.A. Care.
- Please reference the following slide for instructions on setting up an sFTP.
• Forward all inquiries to the [email protected].
• There will NOT be a Webinar on July 25, 2019.
• The next webinar is scheduled for August 08, 2019.
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General Updates and Reminders
L.A. Care sFTP Access
• A Secure Connection Credentials (PGP) using an sFTP protocol must be established to send and receive encounter data. To do this, L.A. Care will need a static IP address that we will use to grant permissions to the site. If you do not currently have one, your Internet provider should be able to set one up for you.
• Once you have the static IP address, please email [email protected] and provide the following information:
1. Provide the contact information for the point of contact (POC) who will be responsible for sending and receiving the Encounter data on the sFTP site
2. Provide the static IP address
• Once your email has been received, you will be contacted for next steps.
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Questions and Answers (Q&A)
As a reminder, please send any PHDP-related
inquiries to [email protected]
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