El Paso Health | About Your Health | Summer 2021

2020 Provider satisfaction survey results Provider satisfaction is of the utmost impor tance to El Paso Health (EPH) and is a key element of the quality improvement program. For the last 5 years, EPH has contracted with SPH Analytics to conduct annual Provider satisfaction sur veys. A random sample of Providers is selected to provide feedback on a variety of domains to include finance issues, utilization and quality management, coordination of care, pharmacy, health plan call center staff, Provider Relations, and overall satisfaction. Results are compared to previous years’ performance and to 2 SPH Book of Business benchmarks for Medicaid and for the Texas Association of Community Health Plans (TACHP). For the third year in a row, results of each domain of the 2020 sur vey significantly outperformed both the Medicaid and TACHP benchmarks. The highest performing domain was “Health Plan Call Center Ser vice Staff” with a score of 56%. EPH Providers were also asked to provide an overall satisfaction rating for El Paso Health and 2 other MCOs in the area. Providers gave EPH the highest overall satisfaction rating with a score of 93%, an increase from last year. As always, we thank you for the quality care you provide our members, and we appreciate your continued cooperation in our ongoing quality initiatives. We look forward to improving our relations with all Providers and providing the best customer ser vice. If you have any questions, please contact the Provider Relations depar tment at 915-532-3778 . resources E l Paso Health is committed to preventing fraud, waste, and abuse in order to comply with the Office of the Inspector General’s directive. In times of crisis and uncertainty, like today’s global COVID-19 crisis, this represents an even greater challenge. Therefore, we must stay on top of the ever-changing health- care fraud and abuse schemes. Both the Centers for Disease Control and Prevention and the Centers for Medicare &Medicaid Services have released a set of toolkits for Providers, states, and insurers to help the health-care system prepare and assist in swiftly administering vaccine products as they become increasingly available. These resources are designed to increase the number of Providers who can administer the products and ensure adequate reimbursement for administration in Medicare, while making it clear to private insurers and Medicaid programs their responsibility to cover these products at no charge to beneficiaries . These webpages also provide the payment allowances and other related information, such as HCPCS codes, for these products. ■ cms.gov/medicare/medicare-part -b-drug-average-sales-price/covid-19 -vaccines-and-monoclonal-antibodies ■ cdc.gov/vaccines/covid-19/health -systems-communication-toolkit.html ■ cms.gov/covidvax-provider Examples of vaccine-related waste, abuse, and fraud include: ■ Selling or otherwise misdirecting a vaccine. ■ Billing a patient or third party for a vaccine (other than administration fees). ■ Failure to meet licensure requirements for enrolled Providers. ■ Sending a parent or guardian to collections or charging additional fees for non-payment of the administration fee. ■ Failure to properly store and handle a vaccine, which can lead to negligent waste. ■ Ordering a vaccine in quantities or patterns that do not match Provider profile or otherwise involve overordering of doses. If you suspect fraud, waste, or abuse, you can report it to our hotline at 1-866-356-8395 . Preventing fraud, waste, and abuse 3