2 stay informed Access and Availability Standards for Specialty Providers Timeliness of care is defined by the National Academy of Medicine as “reducing waits and sometimes harmful delays for both those who receive and those who give care.” In accordance with the Texas Health and Human Services Commission and Texas Department of Insurance mandates, El Paso Health must monitor our Providers on an annual basis for office accessibility compliance. Our Quality Assurance and Performance Improvement programs monitor these standards. El Paso Health members must be able to schedule an appointment for covered specialty services within the time frames mandated by TDI and HHSC: ■Specialty routine care must be provided within 21 calendar days of request. ■Specialty therapy (PT / OT / ST) evaluations must be provided within 21 calendar days of submission of signed referral. Having timely appointments for our members aids in their care and may possibly avoid unnecessary emergency room visits and hospitalizations. As always, we thank you for the quality care you provide our members, and we appreciate your continued cooperation in our ongoing quality initiatives. If you have any questions on the requirements, please contact the Provider Relations or the Quality Improvement Department at 915-532-3778. Advantages of billing your claims electronically through a clearinghouse Did you know El Paso Health accepts electronic claims from Availity and Trizetto Provider Solutions, LLC? Billing your claims through a clearinghouse offers several advantages, such as speed, accuracy, cost-effectiveness, transparency, and compliance. Electronic claims are transmitted instantly. This leads to quicker processing and payment from El Paso Health. When you submit your claims electronically, it also reduces errors that can occur during data entry. Clearinghouses validate accuracy, reducing rejections or denials from El Paso Health. When you submit your claims electronically, you can track real-time transmission and your rejections immediately. Also, clearinghouses comply with industry standards, such as HIPAA, which mandate secure electronic transactions for health-carerelated transactions. Securely file your claims electronically and receive a notice of submission. Contact our Provider Relations Department at 915-532-3778, ext. 1507, if you need assistance. Below, please find El Paso Health’s Payer ID Numbers: ■El Paso Health—STAR: EPF02 ■El Paso Health—CHIP: EPF03 ■Preferred Admin. UMC: EPF10 ■Preferred Admin. EPCH: EPF11 ■Healthcare Options: EPF37 El Paso Children’s Hospital Multispecialty Center Set in the heart of El Paso, the new El Paso Children’s Hospital Multispecialty Center is home to some of the most talented surgeons and specialists in the nation, dedicated to providing quality care to patients in a space designed specifically for children and their families. The new space includes 52 exam rooms, 10 infusion bays, audiology services, a state-ofthe-art lab, and radiology services. This model of care brings together El Paso Children’s Hospital, Texas Tech, and community physicians under one roof, providing a multidisciplinary approach to patient care found in larger children’s hospitals across the nation. The center, located at 5400 Alameda Ave. in the former Food City building, was beautifully redesigned and is now home to expert physicians and their care teams, treating a vast number of conditions affecting children across the region. Children’s hospitals across the nation have long provided multidisciplinary clinics for their most vulnerable patients, and that model of care is now available here in El Paso. Clinics like brachial plexus, cystic fibrosis, cranial and facial, spina bifida, and vascular anomalies are designed to have patients come to one clinic visit and be seen by all of their specialists and members of their care team. This service helps eliminate the need for parents to drive all across town, and sometimes out of town, in order for their children to see all the doctors necessary to treat them for various conditions.
RkJQdWJsaXNoZXIy MjI2MTU5NA==