3 stay informed El Paso Health welcomes a new pharmacy director We’re thrilled to share some exciting news with our El Paso Health Providers! We’d like to announce the addition of a pharmacy director to our team: Angel Palacios. This marks a significant milestone for us, as it’s the first time we’ve welcomed a pharmacist into our organization. Our new pharmacy director will play a pivotal role in enhancing our services and furthering our commitment to excellence in health care. One of his primary responsibilities will be to assist in the authorization reviews for clinicianadministered drugs, with a key focus on improving turnaround times. This strategic Dr. Angel Palacios Meet El Paso Health’s Special Investigations Unit team In compliance with Texas regulations, managed care organizations like El Paso Health are mandated to establish robust procedures for preventing and detecting waste, abuse, and fraud within the health-care system. At the forefront of this effort is El Paso Health’s Special Investigations Unit (SIU), dedicated to safeguarding the integrity of health-care services. The SIU team includes dedicated professionals committed to upholding the integrity of health-care services. Among them are Alina Macias, a specialized claims auditor holding certifications in billing and coding; Jennifer Herrera, SIU assistant; and Ismael Gamez, an experienced clinical registered nurse. Their combined expertise and vigilance play an essential role in safeguarding against fraud, waste, and abuse and promoting ethical health-care practices within our network. Proactively addressing potential risks and ensuring adherence to regulatory standards, El Paso Health’s SIU team contributes significantly to fostering trust and confidence in the health-care services provided to our members. SIU, along with our organization, remains committed to our mission of delivering high-quality care while maintaining the highest standards of integrity and accountability. SIU audits focus on several key aspects, including ensuring accurate documentation and proper coding, obtaining required authorizations prior to services, and monitoring service frequency within approved limits. Let’s work together to maintain the integrity of our health-care system and prioritize the well-being of our community. initiative underscores our dedication to providing timely and efficient care to our members. By integrating the expertise of a pharmacist into our team, we’re not only elevating our internal capabilities, but also strengthening our relationships with pharmacy providers. At El Paso Health, we’re continuously striving to enhance the quality of care we deliver to our members. The addition of our pharmacy director is another step forward in this journey. We’re confident that our new pharmacy director will bring fresh perspectives, invaluable insights, and a wealth of experience to our organization. This expertise will undoubtedly contribute to our mission of being the region’s trusted health plan. We look forward to the positive impact he’ll make on our organization, and, most importantly, on the lives of our members. Here’s to continued growth, collaboration, and excellence in health care at El Paso Health! Alina Macias Jennifer Herrera Ismael Gamez When in doubt, don’t hesitate to reach out! You can contact our waste, fraud, and abuse hotline at 1-866-356-8395. Remember: You can choose to remain anonymous.
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