Provider Newsletter ABOUT YOUR HEALTH is published as a service for members of the EL PASO HEALTH Provider network. EL PASO HEALTH Executive Offices are located at 1145 Westmoreland Drive, El Paso, TX 79925, 915-532-3778 or 1-877-532-3778, elpasohealth.com. Information in ABOUT YOUR HEALTH comes from a wide range of medical experts. If you have any concerns or questions about specific content in this newsletter, call 1-877-532-3778. Models may be used in photos and illustrations. Member Services 1-877-532-3778 EPHP7472307-EPH-PR-Fall 2023 Provider Newsletter 2023 © Coffey Communications, Inc. All rights reserved. stay informed Noninvasive prenatal testing codes no longer require authorization El Paso Health (EPH) continues to improve health outcomes for our members. As of July 1, 2023, EPH has removed the prior authorization requirement for noninvasive prenatal testing (NIPT) for our in-network Providers. This means it is even easier for our Providers to provide high-quality care with less administrative burden. The CPT codes that no longer require prior authorization are the following for in-network Providers: ■CPT 81220 ■CPT 81243 ■CPT 81420 Please keep in mind that outof-network Providers continue to require prior authorization for the CPT codes listed. We encourage our Providers to use EPH in-network laboratory Providers to expedite these services. If you have any questions, please feel free to reach out to the Prior Authorization Department at 915-532-3778. Quality Improvement Initiatives: What you need to know HHSC holds El Paso Health (EPH) accountable to a variety of quality measures through varying initiatives. Based on 2021 data, EPH was asked to implement a variety of interventions to help drive performance on measures that were not performing to standard. Many of these initiatives include text messages and outreach to members to encourage them to schedule and keep their appointments with their Primary Care Provider and / or specialists. Some of the topics recently targeted include: ■Eye exams for members diagnosed with diabetes. ■Follow-up treatment after an Emergency Department visit for behavioral health. ■Encouraging members to know their Primary Care Provider. ■Educating pregnant members on the risk factors of having a baby with low birth weight. EPH takes steps to outreach and educate our members, but our Providers also play a key role in the success of our Quality Improvement Program! Everything from ensuring proper documentation during Well-Child visits to educating members on appropriate use of antibiotics contributes to meeting our goals. Things Providers can do to help ■Ensure adequate appointment accessibility. ■Make sure members have a follow-up appointment scheduled before they leave your office. ■Take steps to ensure adequate stock of vaccines. ■Make appropriate referrals to specialists as needed. ■Order appropriate labs and screenings based on specific risk factors. Please contact the Quality Improvement Department at 915-532-3778 if you have any questions. As always, we look forward to your continued cooperation on all our quality initiatives!
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