Provider Alert Reports explanation
Practice-specific Provider Alert reports were distributed on Friday, November 4, 2011, to your primary care practice MN-ITS mailbox that includes information about patient coordination and continuity of care.
Who should read this?
This message and the Provider Alert report should be directed to the health care home team member(s) who work with the patient registry to determine who qualifies for care coordination and the Health Care Home (HCH) tier level estimated for each patient.
Who received this report?
Clinics who received this report are certified as a Health Care Home, participating in the Primary Care Coordination program or the ABCD program.
Why did I receive this report?
DHS is committed to providing timely, relevant, and actionable data to providers to help facilitate the successful care coordination of services for their MHCP patients. This report is still considered to be in the ‘pilot’ phase. If you have feedback on the Excel format, MN-ITS mailbox delivery system, or the content of the report, please share your feedback by responding to this email (please DO NOT hit ‘reply all’) OR by emailing Rachel Tschida. We hope to send monthly Provider Alert reports and are developing more specific patient-level reports as well.
How was this report generated?
Practice-specific Provider Alert reports were generated for providers to review patients for whom a claim was submitted for an emergency room visit or hospital admission that happened in September, 2011 and was paid by the mid-October billing cycle. DHS Medicaid enrollment and claims data were used to create this report.
Which of my patients appear on this report?
Patients were attributed to the clinic they visited most frequently for HCH care coordination (S0280/S0281) and Evaluation and Management (E&M) services, during the previous 24 months, ending on the last day of the report month. Each recipient of HCH services was assigned to the clinic associated with the most recently submitted care coordination (S0280/S0281) claim. All other patients on your list were attributed to the clinic most frequently seen for E&M visits in the previous 24-month period. If the patient had equal numbers of E&M visits to multiple clinics, the recipient was assigned to the clinic visited most recently.
What data will I find in this report?
This report includes information related to coordination and continuity of care including:
- Hospitalizations and emergency room visits
- Health care home provider or majority source of care provider
- Probability of hospitalization in the next 12 months
- Health care home claims status
-Estimated HCH Tier
-Need for interpreter
-Mental health conditions
Where can I find the Provider Alert file?
The Provider Alert file can be found in your MN-ITS Mailbox under Miscellaneous Received, in File Type Provider File. Contact your MN-ITS Administrator in your business office if you need access to the MN-ITS Mailbox. If you need more information about MN-ITS please contact the Provider Call Center at 651-431-2700 or toll free 1-800-366-5411 and press 6.
How to read the report
A Provider Alert Reference Guide is available on the DHS Provider Manual. It includes definitions of all of the data elements on your report.
What if I have more questions?
If you have more questions about the Provider Alert file please contact Dean Ewald at 651-431-3009.
Thank you for your help and feedback as we all continue to work to improve primary health care services and outcomes for Minnesotans.
