When patients, providers, and health insurance companies work together, we can create happier, healthier communities. CDPHP values the partnership we have with you and wants to ensure you have the resources you need to get your job done. From easy access to patient benefit and claims information through the provider portal to in-office visits from our provider relations team, CDPHP is committed to working with you.
Chances are the health care landscape today looks much different than when you started your career: regulations are implemented and then change, quality measures evolve and shift, and patients face an increasingly complicated and costly system. We’re committed to keeping you up to date with news you need to know. Visit here often for the information and resources you need to stay current on the local health care landscape.
Throughout 2020, the CDPHP Enterprise Training team will be offering free, monthly “White Glove” customer service training classes for providers, their management staff, and office personnel. The classes, which will be held at our Patroon Creek headquarters, will include:
A 2-hour leadership session geared for the medical practice’s management staff
A 3-hour customer service training designed for the office staff
The health care app ER Anywhere, developed by United Concierge Medicine, aims to reduce health care costs, relieve stress on emergency personnel and agencies, and improve patient care by offering CDPHP Medicaid members a convenient alternative to emergency room (ER) visits. By downloading the ER Anywhere app via Apple Store or Google Play, or by calling 1-866-ER-ANYWHERE, patients can consult with an emergency medical provider about acute medical issues 24/7. Emergency personnel then triage the patient, determining whether their condition warrants ambulance transport, medication, testing, or a follow-up appointment with a physician.
CDPHP® strives to enhance awareness and empowerment related to health care and to address barriers that affect the community, internal staff, and medical providers. To this end, CDPHP created an internal Diversity Matters workgroup, which focuses on cultural competence, health literacy, and health disparities. The goals are to investigate the challenges that impact the social determinants of health and develop strategies for improving the overall wellness and satisfaction of our members and our community.
New York state requires CDPHP, as a Medicaid Managed Care plan, to implement a Children’s Behavioral Health Pharmacy Program that includes the monitoring and oversight of key medications for children. Effective February 1, 2020, prior authorization will be required for:
Quarterly, Capital District Physicians’ Health Plan, Inc. (CDPHP®) implements appropriate code auditing changes to remain current with industry standard coding updates. Updates are made to our code auditing software Change Healthcare Technologies, LLC ClaimsXten™ based on recommendations from a variety of sources, including the American Medical Association (AMA), Centers for Medicaid and Medicare Services (CMS) Correct Coding Initiative and Medically Unlikely Edits, input from specialty organizations, the CPT® manual, and the HCPCS Level II manual.