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.
On an annual basis, CDPHP assesses member satisfaction with their health care providers and our health plan using the Consumer Assessment of Healthcare Providers and Systems (CAHPS®) and Health Effectiveness Data and Information Set (HEDIS®) surveys. Members rate their satisfaction with various aspects of health care, including their health plan, overall health care, primary and specialty care, provider communication, shared decision making, health promotion, coordination of care, and access to care. At CDPHP, we use the results to enhance members’ care experience by building on our strengths and making necessary changes to address any areas that could be improved.
In a move designed to relieve some of the administrative burdens experienced by medical practices within our network, CDPHP is removing the requirement for prior authorization for the following services and procedures, effective January 1, 2020:
Quarterly, Capital District Physicians’ Health Plan, Inc. (CDPHP®) implements appropriate code-auditing changes to remain current with industry standards. 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 coding system.
While helping adolescents avoid unintended pregnancies, sexually transmitted infections, depression, eating disorders, and substance abuse is necessarily a community-wide initiative, primary care providers are in a great position to support teens and their families in this effort. Indeed, a healthy transition to adulthood relies on having a non-judgmental adult who can offer accurate information about sensitive topics like sex, birth control, sexually transmitted infections, body image issues, smoking, depression, and substance use/abuse, among others.
CDPHP is supporting a New York State Department of Health (NYSDOH) performance improvement project to promote screening, testing, and linkage to services for Managed Medicaid members ages birth to three years. The initiative focuses on achieving improved health outcomes for these children and educating parents/caregivers about the negative consequences of lead exposure, newborn hearing loss, and undiagnosed developmental delays.
CDPHP has partnered with multiple community organizations to identify resources that can help remove barriers to care for those members who are grappling with issues like food insecurity, housing instability, and transportation. If your CDPHP patient needs this type of assistance, you can call our Single Source Referral Line at 1-888-942-3747, providing the patient’s name, date of birth, and social determinant of health issue, and we will connect the member to the appropriate local resource.