Partners For Kids - Humana Agreement
Partners For Kids is now contracted with AmeriHealth Caritas and Humana’s managed Medicaid plans. Both contracts went into effect February 1. Announcement letters regarding the AmeriHealth agreement were sent to providers in November. Announcements regarding the Humana agreement were sent to providers January 31. Providers who wish to opt out of participation in this agreement must notify Partners For Kids in writing by end of day February 14.
Orientation sessions for Humana have been scheduled for February 20 at noon and February 23 at 7 a.m. Click here to pre-register for the February 20 session and here for the February 23 session.
Partners For Kids is currently out-of-network for Anthem’s Medicaid plan. Learn more on how to help patients select another health plan, so that they may still be seen in your practice.
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Enhancements to Find a Provider Tool
The Find a Provider tool on the Partners For Kids website now includes providers who are credentialed in our West Central Region counties. The tool will continue to be updated monthly.
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In Case You Missed It: AmeriHealth Caritas Overview Presentation
Thanks to everyone who attended the January 31 and February 1 AmeriHealth Caritas information session. If you were not able to attend, click here to view the overview presentation. If you have questions, reach out to your Partners for Kids provider relations representative.
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Save The Date: Next Partners For Kids Quarterly Webinar
Save the date of Thursday, April 26, from noon to 1 p.m. for our next quarterly webinar on “Increasing Immunization Rates: Worth the Shot,” by Kate Krueck, MD and Dr. Matt Washam, MD. As a reminder, participating in a quarterly webinar fulfills your primary care network requirement for 2023. Webinar links will be sent as the date approaches. Please reach out to PFKProRelations@childrensdayton.org with questions.
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Now Available: Constipation Resources
Partners For Kids has two new constipation resources available on our website. Practices can use a constipation resource guideline on how to manage functional constipation in a primary care setting along with important information regarding medication coverage. Additionally, there is a patient facing tool to educate families on functional constipation that contains an action plan to guide patients through the clean-out process.
A constipation cooking class is also available for parents and kids at the Connor Child Health Pavillion. To learn more or register, please call 937-641-4667.
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Reminder: 2023 Partners For Kids Primary Care Network Requirement
Every Partners For Kids credentialed primary care provider must participate in at least one activity that satisfies the Partners For Kids primary care network requirement by December 31 to ensure eligibility for 2023 incentive bonuses. Click here to view qualifying activities that will help you meet the 2023 network requirement.
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Partners For Kids Quarterly Webinar Recording Now Available
The recording of the January 16 quarterly webinar, “Asthma in Primary Care,” featuring Lisa Ulrich, MD, and Daniel Evans, MD, is now available.
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Quality Improvement Spotlight: Lead Screening
Evidence shows that compliance with lead screening increases when testing is initiated at the point of care for preventive services (provider’s office) when compared to a separate trip to an outside lab facility for testing. The Partners For Kids Lead QI project assists practices with the implementation and optimization of lead screening. As a reminder, lead testing is also a Provider Incentive Plan measure for primary care providers in 2023.
If you would like further information on this project, have questions, or would like to begin this work please reach out to the PFK QI Team at PFKQICoaching@childrensdayton.org.
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Pharmacy and Prescribing Updates |
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RSV season has ended in Ohio – Synagis® prior authorizations have expired for all Ohio Medicaid patients
Respiratory syncytial virus (RSV) rates have declined across Ohio to levels that signal the end of the 2022-2023 RSV season. Effective February 15, 2023, Synagis® prior authorizations will not be approved for Ohio Medicaid patients. In addition, any active Synagis® prior authorizations received through Gainwell and ChangeHealthcare have expired on February 15th. If there are extenuating circumstances where a patient requires RSV prophylaxis beyond this date, Gainwell and ChangeHealthcare will consider those requests on a case-by-case basis.
If you have any questions please do not hesitate to reach out to the Partners For Kids pharmacy team (PFKPharmacy@childrensdayton.org).
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Asthma Pathway and Prescribing Guidelines
A newly updated asthma pathway is now available for your reference. This guide assists in the evaluation and management of patients with different severities of asthma.
For questions or to arrange a visit with the pharmacist, please email PFKPharmacy@childrensdayton.org
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February Managed Care Plan Updates
CareSource has published a variety of updates and policy changes. Click here to view a comprehensive overview
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- February 20, noon to 1 p.m.: Humana Information Session
- February 23, 7 a.m. to 8 a.m.: Humana Information Session
- Week of February 27: Primary care incentive check distribution
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April 26, noon to 1 p.m.: Partners For Kids Quarterly Webinar: “Increasing Immunization Rates: Worth the Shot,” presented by Kate Krueck, MD, Dr. Matt Washam, MD
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If your patient is currently receiving WIC or SNAP benefits, they will be automatically re-enrolled in Ohio Medicaid. As the Medicaid re-enrollment process starts this month, please encourage patients who may be eligible to apply for these benefits. For patients who are not eligible, encourage them to update their contact information with the Ohio Department of Job & Family Services to ensure they are informed when it’s time to re-enroll in Medicaid. Learn more about the eligibility criteria for WIC or SNAP benefits.
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Contact Partners For Kids Provider Relations
If you have questions regarding any of the information in this newsletter or suggestions regarding newsletter content that would be useful to your practice, please contact us at PFKProRelations@childrensdayton.org.
Visit us at PartnersForKids.org
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