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Provider Digest | Volume 42

Date: 06/29/22

Provider Satisfaction Survey: We Want to Hear From You!

In July, you will receive our annual Provider Satisfaction Survey. We value our provider partners and your feedback will help us understand how we can better serve you. 

The surveys are being sent via our vendor SPH. You will see the Trillium, Health Net, Wellcare By Health Net and/or Wellcare By Trillium logos on the surveys.

Please return the survey by mail or respond online via the survey link you receive. The survey will be open through 9/30/22.

Thank you for sharing your insights. If you have any questions, please contact your Provider Services Representative.

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Chiropractic and Acupuncture Prior Authorization Requests: Trillium Recognized Functional Scoring Tools

Trillium Community Health Plan does not require authorization for the first 8 visits for chiropractic and acupuncture care. However, if additional visits will be requested, a functional scoring tool recognized by Trillium is required to be completed within the first 8 visits AND when subsequent requests for authorization are submitted. After completion of 8 visits, prior authorization is required for continuation of care. Please submit clinical information that includes a recognized functional scoring tool (baseline and current) when requesting prior authorization. 

Below is a list of scoring tools recognized by Trillium and the Oregon Health Authority. Guide Line 56 also has acceptable tools and can be located via LipaLine. Please note that Oregon Health Authority excludes STarT Back Assessment Tool.

  • Neck disability index – Neck
  • Oswestry Disability Index – Back
  • Bournemouth Back questionnaire – back
  • Lower Extremity Function Scale (LEFS) – lower extremity, could also use on back if reasonable
  • QuickDASH – arm, shoulder, hand (Possibly neck if reasonable)
  • McGill Pain Questionnaire / Short-Form McGill Pain Questionnaire (Pain anywhere)

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Trillium Medicaid Bi-Annual Capacity Review

Oregon Health Authority (OHA) requires Trillium to report in-network provider capacity on a bi-annual basis to ensure members in our communities have access to high-quality healthcare. As a participating Trillium provider, please provide your current Trillium patient capacity here. As always, thank you for being a valuable provider partner in serving our community.

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Make Sure Your Patients Are Ready For Summer Fun

Summer is here and your patients may be participating in lots of indoor and outdoor activities, including travel. In addition, events like the World Athletic Championships in Eugene will bring larger numbers of people to Oregon. Encourage your patients and their families to stay safe and healthy this summer by getting COVID shots and booster shots when eligible, and ensuring children are up-to-date on their immunizations and well-child visits. Thank you for your partnership in helping our members stay healthy.

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Healthier Oregon: Better Care for More People

Starting July 1, 2022, more adults will be eligible for full Oregon Health Plan (OHP) benefits, regardless of immigration status. This program is known as “Healthier Oregon.”

Who is eligible?

People who live in Oregon who:

  • Meet income and other criteria
  • Currently don’t qualify for full OHP benefits because of their immigration status, and
  • Are 19-25 years old or 55 years and older

If you have patients who may be eligible for Healthier Oregon, please let them know.

For more information to share, please download the Healthier Oregon flyer (available in 10 languages). You can find also visit the OHA Healthier Oregon webpage.