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Provider Digest | Volume 142

Date: 10/02/24

Trillium Medicaid Providers: Take the 2024 Social Needs Screening Inventory Survey 

Trillium is launching this Social Needs Screening Inventory Survey to gather responses necessary to pass the new Social Needs Screening and Referral CCO incentive metric. The survey will be used to conduct an environmental scan to help us identify how members are being seen, the capacity of health-related social needs referrals, resources available, and the gaps that must be addressed.
 
Organizations who complete this survey by October 31 may be eligible to earn a bonus which is outlined within Trillium's 2024 CCO Quality Pool Bonus Funds Program. Thank you for your partnership in helping our members stay healthy. 

Note: If you would like to gather the information before taking the online survey, please view the Social Needs Screening Inventory Survey in PDF format.

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Trillium, Health Net and Wellcare Transition to Availity Essentials in January

Trillium Community Health Plan (Trillium), Health Net Health Plan of Oregon, Inc. (Health Net), Wellcare By Health Net (Wellcare) and Wellcare By Trillium Advantage (Wellcare) have chosen Availity Essentials as our new, secure provider portal. Starting January 20, 2025, you can validate eligibility and benefits, submit claims, check claim status, submit authorizations, and access Trillium, Health Net and Wellcare payer resources via Availity Essentials.

If you are already working in Essentials, you can log in to your existing Essentials account to enjoy these benefits for Trillium, Health Net and Wellcare members beginning January 20, 2025: 

  • Use Availity Essentials to verify member eligibility and benefits, submit claims, check claim status, submit authorizations, and more.
  • Look for additional functionality in Trillium's, Health Net's and Wellcare’s payer spaces on Essentials and use the heart icon to add apps to My Favorites in the top navigation bar. Our current secure portal will still be available for other functions you may use today.
  • Access Manage My Organization – Providers to save provider information. You can then auto-populate that information repeatedly to eliminate repetitive data entry and reduce errors.  

If you are new to Availity Essentials, getting your Essentials account is the first step toward working with Trillium, Health Net and Wellcare on Availity.

Getting Started: Designate an Availity Administrator for your Provider Organization

Your provider organization’s designated Availity administrator is the person responsible for registering your organization in Essentials and managing user accounts. This person should have legal authority to sign agreements for your organization.

  • If you are the designated Availity administrator for your organization, visit Register and Get Started with Availity Essentials to enroll for training and access other helpful resources.
  • If you are not the designated Availity administrator for your organization, your designated Availity administrator will determine who needs access to Availity Essentials on behalf of your organization and will add user accounts in Essentials.  
  • If you are not sure who will be the designated Availity administrator for your organization, share this information with your manager to help determine who will be the designated Availity administrator for your organization.  

We will be hosting webinars to provide an overview of Availity Essentials. You'll learn how to verify eligibility and benefits, submit claims, check claim status, submit authorizations, and more. Dates will be shared closer to the effective date of January 20, 2025.

If you need additional assistance with your registration, please call Availity Client Services at 1-800-AVAILITY (282-4548). Assistance is available Monday through Friday, 8 a.m. – 8 p.m. ET. For general questions, please reach out to your assigned health plan Provider Engagement Representative.

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Responses Due February 28, 2025:Trillium Medicaid Bi-Annual Capacity Review

Have you completed the Trillium Provider Capacity Survey yet?

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. The survey is only four questions and takes approximately 2 minutes to complete.

Please take the survey by February 28, 2025.

Thank you for your partnership in helping our members stay healthy!

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