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Provider Digest | Volume 155

Date: 01/29/25

Trillium 101: Access to Care Sessions

Would you like to learn more about Trillium and how we can collaborate with you to improve the health of our members and local communities? 

Please join us for “Trillium 101: Access to Care.” Facilitated by Kristinia Rogers and Lamar Tillman, Trillium’s Traditional Health Worker Liaisons, this interactive session for providers and community partners explores a variety of topics about our organization’s programs and services, including:

  • CCO Service regions
  • Interpreter Services
  • Case Management Programs
  • Behavioral Health 
  • Traditional Health Workers
  • Dental Care 
  • Non-Emergent Medical Transportation (NEMT) 
  • Health-Related Social Needs (HRSN)
  • Flexible Services
  • Telehealth & Nurse Advice Line
  • Connect Oregon
  • Grievance and Appeals 

Sessions take place on the fourth Tuesday of every month, February-June, from 11:30 a.m.-12:30 p.m:

Register for Trillium 101: Access to Care

If you need accommodations or would like to schedule an individual session for your team/organization, please contact THW@TrilliumCHP.com.

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    Trillium Medicaid Providers: Helping You Care for Your Patients is Our Top Priority

    Strong communication and trust between you and your patients will help ensure they’re satisfied and have good outcomes. You can rely on Trillium Community Health Plan for information and support to help you keep those patient relationships strong.

    Annual CAHPS Survey
    Happening February Through May
    The Consumer Assessment of Healthcare Providers and Systems (CAHPS) Health Plan Survey is an opportunity for your patients to share their healthcare experiences with you as their provider and with their health plan. Your patients are asked specific questions, which include how well their doctor communicates, if they felt their doctor listened to them, and if their doctor explained things in a way that was easy to understand. Also included are questions on how well different healthcare providers are communicating about care coordination and a (0-10) rating of the patient’s overall satisfaction with their healthcare, personal doctor, and specialists.

    Annual Provider Satisfaction Survey
    You are essential to providing the highest quality healthcare possible for our members, and your satisfaction is very important to us, too. We assess your experience with us through an annual Provider Satisfaction Survey. These survey results are reviewed by the health plan and are key to helping us improve your experience, so please be sure to complete the survey if you receive one.

    Our Support Doesn't Stop There
    Our provider website contains essential information, including member surveys, health equity resources, language services and resources, provider credentialing rights, the utilization management process, how to access care management services and other sources of support for you. Read more on Trillium's Providing Quality Care webpage. If you have additional questions or need specific support, call Provider Services at 1-877-600-5472.

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      Trillium Medicaid Providers: Annual Fraud, Waste and Abuse Training

      The Oregon Health Authority requires all coordinated care organizations to ensure Medicaid providers have access to an annual Fraud, Waste and Abuse training. 

      Please review Trillium's Fraud, Waste and Abuse (FWA) Annual Training for Healthcare Providers (PDF) to learn more about:

      • Definitions of FWA
      • FWA laws
      • Billing practices
      • Reporting FWA

      If you have any questions, please contact your assigned Provider Engagement Representative. Thank you for your partnership!

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      New Nutrition Benefit for Trillium Medicaid Members

      Through Oregon’s Health-Related Social Needs (HRSN) Initiative, Coordinated Care Organizations (CCOs), providers, community organizations, and others offer a set of non-medical services through Medicaid to Oregon Health Plan (OHP) members. HRSN services include housing-related supports, nutrition services, and climate devices for qualifying individuals experiencing a life transition.

      Trillium's HRSN nutrition benefit launched on January 1, 2025 and helps provide medically appropriate foods to people with qualifying life and health conditions. 

      Possible support for qualifying Trillium Medicaid members includes:

      • Nutrition Education
      • Medically Tailored Meals
      • Medically Tailored Meals Assessment

      To qualify for HRSN nutrition benefits, at a minimum, the Oregon Health Authority (OHA) requires that individuals must: 

      • Be an Oregon Health Plan member AND 
      • Have at least one of the following health conditions AND 
        • Complex physical health condition 
        • Complex behavioral health condition 
        • Developmental or intellectual disability 
        • Difficulty with self-care and daily activities 
        • Experience of abuse or neglect 
        • 65 or older 
        • Under age 6 
        • Pregnant or gave birth in the past 12 months 
        • Repeated use of emergency room or crisis services AND
      • Screen positive for low or very low food security AND 
      • Meet other benefit-specific requirements, depending on the benefit.

      To learn more about eligibility requirements for the HRSN nutrition benefit, visit the Oregon Health Authority's Nutrition Benefits webpage.

      To learn more about Trillium's HRSN nutrition benefit or refer a Trillium member, visit www.trilliumohp.com/hrsn.

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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. 
      • Download the Availity Essentials Resources Flyer for helpful tips and information

      Training webinars
      Starting January 21, 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.

      • Sign up for the webinars 
      • Note: Providers are required to sign in to Essentials first, then they will be redirected to the list of webinars.

      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 Administrator:

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