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Comprehensive Primary Care Plus Updates 
May 2, 2018
CPC+ Updates and Reminders

New Utilization and Quality Reports
New reports including data through 12/31/2017 are available on the  My Account  portal. The reports cover gaps in care and detail on high-cost members. 
Supplemental Data for Quality Measures
A key element of CPC+ is the monitoring of quality data. We report data back to CPC+ providers on 10 quality measures. Most data is generated from claims. However, you may have additional data that can improve your quality scores. Examples: You may have medical records of a member having a colonoscopy prior to enrollment with QualChoice. Or a member who had a total hysterectomy does not need to be included in the cervical cancer screening measure.
To improve your 2017 quality measure ratings, you may submit the CPC+ Supplemental Data Submission Form, now available on the portal. Follow instructions on the spreadsheet and submit to CPC+@QualChoice.com.
  • Care plan dates must be submitted once every 6 months. Care plans are required on at least 10% of your QualChoice population in your practice, starting with your highest risk members (Complex and Risk Tier 4). Care Plans for Risk Tier 1 members may not be included.
    • Multiple care plan dates may be submitted for each member.
    • Dates may be submitted during the quarter in which they were documented AND up to one month after that quarter. Example: Second Quarter care plans may be submitted April 1 through July 31st.
    • A history of previous quarter plans can be accessed through the My Account portal.
  • Clinics must submit Category II CPT codes as eCQMs for these measures:
    • Controlling Blood Pressure
    • HbA1c Poor Control
    • Tobacco Use
For questions, refer to the CPC+ Participating Provider Training document or  find the answers to FAQs here . You can also email your questions to QualChoice at CPC+@QualChoice.com .
QualChoice Health Insurance
 | 800.235.7111  | newseditor@qualchoice.com  | QualChoice.com

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