February 22, 2022

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Our contract with Anthem/BCBS-GA offers TCCN a great opportunity to improve the support and resolution process for Anthem/BCBS-GA related activities in the months and years ahead.

To accomplish this TCCN has been striving to set up a regular set of meetings and touch points with Anthem since Nov ‘21. There have been a number of interactions between our organizations for the last several months, including ones to address major provider load issues and fee schedule related items. Significant progress has been made on both issues.

As of Monday, we have a first of an ongoing series of regular meetings between our team and Anthem scheduled for next week. While the progress has been slower than we had hoped, there is clearly commitment from our Anthem partners to make this new relationship and process work for everyone involved.

We sincerely appreciate our members support and patience as we navigate this new relationship and are committed to getting you the help and support that you deserve for your practices and patients going forward.

Our plan is to provide you with regular updates twice a week in this new format below, as well as a host of supporting information and documents which will be centrally accessible to you and your practice.

As our most important customers please let us know any other ways or things we could do to help make this process better!!

Sincerely,

Brad Weselman, MD

Executive Director

As you may already know, TCCN currently has an active EPHC (Enhanced Personal Health Care) value-based contract with Anthem. We have already seen great outcomes with this agreement and we thank all member practices for your continued support and participation.

To read more about the Anthem EPHC program and requirement, click here.

In addition to the EPHC contract, TCCN also secured amended Anthem rates that went into effect on January 15, 2022.

Here are the details you need to know:

• TCCN is making progress on signing a base agreement with Anthem. Once the TCCN agreement is signed, all contracts will wrap up under TCCN. For now, TCCN successfully secured amended Anthem rates with a new fee schedule effective January 15, 2022.

• We have created an Anthem FAQ document to address some of the most pressing questions.

Key Points:



• The amended Anthem rates secured by TCCN will not modify, edit, or amend any of the Policies, provisions, or obligations under your existing Anthem participation agreements.

• TCCN does not have access to practices' existing Anthem agreement. Refer to the Anthem Provider Manual for specific questions regarding your existing Anthem contract.

• The TCCN amendment did not affect the participation status or credentialing of any provider. Any provider that was not credentialed with Anthem prior to 1/15/22 will remain uncredentialed until credentialed by Anthem or its delegated entity.

• The Anthem/TCCN Rates only apply to those providers that were previously on Anthem products/plans.

• Do you offer Telehealth services? If your practice provides Telehealth services, please utilize the Provider Maintenance Form to notify us and we will add a telehealth indicator to your online provider directory profile. 

• Register today to view Blue Cross and Blue Shield of Georgia (BCBSGa) and BlueCard® member eligibility and benefits, claims inquiry and more through Availity. Availity is a multi-payer portal that gives health care providers secure access with one sign-on to multiple payer’s information. For information or questions regarding BCBSGa services on Availity; to view a demo of the Availity provider portal; or, to register for training, please visit www.availity.com. 

Most Importantly:

• The Anthem/TCCN Rates apply only as long as you remain a member of TCCN and participate in the Anthem’s Freestanding Patient-Centered Care Program (value-based agreement) through TCCN.

• If a practice leaves the TCCN network, they are no longer eligible to participate in the TCCN Quality Program and will no longer quality for TCCN rates.

Since the TCCN / Anthem rates went into effect on January 15th, we are aware that some claims may not be processing according to the new fee schedule. TCCN is currently working with Anthem to quickly resolve this issue.

• Anthem is working to properly associate all TCCN providers and practices with the correct fee schedules for all respective products included in the 1/15/22 effective date. 

• In the interim, practices may receive erroneous payments until this issue has been corrected. Anthem anticipates the issue to be resolved within 7-10 days.

• Anthem will then undertake a claims project to resolve the incorrect payments made once all the correcting is done.

• TCCN will update practices with further instructions as soon as additional information is received with our Anthem partners. Please stay tuned!

TCCN is negotiating a Delegated Credentialing agreement with Anthem, and we anticipate that this will solve many of the difficulties in adding new physicians to the agreement. 

The contract amendment did not affect the participation status or credentialing of any provider. More information about the credentialing agreement is coming soon.

Practices should continue to verify individual providers participation status with Anthem until the TCCN Delegated Credentialing agreement is complete.

Earlier this month, we launched our 2022 TCCN Quality Program. This year, we will continue to renew our commitment to excellence by focusing on moving the needle forward on quality improvement outcomes.

Our network objectives for this year are to improve well child visit compliance rates, appropriate treatment for asthmatics, and appropriate screenings.

Your Next Steps:

1. Review the 2022 quality program requirements and measures of focus.

2. Commit to quality improvement activities and coding for the 2022 TCCN Measures of Focus:

• Well Child 0-30 months​
• 3-21 Well Child Visits​
• Asthma
• Behavioral Health and Depression Screenings
• Anthem/BCBS Contracted Measures

3. Complete by 2/28/22 the required 2022 TCCN Quality Program Attestation online at https://www.surveymonkey.com/r/VM7FFH6

4. Commit to attending at least one of the two TCCN Clinical Quality Forums in 2022.

5. Continue current Quality Improvement efforts and adhere to Minimum Standards.

Please contact [email protected] with any questions you may have. 

Reminder of the deadline for the additional Pfizer discounts on Prevnar 13 (for pediatrics) and Prevnar 20 (currently approved for ages for 18 and up) is coming up soon on February 23, 2022. 

• For Prevnar 13 and Prevnar 20 – the TCCN Pfizer program discount is 11.455% for a limited time until February 23, 2022. 

Starting on February 24, 2022, the discount on Prevnar 13 and Prevnar 20 will be 5% as long as the TCCN Pfizer Program Participants maintain market share of 80% or higher. 



• TCCN currently meets this market share threshold.  
• This new discount of 5% was announced in December 2021, and is an increase from the 2% discount with the initial TCCN Pfizer Program rollout in May 2021.

To join the TCCN Pfizer Program please follow the steps below:

The process for joining this program is simple, and they are outlined below:

•  1.     Each practice will go into their Pfizer account and enter in code Z33753Z, this will assign you to the TCCN Program. Instructions for activating account in Pfizer:
• a.     Create your Prime Contracts account at the following URL: https://PrimeContracts.Pfizer.com
• b. Select Register button. Even if you currently have a Prime Ordering account, you must click 'start registration'.
• c.      After registering and then signing back into the Portal, you will see the 'Welcome to the Prime Contracts Portal' page. On this page enter the following Registration Code: Z33753Z, then follow the directions to join the contract.

Please reach out to Barbara Douglas, TCCN Program Manager, [email protected] or 770-333-0033 ext-201, if you have any questions. 

Reminders (please use links below to review)

• CHADIS Web-Based Health Assessment Discount Program, Webinar Recording

NEW- Endocrinology Referral Guide on Choa.org

We are excited to announce the Endocrinology referral guide in now available as a resource on the Choa.org website. This referral guide is designed to be a tool and resource to help patients find the services they need. A special thank you goes out to the Children's endocrinology team for creating this helpful resource!

Access the Endocrinology Referral Guide Here

NEW- Community Infectious Disease Webinar: February 28th at 12pm

The community outreach committee for Children's and Emory is holding their next virtual webinar on February 28th! The guest speaker will be Dr. Matt Linam, an Infectious Disease Specialist will be speaking on the topic of COVID-19 and high yield ID cases. 

Webinar details are include below:

ED Webinar Series: 

Topic: Infectious Disease Emergencies Speaker: Dr. Linam

When: Monday, February 28, 2022 @ 12:00 p.m. – 1:00 p.m.

Where: Virtually via Zoom

Register Now: https://us02web.zoom.us/webinar/register/WN_JNsJCYg_T9uGN-4mECOMJw

Mead Johnson Nutrition Clinical Research - Infant Formula Study

Mead Johnson Nutrition Clinical Research Department is currently in the process of identifying sites interested in and capable of conducting clinical research studies with infant formula in term infants. Please provide information about your facility, your COVID-19 policies, contact person, patient population, previous research experience, and interest in conducting clinical trials by completing the questions on the attached survey and returning it via e-mail [email protected] or fax (812-429-8368) as soon as possible. Please answer all questions with the best answer available.

Click HERE to download the survey form

If you have any questions, please email [email protected]

2022 Pediatric Obesity and Endocrine Co-Morbidities Project ECHO Cohort

Ideally, prevention and treatment of obesity and its comorbidities require a multidisciplinary approach that involves collaboration between community health care providers and subspecialists. However, given the national shortage of certain pediatric specialists in the United States, community healthcare providers often become the main caretakers of obese children. This project will involve monthly teleconference sessions between specialists (endocrinologist and gynecologist) and community providers to discuss the diagnosis, monitoring and management of obesity and its potential endocrine comorbidities in children. The goal of the project is to equip community providers with the knowledge and tools necessary to provide comprehensive care to overweight and obese pediatric and adolescent patients using local resources, especially in cases where access to subspecialists is limited.

Utilizing the Project ECHO platform, Children's has facilitated Pediatric Obesity and Endocrine Co-Morbidities cohorts since 2020. The cohort will meet one Monday a month at lunchtime starting March 7^th for eight total sessions.

Active participation is required to obtain CME credit, and participants are expected to present at minimum one case during the series.

Event Details:

All sessions will take place from 12pm – 1pm EST



March 7^th: PCOS in the adolescent: Why treat? – Krista Childress, MD

April 18^th: Diagnosing Diabetes in Children: A1C, glucose tolerance rests and insulin levels – Sobenna George, MD

May 2^nd: Pre Diabetes: To treat or not to treat? – Sobenna George, MD

June 27^th: Type 2 DM Treatment: metformin, insulin and GLP1 agonists – Sobenna George, MD

July 25^th: Interpreting thyroid function tests in the obese patient – Sobenna George, MD

August 15^th: Obesity, elevated triglycerides and elevated LDL – Sobenna George, MD

September 26^th: When to consider Cushing’s Syndrome in an obese patient – Sobenna George, MD

October 17^th: Genetic Obesity – Sobenna George, MD

This series will be limited to 25 participants due to the time constraints of case presentations. There will be an active waitlist, so please add your name if the course is full and you will be contacted if you are able to join.

To register for this series, click here

Physician Education Credits

Children’s Healthcare of Atlanta is accredited by the Medical Association of Georgia to provide continuing medical education for physicians.

Children's designates this internet live activity for a maximum of 8.0 AMA PRA Category 1 Credits^TM. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Reminders (please use the links below to review)

• Starting March 3rd: BMH Project ECHO Cohort for Depression - slots still available!
• Children's Physician Group - Nephrology Referral Guideline
• TCCN COVID-19 Diagnosis and Isolation Algorithm

We are here for you. Please reach out to [email protected] with any questions you may have.