TCCN Lead Primary Care Physicians, Practice Administrators, and Billing Managers,
As the State begins its CMO bidding process for contracts that are planned to start in 2024, you have likely noticed communications being sent to your practice by entities that are interested in entering our market with their CMO product. We are in discussions with a couple of these entities regarding potential contracting through TCCN, and to that end we would like to know which of you would be willing to participate in a new CMO contract should one or more of these entities be selected by the State.
This is your opportunity to make a delegation decision for the following potential new CMO entrants in our market that are expected to make a bid with the State. Your decision will be based on our CMO aspirational fee target, which is linked below. Please note that your response to this request will not affect your previous delegations to TCCN for the existing CMOs in this market or any other contract.
This process of delegation of authority to TCCN is described in your practice's Membership and Participation Agreement, Section 5.2. Per the agreement, each participating practice will be included in any TCCN contract except for the specifically named payor(s) on the TCCN Form of Delegated Authority Exceptions Notice provided. This notice tells TCCN that the practice does NOT wish TCCN to include it in future contracts with the indicated payor(s). The results of this process will provide us with vital information to discuss with payors. If you choose to grant TCCN contracting authority with respect to all potential new CMOs, simply mark the checkbox in the green highlighted area of the form.
TCCN, through a “black box” analysis, has developed an aspirational fee target to be achieved in order to bind your practice to a contract with each specified payor. Each TCCN CMO payor contract will be based on the aspirational fee target presented below, with a guarantee that aggregate reimbursement will not be less than what is represented by this schedule, and could be more, depending on negotiations.
To make sure we have your decisions in time for our response to the potential new entrants, it is critical that you complete your TCCN Form of Delegated Authority Exceptions Notice and return it to Sahdeja Serieux via email (sahdeja.serieux@choa.org) or fax (404-785-9140) by Friday, August 12th. Please note that your delegation decisions will be effective for two years.
Your participation will help us continue to become a stronger network together, enabling us to forge successful contracts and working relationships with all major payors.
If you need a refresher on the delegation process, we recommend watching this video from the original delegation period in 2017 prior to completing the form.
If you have any questions about this process or need a reminder of your previous delegation decisions, please reply to this email or call us at 404-785-0101.
