MY 2019 Preliminary Onpoint-Generated Results Webinar
Come learn more about the MY 2019 Preliminary Onpoint-Generated Results Release at our webinar! The session will be recorded and made available for those who can’t join live.
August 24, 2020 | 1:00 p.m. - 2:00 p.m. PDT
Register here!
What to Do Right Now: Send Questions and/or Appeals by Sept. 9
Today’s release kicks off the beginning of a 15 business day participant questions and appeals period. You can submit questions and/or appeals at any time until September 9, 2020 at 5:00 p.m., but we recommend you submit early to allow ample time for investigation and follow up.
Who can submit an appeal?
POs can submit questions or appeals for the following MY 2019 results:
- Appropriate Resource Use (ARU)
- Total Cost of Care (TCOC)
- Behavioral Health & Substance Use (COB & HDO)
- Encounter Measures (ENFMT & ENLAG)
- Statin Use (SUPD for Medicare Advantage only)
POs can also submit questions about their Commercial ACO results, though we are not accepting appeals for this product line at this time.
How to submit an appeal or question:
- Review the AMP Questions and Appeals Submission Guide
- Identify the organization name and ID, measure rates in question and applicable product lines and health plans, as well as any rationale and documentation you have to support the claim
- Email the identified information to appeals@iha.org
Reminder: We finalized the MY 2019 Audited Quality Results for AMP Commercial HMO and Medicare Advantage on August 14, 2020. We won’t be taking questions or appeals for those results during this Q&A period.
Coming August 24th: Onpoint Member-Level Detail Portal!
To support questions and appeals, participants in the AMP Commercial HMO, Medicare Advantage, and Medi-Cal Managed Care product lines can view which patients fell into the numerator and denominator for each utilization measure in the Onpoint Member-Level Detail Portal. Make sure to review the updated preliminary data on August 24th to better understand your results! Need access? Email amp@iha.org.