Frequently Asked Questions

The following are questions that you may have regarding Person-Centered Medical Homes and on the process of becoming a PCMH recognized group.


DSS PCMH Questions:

Q: What is a CMAP number?

A: It is your Medicaid number, also called your AVRS number that is used to submit claims to DXC Technology. It is a nine digit number that starts with 00.


Q: Can my practice still apply for the State of Connecticut Department of Social Services PCMH program if providers are not CMAP providers?

A: No, providers need to be enrolled as CMAP providers prior to submitting a PCMH application. Providers must also be either pediatric, internal medicine, family practice, or geriatric primary care providers.


Q: How long does the enrollment process take with DXC Technology?

A: Once the enrollment form is submitted to DXC Technology, it could take up to 45 days for processing. Submitting the enrollment form on line can speed up the process.


Q: What if providers are pending status to be a CMAP provider?

A: Applications should be submitted with CMAP providers ONLY. CHNCT is currently in the process of developing a process with DSS in which previously pending CMAP providers can be added to the PCMH application.


Q: How do I apply to become a CMAP provider?

A: You can go to the following website: www.ctdssmap.com. Click on provider enrollment, under "provider", complete application.


Q: I submit claims to DXC Technology using the NPI #. Why do I need to submit my CMAP #?

A: Your CMAP number will be used by DXC Technology to recognize your practice as a PCMH that is eligible for enhanced reimbursements.


Q: If one or more practice sites are applying, do I need to complete a separate PCMH application for each site?

A: Yes, a separate PCMH application needs to be submitted for each practice site.


Q: How do I know if my EHR is ONC certified?

A: Your electronic health record vendor should be able to tell you if your EHR is certified.


Q: Can my practice still apply to the PCMH program if I do not have a ONC certified EHR?

A: Yes, your practice can still apply to the PCMH program. Once your PCMH application has been approved, your practice will be eligible to apply for the Glide Path. The Glide Path will allow you to receive payment incentives to help you to obtain a certified Electronic Health Record.


Q: Can DOs, APRNs, and PAs be included on the PCMH application?

A: Yes, as long as the providers manage a panel of patients, they are CMAP providers, AND if at least 60% of their clinical hours are spent providing primary care services to a panel of patients. PA and APRN practitioners that do not have their own panel of patients but serve to support the panel of a primary care physician can qualify as PCMH providers.

NCQA Questions:

Q: Who can submit for Patient Centered Medical Home (PCMH) 2014?

A: PCMH is for practices with primary care clinicians, where at least 75% of the Primary Care Physicians’ (PCPs’) patients come for:

  • First contact
  • Continuous
  • Comprehensive PCP services

Clinicians may be selected as personal PCPs.


Q: What PCP’s should I include on my survey?

A: All the PCP clinicians who work together at a site must be included.


Q: What if my practice includes non-PCP physicians?

A: Specialists at your site should not be included in the Recognition process. All clinicians included in the Recognition, including OB/GYNS, must fill PCP role for 75% of patients. It is suggested that practices clarify eligibility before they begin to work. Practices may send an email to PCMH@ncqa.org. NCQA will launch a Specialist Recognition Program in mid-2013.


Q: What is a multi-site organization?

A: Multi-site practices have:

  • 3 or more clinical sites
  • Share the same Electronic Medical Record (EMR)
  • Share the same policies and procedures for staff
  • Ability to be bound under a single contract

Q: How do I get the software licenses?

A: The free Online Application Account is available at http://store.ncqa.org/index.php/2014-pcmh-survey-tool-web-based.html.

  • Your "Administrative/Business Account"
  • Organization needs only 1 account
  • All sites on the same account
  • PCMH 2011 on same account as old version (PPC-PCMH)
  • Reusable over time for add-ons, upgrades, renewals
  • CAHPS-PCMH on same account
  • Agreements are attached here
  • Safeguard the user ID and password

The Interactive Survey System (ISS) Tool is available at https://iss.ncqa.org/RDSat/ATLogin.asp?Redirect=true.

  • $80 per site for PCMH 2011
  • One tool for each site
  • Multi-site practices need special approval and naming conventions
  • Keep your URL, username, and passwords safe

Q: Where do I find my NCQA License Number?

A: NCQA emails your license number at the time of purchase of the ISS Survey Tool. It is also available in the ISS Survey Tool after the product name.


Q: What are the steps to complete the Online Application?

A:

  • Launch the Online Application Account
  • Sign the Agreements electronically
  • Create a separate application for each site
  • Enter the ISS license # for each site — creates a link
  • Enter your clinician data for each site
  • Bind your clinicians to each application — who’s current
  • Submit each site application to NCQA
  • NCQA needs 5 business days to verify site prior to accepting ISS tool — NCQA will send you an e-mail

Q: Is there a time limit from the application submission to the ISS Tool?

A: There is no time limit from the application submission to the ISS Tool. You can submit your ISS Survey tools at any time after you receive the e-mail from NCQA. Three months is a good target for submission of the ISS Tool. NCQA recommends that you attend "Getting on Board" again if you delay many months, as NCQA may make system changes.


Q: What is an Add-on Survey?

A:

  • For practices that want to achieve a higher level
  • Level I or II may submit anytime during their current recognition period
  • Add-on application through the Online Application
  • NCQA prepares your tool to receive new data; issues a new ISS license #
  • You may add to any Element with < 100% score
  • No need to resubmit for all Elements if you’re satisfied with the score
  • Upload new documents
  • Submit and receive new decision
  • Add-on fee is 50% of initial fee for Recognized practices

Q: What is the process for Renewals/Upgrades PPC-PCMH to PCMH 2014?

A:

  • Level II and III PPC-PCMH sites should submit documentation with 12 Elements for Renewals and Upgrades
  • For all the remaining elements for factors that you answered "Yes," you must attest that you are eligible and implement those factors.
  • "ABC Family Practice previously achieved Level 2 or 3 Recognition as a Patient-Centered Medical Home and attests that the responses to the factors for this element reflect the current operations of the practice site and the documentation to support these responses can be provided on request."
  • The practice must be able to provide documentation for the elements that do not require documentation if it is selected for audit.

Source: www.ncqa.com

Glide Path Questions:

Please email us with any questions at this time.

EHR Questions:

Please email us with any questions at this time.

This portion of the HUSKY Health website is managed by Community Health Network of Connecticut, Inc., the State of Connecticut’s Medical Administrative Services Organization for the HUSKY Health Program. For the general HUSKY website gateway, please visit www.ct.gov/husky. HUSKY Health includes Medicaid and the Children’s Health Insurance Program, and is administered by the Connecticut Department of Social Services.