CareOregon wants to hear from you: Provider satisfaction improvement project

Physicians, facilities and other providers are vital partners in achieving CareOregon’s mission to ensure access to high-quality health care for Oregon’s vulnerable populations.

To make sure that providers’ experience with CareOregon is the best it can be, we’ve launched a process improvement team, the Barrier Breakers.

The Barrier Breakers will address several areas to increase provider satisfaction, said Rebecca Fortuine, the team’s co-leader.

“We want to address remittance messages and remittance advices first to make sure they are clear and consistent,” Rebecca said.

Remittance advices, which accompany payments to providers, explain how services were paid and how the payment for the claim was allocated. If services were not payable, it explains why. Understanding the coding on the remittance advice is key to understanding the document.

New Links

The first change is links to HIPAA remittance message codes. One link connects to Claim Adjustment Reason Codes and the other goes to Remittance Advice Remark Codes.

“We added this tool in response to feedback that remittance advices sometimes go to different people in an office,” Rebecca says. “The code definitions are not always available to everyone who needs to look up and decode Claim Adjustment Reason and Remittance Advice Remarks codes.”

These links are also on the Providers Resource List page. Scroll down to "Web Links".

Barrier Breakers

On that same page, providers will also see a new Barrier Breakers email address (providersatisfaction@careoregon.org) to connect providers with the team.

“We want to hear from our providers about their experience with CareOregon,” Rebecca said. “But more importantly, we want to get their suggestions on how we can further improve. Perhaps they know of resources or processes that other companies have used that we should look at and consider adopting.

“The team is also looking for providers who are willing to partner with us to test potential improvements to our systems,” she said. “We’re looking forward to hearing from our providers and getting their input to this important process.”

The new mailbox does not replace other links connecting providers to CareOregon.

• For claims inquiries, continue to use claimsspecialists@careoregon.org.
• For systems access, use providerhelpdesk@careoregon.org.

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