FREQUENTLY ASKED QUESTIONS

How does my facility benefit from working with Oklahoma Clinical Management?

- One of the most important benefits with the Annual Wellness Program is the ability to reduce costly readmissions, or “bounce backs”. OCM’s questionnaire helps to drill down on specific issues that the patient might not have otherwise shared with medical personnel. This helps with overall finances between the facility, the resident and Medicare.  Also as part of our service, you will receive a framed Certificate of Participation in order to show local State and Federal agencies that you and your facility have chosen to go above and beyond for the residents.

 

Am I required to sign a contract with OCM?

-No. No contract is required. However, we do require an authorization form to be signed from the administration, prior to work starting, for specified dates of service. Our authorization form covers our consent to records, consent for billing, no sales of DME, our privacy policy and no cost to facility.

 

Why am I just hearing about the AWV program?

-You are not alone. For years, Medicare and the medical industry have worked from a reactive aspect. Medicare implemented this program in 2011 to become more proactive in reducing costs. Education on Medicare’s Prevention Program has not been widely shared in the medical communities until recently, within the MIPS program, which is physician based.

 

Can I opt out of AWV participation?

-Yes, however opting out is discouraged. Participating in the AWV helps your seniors age in place, which is medically and financially beneficial, for not only the resident but the facility as well. Although it is not required for facilities, the AWV can increase the quality of life and quality of care for your residents.

 

How does OCM access information to perform the AWV?

-We come to you. With consent from the administration, OCM does require access to either paper charts, electronic charts, or both. We will need to report specific demographic and medical information, as required by Medicare.

 

How does OCM interact with my staff?

-Once access to the residents information is granted, interaction with your staff is very minimal. It is our goal to maximize our time but minimize any interruption in your day-to-day operations. We understand that your services are priority.

 

Does the AWV transfer care to another physician?

-NO. Absolutely not. We specifically work in conjunction with their current PCP. Our goal is to work with as many providers and caregivers as necessary, for the resident’s care. We do have our own Direct Supervising Physician that oversees our work but does not assume care of any residents.

 

Is the AWV a clinical, physical exam?

-No, the AWV is a non-clinical, non-physical questionnaire. We do physically take vitals to record but there are no other physical interactions with the residents. We complete a proprietary, comprehensive questionnaire in order to obtain a complete head to toe assessment for the resident’s capabilities. This includes cognitive, fall risks, ADLs and more. Information is obtained through a comfortable one-on-one conversation that discourages “white coat syndrome”.

 

Why are the primary care physicians not completing this service?

-OCM has found that most doctors have their time filled with current symptoms and ailments. It is difficult for doctors to stop and learn a new program, hire additional trained and knowledgeable staff and manage numerous additional visits, without disruption to their office.

 

Is OCM contracted with Medicare and HIPAA compliant?

-Yes and Yes. We have been contracted with Medicare since early 2018. We are HIPAA compliant by using encrypted email and encrypted software. We also require background checks on all members of OCM and those can be provided, if requested.

 

Does OCM share or sell PHI (Protected Health Information)?

-No. We will share information only as requested by Medicare. We do not share or sell individualized PHI.

 

Who are your industry partners?

-We are partnered with some recognizable senior sources: CMS- Centers for Medicare and Medicaid Services, OKALA- Oklahoma Assisted Living Association, CareProviders- Oklahoma’s Nursing Home Association, DBA- Diversity Business Association and Healthy Aging- an Oklahoma state program.

 

Where and to whom do you offer your services?

-We service the entire state of Oklahoma. We work with churches, senior centers, aging centers, independent providers, healthy living expos, independent living communities, assisted living communities as well as nursing homes. We will service any location that carries a senior status.

 

How long does the AWV take and what does it cost?

-The AWV takes no more than 10-15 minutes per resident. There is no upfront cost to the facility or resident. The service is covered 100% through their Part B plan.

 

How do you know if it has already been completed?

-We have access to CMS specifically to check the eligibility for preventive services, prior to completing. This will let us know: if they have Part B, if they have an advantage plan, if it has been done and the next date it can be completed. This avoids billing errors and claim denials that could affect the patient. Most advantage plans have their own wellness visit so we strictly focus on those with original Medicare.

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