Empower Healthcare Solutions, LLC (Empower) is a Provider-led Arkansas Shared Savings Entity (PASSE). This new model of care was developed to address the overall health care needs of Medicaid beneficiaries who have complex behavioral health or intellectual and developmental disability (IDD) service needs. Goals of the PASSE program are to:
Clinical Practice Guidelines
Current Clinical Practice Guidelines
In recent years, the process of developing clinical practice guidelines has undergone significant re-evaluation by national professional organizations including the American Medical Association and the Institute of Medicine. With an eye toward increasing rigor and improving transparency, these organizations have articulated principles that form the foundation for new standards of guideline development. The American Psychiatric Association (APA) and the American Academy of Child and Adolescent Psychiatry (AACAP) have both published statements on their websites in support of these new standards.
Empower Health Solutions has adopted clinical practice guidelines published by the APA, AACAP, and other professional organizations. This was based on their reputation as primary contributors and developers of guidelines representing acceptable standards of care at the time of origination.
Related to the continued evolution of clinical practice guideline development calling for higher standards of evidence, the industry currently has maintained or produced a limited number of guidelines that meet the new standards for guideline rigor and transparency. Accordingly, Empower has reviewed and adopted the following guidelines that meet those standards:
Contracting/Credentialing With Us
Contracting/Credentialing With Us
Empower Healthcare Solutions is excited to partner with Access Health under our Passe program in order to provide a higher level of care and care coordination services to all Medicaid beneficiaries receiving benefits.. The purpose of this model is to improve the health of those who need intensive levels of specialized care, link providers of physical health with specialty BH and DD providers and coordinate care for all community-based services.
Access Health Services
Access Health Services provides administrative services to health-related clients such as Medicare Advantage special needs plans, Medicaid support companies, non-governmental health plans, as well as small clinics, providers, or ancillary vendors.
Join Our Network
Any Provider of healthcare services who would like to become a participating provider with Empower must be enrolled in the Arkansas Medicaid Program before Empower can pay for services by the provider to the Arkansas Medicaid member. To become an Arkansas Medicaid Provider, please visit AR Medicaid Provider Enrollment by clicking here.
We appreciate your time and consideration in joining our networks and recognize that it is only through exceptional professionals like you that we can make high- quality health care more accessible to a greater number of people.
Cultural Competency Plan
Empower Healthcare Solutions (Empower) integrates cultural linguistic competency concepts into programs, services, policies and processes that reflect an understanding and respect for the diverse cultural and linguistic needs of members, providers, clients, staff members, and stakeholders in the provision of services. This includes individuals who have disabilities, limited English proficiency, specific populations such as Lesbian, Gay, Bisexual and Transgender (LGBT), and individuals who have diverse cultural and ethnic backgrounds.
Empower’s Cultural and Linguistic Program includes:
Availability of telephonic oral interpretation by staff or contracted vendor (if applicable) 24 hours, 7-day a week including American Sign Language (ASL) referral
Availability of TDD/TYY and/or relay services
Availability of referrals to network providers for services in specified language or for cultural needs
Translation of written materials as required or requested
Provision of member materials in plain language
Member testing of materials that includes review by representatives of the member population for which the materials/websites were designed, to ensure their readability, perceived usefulness, and that they appropriately address the cultural diversity of the target populations.
Mechanisms can include, but are not limited to, review by consumer members/advisory committees, or by focus groups, internal review by diverse staff, access to websites to practice and use tools. Results of such review are then incorporated into the final version of materials.
Login to the HHAeXchange Portal to take advantage of:
- FREE Electronic Visit Verification (EVV) tools
- Open Model EDI Integration with 3rd Party EVV Vendors
- Real-time, two-way messaging with each PASSE
- Receive recipient demographics, authorizations, and plan of care electronically
- Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle
EVV and Claims Billing for Personal Care Providers visit HHAeXchange for FAQ’s, info sessions, trainings, and integration.
Fee Schedules, Codes, and Unique Modifiers
Provider Forms and Resources
Provider Authorizations Forms
Quality Improvement Resources
Providers Quality Improvement Activities
Empower Quality Department Announces Launch of Empower Medical Record Documentation Audits
Empower Healthcare Solutions is in the process of launching its first Provider Medical Record Documentation Audits. These Medical Record Documentation (MRD) Audits will be conducted with Primary Care Physicians (PCPs) and Behavioral Health Physicians in the Empower network.
These audits are an integral part of Empower’s Quality Improvement process, which seeks to improve member care and treatment outcomes. The audits are conducted with the intent of improving the quality of providers’ medical recordkeeping and assuring that providers comply with state and federal regulations and other established standards, such as the Empower Provider Manual. [Note: These MRD audits will not review for the medical necessity of services provided.]
Checklists for Medical Record Documentation Audits
An audit checklist that will be utilized for review of the documentation in the member records has been developed for the PCP records and a different checklist for the Behavioral Health Physician records.
The Checklists were developed utilizing standards identified in:
Manual for Empower Healthcare Solutions Providers;
Arkansas DHS Manuals;
Federal and state requirements (such as HIPAA and CMS standards; Arkansas Child and Adult Maltreatment Acts);
NCQA standards, best clinical practices, and Empower Clinical Practice Guidelines; and
National Accreditation standards.
All documentation in the member’s medical record for which the identified physician has medical responsibility may be reviewed as part of the audit. For example, if the selected Behavioral Health Physician provides services in an outpatient behavioral health program and is, therefore, medically responsible for all of the member’s behavioral healthcare, documentation of all services provided to the member are subject to review (not just the physician’s).
To see the Medical Record Documentation Audit – Behavioral Health Physicians Checklist click here.
To see the Medical Record Documentation Audit – Primary Care Physician Checklist click here.
Revised Medical Record Documentation Audit Timeline
In mid-December, providers who have been selected via a random sampling will receive a Notification Letter telling them that they have been selected to participate in the MRD Audit. The letter will include
A copy of the applicable MRD Audit Checklist (based upon provider type) that will be utilized
An explanation of the MRD Audit process
Information regarding record submission.
In the week following the mailing of the Notification Letters, Empower will reach out to those providers in order to obtain the contact information for the staff persons who will be responsible for providing requested records to Empower and the method that the provider plans to use to submit records.
At the beginning of January 2021, providers will receive a list of five (5) members whose records will be audited and a list of the requested documentation. Requested records must be submitted to Empower within fourteen (14) calendar days.
Providers may submit or give access to records utilizing several methods:
Direct access to the provider’s electronic medical records for the identified members
Secure File Transfer Protocol option, which will allow providers to upload records to a secure server (not yet available, but expected to be available by December).
When the audits are completed, feedback will be given to each provider whose records have been reviewed. Results from individual provider audits will not be published. Empower will aggregate the results of all record audits and review the data analysis of findings to identify key processes for quality improvement.
To see the Timeframes for Medical Record Documentation Audits click here.
Watch the Empower website for updates on the Medical Record Documentation Audits!
COVID-19 and Other Communicable Diseases: Potential Quality of Care Review of Empower Provider Policies and Practices
The Quality Management Department is launching a Potential Quality of Care (QOC) review of Empower providers’ policies and practices relative to COVID-19 and other communicable diseases. This review is a part of Empower’s Quality Improvement process, which seeks to improve member care and treatment outcomes. Empower Staff and Providers have the responsibility to ensure the health and safety of individuals who are enrolled in the Arkansas Medicaid PASSE program and review concerns that place the health and safety of members at risk.
Because of the COVID-19 pandemic, Empower understands that our members are at risk of contracting the disease, as we have seen increasing numbers of our members with diagnoses of COVID-19. As with any communicable disease, our members are placed at risk by many factors, some of which include residing in group homes and facilities and staff coming and going from members’ homes and facilities in which they are receiving services.
With this heightened awareness and risk, Empower wants to insure that providers have:
Policies, procedures, protocols, and mitigation plans to prevent the spread of COVID-19 (and other communicable diseases) when there is a positive identification of provider staff or members
Policies, procedures, and plans to insure the continuation of treatment services for members when face-to-face contact is not recommended.
For the initial phase of this potential QOC review, Empower is sending letters requesting related policies, procedures, and plans to Psychiatric Residential Treatment Facilities and Intermediate Care Facilities. The letters will provide the details of the information that providers are asked to submit to Empower.
Empower appreciates the work and efforts made by our providers to ensure the health and safety of our members and your staff! Thank you!
This webinar will cover Empower related information including provider responsibilities, provider resources, member rights and responsibilities, eligibility, covered services, utilization management, care coordination, claims submission, quality improvement, the empower portal and more.
ACES AWARENESS PRESENTATION
This presentation will provide an overview of the Adverse Childhood Experiences (ACEs) tool and the importance of recognizing how adverse childhood experiences and trauma impact overall health and outcomes for adults.
Recommended audience is Clinicians, Case Managers, Mental Health Professionals, Clinical Directors and Nurses for Psychiatric Residential Treatment Facilities.
Thursday, February 24, 2022
11:00 a.m. – 12:00 p.m.