Submit more Wellness Assessments, become a Platinum provider and take home a well-deserved fee increase*
When you become an Platinum provider, as evaluated by the Achievements in Clinical Excellence (ACE) program, you may become eligible for all sorts of fantastic perks, such as:
- 3% esclator on top of your current fee schedule for commerical business for twelve months
- FREE unlimited CEUs for twleve months
- Recognition and callout to Optum Care Advocates on LAWW, which can lead to more referrals‡
‡Due to state regulatory requirements, California, Colorado, Maryland, Missouri, New York and Texas provider tiering will not be displayed on clinician search results pages. If your practice resides in one of the excluded states, it’s very important that you continue submitting ALERT Wellness Assessments. Your data will continue to be evaluated, and you or your group’s data can still qualify for ACE perks such as free CEUs and the twelve-month fee increase.
But to be eligible for all these benefits, you need to submit more Wellness Assessments. As you may know, ALERT is built on a confidential, reliable and validated means of identifying targeted risk issues through a review of Wellness Assessment and claims data. In addition, it provides a baseline measure of member functioning combined with later measures to reflect change in member functioning over time.
- The WA is a one page assessment tool that you ask the member to complete at the first visit (or prior to the first visit) and then review with the member before faxing to Optum
- The WA is administered again by you and completed by the member on session 3, 4 or 5 and again reviewed by you and faxed to Optum
- Clinician participation rates in administering the Wellness Assessment are included in evaluation in the ACE program
- The more WAs that are submitted, the better cases can be tracked, and the more Member outcomes will be reported back to you in aggregate
Submitting Wellness Assessments is an ongoing process
*All Wellness Assessments must be submitted by June 30th of each year in order to be included in the most current evaluation period. Providers will then be notified of their latest data results and ACE scores by the following November. In January, all ACE scores will be published to Provider Express and made publicly available. The following March the 3% fee increase will go into effect for clinicians and groups that were evaluated as Platinum. The 3% fee increase will remain in effect for twelve months. This data review occurs annually. If a clinician or group does not tier Platinum, the fee schedule will be adjusted back to the previously contracted rate(s) that were in effect prior to the fee increase going into effect.