Quality Improvement Program

AHCCCS sets goals for health plans. AHCCCS examines how well health plans are performing against their goals for access to care and utilization of preventive services.

• AHCCCS Performance Measurement

AHCCCS wants to know how satisfied members are with their AHCCCS plans, the care they receive, and their doctors. Below are the latest member satisfaction survey and provider satisfaction survey.

• AHCCCS Member Satisfaction Survey Results
• AHCCCS Provider Satisfaction Survey Results

Arizona Complete Health-Complete Care Plan Internal Performance Measure Results

AzCh-CCP Provider Forum Feedback May 2021

Q1: What was your overall evaluation of the presentation?

• Good - 40
• Good - 46
• Fair - 4
• Poor - 0
• Total - 90

Q2: How would you rate the presenter?

• Good - 50
• Good - 38
• Fair - 2
• Poor - 0
• Total - 90

Q3: Does this provider forum contribute to your overall satisfaction with Arizona Complete Health-Complete Care Plan?

• Yes - 74
• No - 16
• Total - 90

Q4: Do you think the provider forum presentations add value to the services you provide to your members?

• Yes - 83
• No - 8
• Total - 90

Q7: What did you like most about the presentations?

• Useful information and resources
• The variety of presenters was great
• I think these meetings are useful.
• Always well organized
• There were some good topics

Q8: What could be improved about the presentation?

• Could it be a bit longer?
• What do you think about the overall health/performance on various metrics?

Q9 What topics would you like to know more about?

• Claims, Complaints, Appeals
• Claim
• Claim, Complaints & Appeals, Pre-Approval
• Claim, Complaints & Appeals, Pre-Approval
• Claim, Complaints & Appeals, Pre-Approval
• Claim
• Claim, Pre-Approval
• Claim, Care/Case Management
• Contract Deliverables

10: I represent a provider of ____.

• Ancillary - 1
• Behavioral Health - 35
• FQHC - 3
• Health Home - 4
• Hospital Health System - 16
• Other - 11
• Primary Care - 2
• Specialty Care - 18

AzCh-CCP Provider Forum Feedback November 2020

Arizona Complete Health - Complete Care Plan 11/04/2020 Provider Forum Feedback Survey

Q1: I represent a provider of ____.

• Primary Care - 1
• Specialty Care - 3
• Ancillary Care - 0
• Hospital Health System - 2
• FQHC - 0
• Health Home - 2 responses
• Behavioral Health - 1
• Other (specify) - 0

Q2: What was your overall evaluation of the presentation?

• Good - 1
• Good - 7
• Fair - 1
• Poor - 0
• Total - 9

Q3 How do you evaluate the presenter?

• Goo d-3
• Goo d-5
• Fair - 1
• Poor - 0
• Total - 9

Q4: Do you think the provider forum presentations add value to the services you provide to your members?

• Ye s-3
• N o-2
• Please let us know in detail if you like:
• Education on what a health plan expects from the provider is very useful.
• As a specialized provider, it is good to be able to know what AZCH is aiming for.
• 3 There is a lot of information provided in such a forum, and we spend 2 hours of time to listen to each section that does not know whether it is related to our business purpose. It will be. It would be better if there was a forum for a specific topic that would take about an hour, including Q & Amp; A. There are many other insurance companies that hold a specific forum, and there are fewer audiences of those who want to learn about specific topics. If the topic approaches the end, 2 hours is a long time.

Q5 Does this provider forum contribute to the overall satisfaction of the Arizona Complete Health Plan?

• yes.
• no
• no.
• It's a great feature, but it doesn't solve some problems in the AZCH process.
• yes
• yes
• a bit.
• I am looking for specific information provided to me as a position for medical fees for home medical institutions. Timely filing, claim processing, COB problem, appeal process, refund process, etc.
• no
• Total 9 cases

Q6 What do you like most about the presentation?

• Claim
• Nothing in particular
• Claim section
• It was interesting and relieved that other clinics had a similar feedback. It's not a solution, but it's not easy to work with NIA.
• Educational value
• Easy to understand
• Explanation through part of the contract that occurs most irregularly.
• Interaction presenter involving the audience is familiar with each field
• prize
• Total - 9

Q7: How do you think the presentation will be improved?

• More information about behavioral medical specialized providers and insurance claims.
• cancel
• N/A
• I don't know because it was my first participation. It was good that the information was abundant!
• We are radiation tumor, hematology, tumor medicine, and general surgery, so I want more information for each specialty.
• n/a
• Use the results of the audit to determine topics.
• They do a great job, but in the future, I would like them to focus the forum on more specific topics and cover all issues in 1 hour instead of 2 hours.
• Dealing with Claims/Appeals
• Total - 9

Q8: What topic would you like to know more about?

• Claims - 8 responses
• Grievance Handling and Appeals - 6 responses
• Prior Authorization - 2 responses
• Credentials - 2 responses
• Care/Case Management - 1 response
• Other (please specify)
• None
• Chemotherapy Drug Education
• I think the claims check and review process needs improvement.

AzCh-CCP Provider Forum Feedback June 2019

Arizona Complete Care - Complete Care Plan June 2019 Forum Survey

Q1: In which county and on what day did you attend the forum?

• Pima: 6 responses
• Maricopa: 4 responses
• Total: 10 responses

Q2: What was your overall evaluation of the presentation?

• Good: 2 responses
• Good: 4 responses
• Average: 2 responses
• Poor: 3 responses
• Very poor: 0 responses
• Total: 11 responses

Q3: How would you rate the presenter?

• Good: 1 response
• Good: 5 responses
• Average Good: 3 responses
• Poor: 1 response
• Very poor: 0 responses
• Total: 10 responses

Q4: Were the objectives of the presentation achieved?

• Good: 3 responses
• Good: 2 responses
• Average 4 responses
• Poor: 1 response
• Very poor: 2 responses
• Total: 11 responses

Q5: Do you think the Provider Forum presentations add value to the services you provide to your customers?

• Good: 3 responses
• Good: 4 responses
• Average Good: 1 response
• Poor: 2 responses
• Very poor: 1 response
• Total: 11 responses

Q6: How many family members or children do you plan to share this information with in the next month?

• Average family size: 28 people
• Average number of children: 18
• Total: 8 people

Q7: What did you like most about the presentations?

• Having the opportunity to meet with the staff from Arizona Complete Health.
• Very informative and the presentation included a lot of data.
• Seeing people's faces
• Connecting with healthcare provider representatives
• An update from RBHA on what is expected of providers at this time
• Total: 5 comments

Q8: What could be improved about the presentation?

• More opportunities to hear from healthcare providers would be good.
• Specifically focusing on provider needs. A lot of information was repeated from other presentations.
• Agenda and opportunity for questions and answers
• At check-in, a sheet should be distributed with a list of providers/facility members who will be attending and who the provider representatives are and where they will be seated so they can meet in person.
• It would be nice to have a presentation for billing / claims / complaints.
• You should show your provider what you intend to do to solve the problems we have. The claim will not be paid
• Please describe the group where the data is reviewed.
• Total: 7

Q9: Topics that you want to know more in detail

• Reviewing the most difficult part of the provider manual is a good way to spend time in such a forum.
• I want to know more about what a health home model is for your health plan.
• How to connect with Azch and how to solve the problem
• Reasons why complaints are not paid
• 5 Detailed information about COE and COT expected from RBHA
• Total number of answers 5

AzCh-CCP Provider Forum Feedback May 2020

Arizona Complete Health-Complete Care Plan Provider Forum 2020 Feedback Survey

Q1: I am a XX provider.

• Primary Car e-3
• Professional medical car e-17
• Ancilary Car e-3
• Tota l-23

Q2: What was your overall evaluation of the presentation?

• Grea t-3
• Goo d-10
• O K-9 cases
• Ba d-1
• Tota l-12

Q3: How would you rate the presenter?

• Goo d-4
• Goo d-10
• O K-8 cases
• Ba d-1
• Tota l-23

Q4: Do you think the provider forum presentations add value to the services you provide to your members?

• Ye s-17
• N o-6
• Tota l-23

Q5: Does this provider forum contribute to the overall satisfaction of the Arizona Complete Health / Complete Care Plan?

• No
• yes
• I need more coding information
• No, there are still many problems to solve.
• yes
• No, there are still many system errors, and we are waiting for the correction to get a refund.
• N A
• yes.
• It is always confusing who is trying to target such a meeting. Information can be all from program levels to intermediate managers and CEOs.
• yes
• Just reading the script will make a very fast presentation very quickly.
• yes
• yes
• yes
• Same as above
• No
• The current satisfaction is low due to unpaid complaints.
• useful.
• no
• no. However, I expected this to be a hospital forum. Do you know if a session for hospitals will be held?
• It was a waste of time
• yes
• No
• Tota l-23

Q6: What was the best thing about the presentation?

• Distribution materials
• virtual
• Clearing
• Eas y-t o-understand presentation.
• Ability to ask ideas and questions to health plans
• I'm appealing, but I'm about all information
• NA
• Regarding all information
• Nothing in particular
• Presert mechanism
• Intentional, but not very attractive
• Detailed processes and forms
• Clear and concise
• All presentations
• No mention of dentistry
• Telehels POS and modifier are required
• There was a lot of information, but it was well organized, so many different types of providers could get something from the forum.
• Information provided.
• There was no need to move 100 miles for a round trip to participate! :)
• I was able to write a note that draws the attention of the AZ Complete management.
• It is very thorough.
• I am grateful that the actual leader participated, not the agent.
• Tota l-23

Q7: How do you think the presentation will be improved?

• Don't read PowerPoint. The speaker just needs to point out highlights and action steps. I don't want to be read aloud at the meeting because of everyone's time. T
• Please do not read it out.
• I want you to increase the coding of Telehels.
• N/A
• I want you to provide more information about the merger of AZCH and care 1st.
• I want you to solve more
• NA
• Some of them don't need to know, but it is necessary to understand that it may be related to others.
• The latest and specific information for the highest executive officer (CEO) level.
• I want you to pay more attention to the specific services.
• Slowly in interaction with the audience. This time, it was very important, and I felt that each presenter was getting faster.
• I want you to review the process in more detail.
• I like training in direct meeting, but I understand that short presentations are unrealistic.
• I think that's fine.
• These two are related to the general health of the patient as well as medical care.
• Talk more about complaints and complaints
• Divide the forums by provider type and work, and dig deeper into places where there are still problems.
• Monthly update. < SPAN> Ability to ask ideas and questions to health plans
• I'm appealing, but I'm about all information
• Regarding all information
• there is nothing
• Presert mechanism
• Intentional, but not very attractive
• Tota l-23

Clear and concise

• All presentations
• No mention of dentistry
• Telehels POS and modifier are required
• There was a lot of information, but it was well organized, so many different types of providers could get something from the forum.
• Information provided.
• There was no need to move 100 miles for a round trip to participate! :)

1. I was able to write a note that draws the attention of the AZ Complete management.
2. It is very thorough.
3. I am grateful that the actual leader participated, not the agent.
4. Tota l-23 answers
5. Q7: How do you think the presentation will be improved?

AzCh-CCP Provider Forum Feedback November 2019

Don't read PowerPoint. The speaker just needs to point out highlights and action steps. I don't want to be read aloud at the meeting because of everyone's time. T

Q1: In which county and on what day did you attend the forum?

• I want you to increase the coding of Telehels.
• I want you to provide more information about the merger of AZCH and care 1st.
• I want you to solve more
• Some of them don't need to know, but it is necessary to understand that it may be related to others.

Q2: What was your overall evaluation of the presentation?

• Goo d-4
• Slowly in interaction with the audience. This time, it was very important, and I felt that each presenter was getting faster.
• I want you to review the process in more detail.
• I like training in direct meetings, but I understand that short presentations are unrealistic.
• I think that's fine.
• Some of them don't need to know, but it is necessary to understand that it may be related to others.

Q3: How would you rate the presenter?

• Goo d-4
• Slowly in interaction with the audience. This time, it was very important, and I felt that each presenter was getting faster.
• I'm appealing, but I'm about all information
• Regarding all information
• I think that's fine.
• Some of them don't need to know, but it is necessary to understand that it may be related to others.

Q4: Were the objectives of the presentation achieved?

• Detailed processes and forms
• Clear and concise
• All presentations
• Poor - 0
• Telehels POS and modifier are required
• Some of them don't need to know, but it is necessary to understand that it may be related to others.

Q5: Do you think the Provider Forum presentations add value to the services you provide to your customers?

• There was no need to move 100 miles for a round trip to participate! :)
• I was able to write a note that draws the attention of the AZ Complete management.
• I want you to review the process in more detail.
• I am grateful that the actual leader participated, not the agent.
• I think that's fine.
• Q7: How do you think the presentation will be improved?

Don't read PowerPoint. The speaker just needs to point out highlights and action steps. I don't want to be read aloud at the meeting because of everyone's time. T

• Please do not read it out.
• I want you to increase the coding of Telehels.
• I want you to provide more information about the merger of AZCH and care 1st.

Q7: What did you like most about the presentations?

• Some of them don't need to know, but it is necessary to understand that it may be related to others.
• The latest and specific information for the highest executive officer (CEO) level.
• I want you to pay more attention to the specific services.
• Slowly in interaction with the audience. This time, it was very important, and I felt that each presenter was getting faster.
• I want you to review the process in more detail.
• I like training in direct meetings, but I understand that short presentations are unrealistic.
• I think that's fine.
• These two are related to the general health of the patient as well as medical care.
• Talk more about complaints and complaints
• Divide the forums by provider type and work, and dig deeper into places where there are still problems.
• Monthly update.
• Send the power point in advance and have the provider read it. It takes a lot of time to hear the AZCH staff to read power points, and there is almost no time to ask questions or comments. We can read! And as usual, the claim / payment is left for the last 9 minutes. It's great to be able to see the real answer to the question, not the promise of "lively), but not a promise to" turn back. " The form of the forum has not changed since the Sempatico era. I am grateful for giving me the opportunity to express my opinion frankly! thank you.
• Presentation to the facility to make improvements in the relationship between the hospital and the plan. In my personal experience, AZ Complete does not respond to my concerns. This is the same from colleagues from other hospitals.
• To a more attractive presenter-From this side, the presenter feels like he is competing for the fastest speaker, and ends the presentation without asking questions. Very stiff, there is no real intention.
• Tota l-12

Q8: What could be improved about the presentation?

• 23 cases in total
• Q8 What topics do you want to know more?
• Claim s-18
• Complaints and appeal s-9 answers
• Pr e-approva l-7 Answer
• Credentia l-8 Answer
• Case / Care Management --6 Answer
• Others (please fill in specifically) - 5
• N/A
• A method for quality evaluation criteria and specialized medical institutions to check the benchmarks with other medical institutions.
• I want you to improve communication with all departments to provide AZCH members in a timely manner. The problem between the claim and the PA department is that there is no communication line with the complaint, and it is underway with the flow of work. Please work with the provider staff to get more involved with the provider.
• Your presentation is specific and targeted.
• I will probably not participate in the forum in the future, but I am grateful for the opportunity to give my opinion.
• Justice Involbud and Tip Program
• I want you to provide more information about the merger of AZCH and care 1st.

Q9 What topics would you like to know more about?

• Pim a-4 answers
• Maricop a-10 Answer
• Yum a-5 answers
• NA
• Tota l-19 cases
• Q2: Please tell us the overall evaluation of the presentation.
• Goo d-4
• Goo d-8
• Norma l-5
• Ba d-2
• Very bad --0
• Tota l-19 cases
• Tota l-12

Arizona Complete Health-Complete Care Plan Member Satisfaction Survey Results

Arizona Complete Health Complete Care Plan – RBHA Monthly Member Survey Survey Analysis CY2021 Q2 Report

Scope of Work

Good - 4

Good - 8

Average - 6

Poor - 1

Very Poor - 0

Total - 19

Q4: Did the objectives of the presentations come to fruition?

• Good - 2
• Good - 9
• Average - 7
• Poor - 0

Very Poor - 1

Total - 19

ANALYSIS

Q5: Do you think the Provider Forum presentations add value to the services you provide to your customers?Good - 6

Good - 2

Average - 5

Poor - 5

Very Poor - 0

Total - 18

Q6: How many families and children do you expect to share this information with in the next month (estimated)?

Families - Average 26 people

Children - Average 6 people

Total - 14 responses

Q7: What did you like most about the presentations?

"I can do better" from the Director of Certification

Average - 5

I wish the AHA had spent more time explaining their presentation and what they have to offer clinics.

It was an honest and forthright way to raise the issue.

The presenters wanted feedback.

All

Very helpful

Community investment and transparency

Lunch with billing and the AHA

This forum didn't help anyone. It was just insurance companies making excuses for things not working. I didn't learn anything. I knew more about something than some of the presenters did. Customer MRs need to do a better job answering questions and educating providers to talk to authorization departments when necessary.

Setup, location, food. Polite

They were open about issues affecting sanctions and ass.

Total - 12 Answers

Q8: How could the presentations be improved?

· More focus on AZ CH and how we can work better with you guys as opposed to having most of the forum be presented by external parties.Be a bit more determined and have the individuals who make the decisions available.

More focus on billing, claims and credentialing issues.

· The step by step PDF on referrals was very hard to follow. I felt like this would have been better distributed as a handout and then with an offer to help anyone who had questions.I would like it to be held more frequently.

Tailor presentations to the departments and roles of the staff attending. The people attending this meeting are not the ones who put PAs into the AzCH portal.

You need to prepare an answer to any type of doctor, get a name and a phone number to return the answer over the phone. Nobody asked for this information, and did not see if you understood this information so that you could contact me.

· noneI can't think of it for now.

I think it would be nice if there was an agenda or schedule for each session. Some do not apply to me, but I don't know the agenda of the day, so I'm sitting.

· Please educate the customer service staff. Because the person in charge doesn't know anything about authorization. They are wasted our time and we are busy with patients.Ach will probably be able to get a little better in relation to consistent medical providers' concerns. The end of the meeting was a claim session, especially with few solutions related to claims and payers. It is also important to call the speaker on time. If the speaker is delayed, half of the audience left the venue on time, and the speakers will be disadvantaged.

AWC is a bit far for many medical institutions and in the suburbs.

· Total 14 casesQ9 Please tell us about the theme that you want to learn deeply:

A communit y-based service that is not connected to a local resource for all types of clients, houses for both SMI and GMHSA, children's services, and health plans.

· Requests, complaints, qualification certificationI was very interested in the story of BP AHA.

I want you to increase the forum that the provider can get the latest information.

Request and qualification certification

How can the provider representative increase communication with our clinics? The provider's person has not yet promised.

Rejection

Request policy, medical policy, process

Clarify AHCCCS for MR. Allergic insurance is not applied to patients over the age of 21. They say to PCP and patients that they are the services that are covered by insurance, and they get angry when we say they are out of insurance. Then why my doctor introduced your clinic. Many doctors do not know the guidelines of allergic specialists. Please educate them too. That way, both the patient and the doctor should be happy.

A general error that may affect complaints and backlogs Ach and payers. How should we cooperate to make these processes more smooth?

12 No answer

Tota l-12 answers

Arizona Complete Health-Complete Care Plan-RBHA (AzCH-CCP) developed a "Monthly Member Survey" to understand member satisfaction with services and service delivery. The survey results help AzCH-CCP continually monitor member satisfaction and agency performance and identify areas for improvement.

The survey questions are as follows:

Questions 1-5: Patient ExperienceQuestion 6: Outcomes and Functional Improvement