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Providers ask about fax referrals, coverage lapses and reconciliation timelines at DSS forum
Summary
During Q&A providers asked whether the perinatal psychiatry line will accept fax referrals, how to resolve member coverage lapses, and when dashboard targets and reconciliation run‑outs will be set; DSS responded with current procedures and next steps.
During the forum providers asked practical operational questions about referrals, coverage lapses and the data used for targets and reconciliation.
A provider, Paula, asked whether fax referrals could be accepted to simplify EMR workflows. Beth replied that the program currently requires a phone call routed to psychiatrists but said DSS will "take that into account and see if we can...modify," and will keep providers posted. "As of right now, it is a a straight phone call," Beth said.
Providers also raised coverage‑lapse cases. Fatmata acknowledged ongoing work to build an escalation process to resolve coverage lapses more quickly and said providers should continue to contact CHN (and specifically Kim) in the meantime. "We are trying behind the scenes to work out a process where we can seamlessly maybe establish some sort of an escalation where we can get those resolved quickly," Fatmata said.
On dashboard targets, panelists (including Charles and Sean) said current data are insufficient to set reasonable targets and that directional targets would require several years of data; reconciliation and shared‑savings calculations will operate on separate, longer run‑out windows. Sean and Charles offered to review reconciliation timelines in a future forum for additional clarity.
The session closed with a reminder to contact CHN PES representatives for follow up and resources.
