Here we go. And you can just let me know in the chat if my audio is okay. I've been having a little bit of problem, with my audio on this computer, so I just wanna see if it's okay if I need to switch to my headset. So just let me know if you have any problems hearing me. That would be great. Because we have the upcoming celebrations for the what is it? The quadriceps I'm not even sure what they're calling it, what two hundred and fifty anniversary is, but, we just had a massive flyover of the office building. Hopefully, that will not come through on audio if it happens again, but there's been a lot of military flyovers, in the last few days. It's a little creepy, actually. Here, I love flying airplanes, but, that's part of the celebration. So let's get started on the actual presentation today. So welcome to the office hours for June. Thank you so much for joining us. This is gonna be an overview of just some key processes, that we handle, here at NCQA. Very straightforward. May not even take the full hour. And, of course, if you have any questions about what I'm covering or about anything in the program, please feel free to send those through on the q and a, and I will answer them as we get to them. But if not, we'll just go through it forward and talk a bit about, everything, that we're gonna cover today. So first thing, of course, is the disclaimer. This is now something that HRSA has asked us to add to all of our training, making it clear that while these trainings are financed by our contract, with HRSA, they they provide the funds for them. The materials, of course, are NCQAs and not necessarily been approved, by h s HHS or HRSA if they're not federal resources. So that's just something that they want us to make clear as we're going forward. We just did the welcome, and my formal introduction is that I'm Bill Tullock, director in the federal services center here at NCQA, which is the part of NCQA's, organization, the quality measurement research research group specifically or QMERG as we like to call it, that handles our federal contracts. And that, of course, includes the HRSA contract, which I've been working on since, we first got it back in twenty ten, which I'm only realizing now is how long, I've been working on this project. Quite quite amazing, actually. I've been with NCQA actually since nineteen ninety seven, so quite a history with the organization. We're gonna talk a little bit about the NOI process, of course, about how we provide the sponsor code out to, our customers and then also some key information on making sure your codes are up to date. There's a there's a difference I'll go over at that point. There's a difference between how HRSA handles certain, changes to to centers and how, NCQA handles them, and that can actually, cause problems when we're getting to notice of intent approval. So it's just something, important to note, and I'll talk about that more as we get to that section. So let's talk about the NOI process, of course. It's important to note, that the notice of intent, which is what the NOI stands for, is HRSA's, is your request to HRSA as a health center, that you would like them to cover the, the, reviews, the PCMH reviews. And, the process is different depending on whether well, the process is now different in two ways. First difference is, are you a three thirty grantee? That is, are you f are you FQHC and you have access to electronic handbook? Then you do all this through the handbook. If you are a lookalike, then you actually have to go to HRSA, to their sort of their customer service portal, ask a question, and basically request a, spreadsheet they will send you where you can download the information that would normally be sent through the electronic handbook on which centers, you want to get, which centers and which sites you wanna get support for. The other change that happened just this year is that we now have behavioral health support as well in the NOI process. That is if you have the behavioral health distinction on top of, the primary care patient centered around alcohol. Excuse me. I can't I almost miss misstated the name of our own product. If you have the behavioral health distinction or would like to add that integrated behavioral health distinction to your PCMH, you can also request that through the notice of intent. It's very important, though. HRSA would like you to file a second notice of intent. They were not able to change their process, so there was no way to update the notice of intent in the in the electronic handbook to say, this is for, behavioral health distinction. This is for PCMH. So what they'd like you to do is do two separate notices of intent, one for the PCMH and then another one for the same site same centers, or the same sites, excuse me, that where you want the the the behavioral health and put in the notes field in the electronic handbook that this is for behavioral health. You can also add a note in the spreadsheet if you're a lookalike that you would like behavioral health support for a specific site as well. So we it is a double NOI process. They have been accepting, notices of intent where it's for the PCMH, and then they added we'd also like behavioral health in the notes section. But to really be sure you're gonna get, support because we'll have to go back to HRSA, perhaps back to you when we get a notice of intent like that. The best way to go forward is to file two notices of intent, one for the PCMH, a second one for all the same sites where you want behavioral health distinction. And, again, you can do that through the electronic handbook if you're an FQHC and through the spreadsheet that you can request from HRSA if you are a look alike. Those notices of intent are approved centrally at HRSA now. They used to go to the project officers in each region, so it's a much faster process now. And we get a weekly batch report typically on Tuesday, sometimes Wednesday, from HRSA with all of those most recent up notices notices of intent that have been approved. If you are getting close to your reporting date, if you're in annual reporting, we also now have late fees that can apply if you miss your reporting date. We had a lot of problem with with folks. The system doesn't stop you from reporting late, and what we're running into was a lot of folks were reporting late. It was it was causing some some stress on our staff to get those reviews done in in time for the anniversary date. We normally want thirty days to get those reviews done. So if you miss your reporting date, that can cause an issue. So now if you, if you miss your reporting date and you don't alert anyone, there's a fifty dollar fee per site. If you, know you're gonna miss your reporting date and you alert NCQA, we can actually sort of give you a a smaller fee to pay, that will allow you to do that. So if you think you're gonna miss your reporting date for whatever reason, contact your representative. Let them know. So this late fee can be can be adjusted, and give you the smallest possible because HRSA doesn't pay that. However, if you realize that the issue is your notice of intent may not be approved, and that's gonna cause you to be late, please first, you know, contact your rep, but also contact us here at NCQA before you try to self pay or anything. We have the ability now with HRSA, doing all this the notices of intent approval centrally to actually expedite that. So this has happened actually in the last couple weeks. I've been involved when some other staff have been on PTO, where literally we we've had the the site, file a notice of intent in the morning. We've gotten approval, and we've been able to approve their discount code in the afternoon of the same business day so that they could avoid those late fees. I don't think it's a good idea if you wait that long, but if you are getting close to your reporting date and you realize the n o a the NOI, excuse me, may be the only thing standing in your way of reporting, you know, don't try to self pay. Do file the NOI, but then alert your rep, and they'll alert us or you can alert us directly through the HRSA PCMH initiative email address, and we will work with HRSA to get that approval. We send an email to them. We give them their the information. They go into their system. They give us an approval back on the email. We can uncover it. It's great. So if you're running into that, please be careful, and you can avoid the late fees that way. But please, we again, we can we can expedite those if you need us to. So now the sponsor code itself, which is the discount code, it's the coupon code that basically lets you avoid paying, anything for your review. That will actually go out in an email. If you are a, first time, HRSA supporter, or first time getting HRSA support for a review either for a transforming review or say you've had behavioral health distinction for a while and you, you've been paying for it yourself and now you want HRSA to pay for it, well, you wanna make sure that you have your, HRSA ID and your your grant ID, excuse me, and your site IDs all updated in QBAs. And I'll show you how this works. So these are in the l the lookalike format. If your, FQHC, the LAL here will be replaced by the, characters h eight zero, but same format. And you need to make sure that you have these codes and they're up to date both for your grant for your organization, your grantee ID, and for each of the sites, which are your BPIC ID as we call them or or Bureau of Primary Health Care site ID. The important thing is that, we match, the the notice of intent, the grant ID, the site ID. Those match, and then we can actually approve the site. If they don't match, that's when you run into problems. And and that can can really be an issue if you've moved locations. And I'll talk about that, as we get into the the QPass demonstration. But it's important to remember that HRSA considers a site add a site address change. So if you've moved physical locations, they consider that a new site. They in their system, you've closed a site and opened a new one. That's not the case in in in, the QPass. You can simply update the address, and it's the same site to to us. You're gonna update the name of the site. You can change everything about the site, but leave it as the same sort of, historical record in QPass. And what that means is folks don't realize that, when, you move locations, HRSA considers that a new site and issues a new BPX site ID. So that that sec number two here, the site information, that site ID is actually gonna change. And then if that site ID is not up is not matching in QPAS, we're then gonna look at the address, which, of course, is not gonna match because you probably haven't updated your address in QBASS either. And so that can let, really be an issue, with, you'll have ten sites and suddenly nine of them are approved and the tenth isn't. That's because HRSA considers a new site, but QBASS doesn't. So if your site moves, you can go in, you can update, that site information. If you consider it a closed site, and and that and that you've opened a new site rather than simply moving one site from one location to another, then what you wanna do is actually contact your representative. We can, we can't take the the, old site off of your, account because there's a historical record there, but we can hide it. We can make it nonoperational. And then you can add a new site if you are opening a brand new site. But if you're just changing address and you consider the site the same, then just update that address, update the ID in in QPS, and that's gonna make sure everything matches. That first time you go through transforming, whether for PCMH or behavioral health distinction, and, again, if or the first time you receive support in annual reporting for PCMH or annual or behavioral health distinction, you will have to physically enter the code. You'll have to fat finger it, as they say in the business, in into the system. After that first time in annual reporting, then this the discount code will be waiting, and you'll we'll we'll see what it looks like in the, in QPass. But, basically, you will be waiting for us to approve that, and then the little indicator that says it's waiting for approval will go away, and you'll be able to report. So, it is a process that is automated, for you once you go through that second, third, or fourth round of annual reporting. So here's the setup again. Transforming review. If you are coming through either for PCMH or be you're adding behavioral health distinction, then you're going to have to actually go through enrollment, and you're going to have to input that discount code physically when you get to the payment system. Same thing, first time annual reporting. You actually don't have to reenroll the site. The the the the review type will automatically switch once you get recognized from transforming the annual reporting. It'll actually show up on your annual reporting tab when you open up, your manage evaluations, tile in QPASS. But you will have to physically put that discount code into the, annual reporting, ledger or into the ledger for that first time annual reporting. The same thing is gonna happen if you are adding behavioral health distinction, either because you are adding it for the first time or you've been paying for it for a while. So you're still in you're in annual reporting for behavioral health. Either way, transforming your annual reporting, time you get behavioral health support, you're gonna have to put that discount code in again. But as I mentioned, second, third, fourth time, as long as you stay in the, the process and you don't let the recognition lapse, that discount code will be waiting for you. And one once we approve the NOI, once we get that NOI and we go in and approve the discount code, you'll just be able to report. You won't have to do anything but hit create invoice. So you'll see that, in just a moment. It's also important to note that every time you go through the process now, you are going to have to reverify that you are eligible for PCMH. This is something we added a couple of years ago. So, you'll see that there are practice questionnaires. One is your general questionnaires to what your ownership is, how many, you know, Medicare, Medicaid patients, what kind of providers you have, do you have behavioral health providers, all those kinds of questions that help the reviewer understand your practice. Those questionnaires are are answered once, when you go through transforming. Always a good idea to look at those answers and update any of those, responses when you go through annual reporting the first time and each year after just to make sure that you the, you know, the information hasn't changed. Always helpful. But each year at annual reporting, you're also gonna have to go through and physically do an eligibility, check that, basically lets you know, that you are or lets us know that you are still eligible for PCMH. Basically, you are, readtesting that, you are still primary care focused, that you, can still, it's part of the attestation that you can still meet the requirements, those kinds of things. But that eligibility verification, whoops. I didn't mean to go backwards in slides, will be there for, for that purpose. And if you see that you have to, if you see that you have to, do the the questionnaire, you can access it through the practice eligibility tile. So we do have a question. Alright. So, there's a question that came in about the red exclamation point. So we'll see this when we look at Q PAS. So what happens is when you have your when you're going through annual reporting, you've you've gone through you got your HIE support. You get recognized for another year. If you go back into the ledger at that moment, you will see that there's a red exclamation point that says that your site has not been, approved for its next review. Because in QPass, you're always in a review cycle. So the minute you get recognized if you got recognized today, June twenty fifth, and that's your your new anniversary date. So your new anniversary date is gonna be June twenty fifth twenty twenty seven, and your new reporting date is gonna be May twenty fifth twenty twenty seven or May twenty sixth, technically, we do thirty days, you're gonna see that that cycle will automatically be waiting for you in the new, in QPass, which means if you look at your ledger, you're gonna have a cost for that review that will not yet be approved. The red there'll be a red exclamation point that says, this is not yet approved. You file your NOI. If you file your NOI before more than ninety days before your reporting date, we will not approve your review until we get closer to your reporting date. So you may see you may have filed your NOI, got the approval, and you see that exclamation point still there. That's probably because you are too far away from your reporting date for us to approve that. The reason we don't approve that right right then so it's a issue in our accounting system. The minute we approve your review, that goes in as one of our slots used. But right now, like, we're we're we're getting toward the end of our task order period, which is in September. So as we get closer to September, we don't want somebody who has a reporting date in October, which is gonna be in our next task order, to get one of those slots from this task order. And if we approve your review in August, we approve that that, your, say, your November, reporting date, and we were approved we approve that NOI in August, if we take that discount code off, that's gonna go against our current task order slots, which are only good through September. So that's one of the reasons we wait for ninety days. So if you are concerned because the NOI you have evidence the NOI has been approved and you still see that red exclamation point, it's probably because you are too far away from your reporting date for us to update. We will update that as we get closer to the actual date. But, certainly, you can ask that question, and we can get back to you. And we can also see how close you are. And if it's, you know, making you uncomfortable, we may still be able to approve it. So, certainly, ask the question. But if you know your NOI has been approved and you still see that red exclamation point, either we haven't gotten the NOI yet, so there's maybe up to a week delay possibly, and or you are too far away from your reporting date, for us to approve that, and we're gonna approve it closer to your actual reporting date. We have the NOI on file. Don't worry. We we have a whole system where we are tracking what NOIs, we've, we've and what we haven't used. It's all behind the sys it's all behind the the the the page for you or behind the screen, and it's a manual process. So it does take us a little time to update it. But please, if you are getting concerned, alert your rep, final question, and they can check with us, and we can get that approved if there's been an oversight or something. So, again, if you're getting close to your reporting date and you're like, I know that NOI was approved. What's going on? The other issue, and particularly, this is actually a good, another good reminder, if you have nine or ten sites and all but one has been approved, that's when you really wanna double check. Look at your NOI and look at the information you have in QBAS. Are those BPHC site IDs the same? Are those addresses the same? Because if they're not, there may be an issue with HRSA thinking this is a different site than QBAS does. So that may be why one site out of a few. So if none of them have been approved, probably because we even either haven't gotten your NOI or we're holding onto it, and won't, go in and formally approve your discount codes until we get closer to your reporting date. If some of your sites have been approved and others have not and you know they were all on the same NOI, that is probably an address or ID issue that we need to fix, and that may be, require a little back and forth between your organization and NCQA and HRSA to make sure we're all on the same page as to which site has which address and which ID to make sure we're all speaking the same language. Alright. So I'm gonna stop sharing these slides real quick, and I am going to in fact, I'm gonna get out of the slideshow altogether. There we go. And I am going to show us the QPass system. No. I don't wanna share the there we go. So this is, of course, the QPAS system. This is our training system, which I'll actually be going into to do the demo, but it's the exact same site. So, again, this eligibility questionnaire is what we're gonna have you fill out every year, but there's another way to, actually approach that, internally. So I'm gonna sign in as a customer to QPass. I'm gonna go to the my QPass account that I have many, many, many sites. Of course, the training site always takes a minute longer than you would like. The joy of, oh, please tell me it's gonna work. Here we go. Alright. If not, I was gonna have to show you a real account, that could get so this is a a a demo organization. And let me show you, the important coding, areas. So this here, this is the the organization address, that sort of thing. Again, you can update this if you move addresses or change your corporate office, all those kinds of things. Also, make sure that this grantee ID is up to date. If you have not filled out this grantee ID, if you've left this blank, you will not be able to input a site ID for any of your sites. We want that grant ID there. First, filling this field out. I'm pointing to my screen like you can see it. Right? But filling this this field up that I've highlighted, yeah, is the way to alert the system. You are a HRSA grantee, or you're a HRSA sponsor. You you you may be eligible for HRSA sponsorship, and you're gonna be requesting that for your sites, at least some of your sites. So this is where you wanna make sure that that's up to date. Double check your electronic handbook. Make sure your grant ID is the same. Then when you get into your sites so I'm just gonna open up any any old site. You're gonna, again, make sure this address is what you want, the current address. And then here's where you're gonna put your site ID. Now it's possible to be a federally qualified health center with some sites, or if you have a complex organization, you may have both a federally qualified health center and a look alike. That's that's certainly possible. Probably not the case, but, this is all fake data. So so, so don't worry about that. But, again, make sure that this ID matches what's in your notice of intent. Very important. If there's a mismatch, particularly in in the ID number and the address, you may have that issue where you've changed locations, and HRSA considers this a new site. So make sure that if you do change address, you can always come in here and update your address for your sites. You can always update your BPHC site IDs. Again, if you think, however, that that if you consider that you've closed, you know, this twenty twenty four demo site and you're opening a new site, then you're gonna wanna request. Now I can edit this one, but notice I can't delete these sites because they're all enrolled in a program already. And I'm looking this way. I apologize because I've got my laptop open, and the screens are covering each other a little bit. So but if you have if you, have officially closed, say, this site here, you're gonna wanna alert your rep and say, look. We've closed this site. We have a historical record, so we can't delete it. Can you make it, sort of nonoperational? And we'll put it into your history, but it it'll go away off this list. To do a new site, you would come over here and create a whole new site with all this information, the NPI number, etcetera, etcetera. I'm not gonna actually create a new site, though, because I've already have enough of them in here. But if if you're just moving this demo site from five fifty five thirteenth Street, which actually was the fur the address of the first, job I had at NCQA, but we're going to update that to NCQA's current street address, which is eleven hundred thirteenth Street Northwest. And then I'm going to save that that change. Then I have updated that site in NCQA system. Person may consider that a new site. I may have to update that BIPIC site ID as well, But for NCQA purposes, it's the same site. So that's that's where you may run into a disconnect. And so if we come in and we have, an NOI that says this is at five five five thirteenth Street and has a different site ID, that's where we're gonna run into that problem. Or more likely, your NOI is gonna say eleven hundred thirteenth Street. But since you didn't update your site ID, this isn't gonna match down here. There'll be a brand new ID from HRSA. So you have to make sure you update that once you get it from HRSA. And just double check when you're filling out your NOI that your grantee ID at the organization level and your site ID is the same. Now if you are in a new site, I wanna show you one more thing. Some of your organizations are more complex. This system assumes you have an organization, a health center, and several sites. That's all. If you've got a corporate organization and then a health center as part of that organization and then the sites, that's a little bit more complicated because her your if you wanna share policies across all your your different types of organizations, then you're gonna want them all in one account in QPass. So what you do there is when you create a site that isn't part of the health center, you can click this little button, which means we won't expect to see a site ID, but we also wouldn't expect HRSA to pay for that site. Very simple just to alert NCQA. That's all you need to do. This is not gonna be part of our health center site. So if your organization is more complicated and you've got health center and nonhealth center sites that are in QPAS, but they're all part of the same account, this is the way you can designate between them. The ones that are gonna get HRSA support have to have an ID in this field. The ones that don't, you just check this box. Very simple. Alright. Any further questions? That's really the the material that we were gonna cover. This office hour is very straightforward, but very important to make sure. And probably the best, again, the best advice is when you're filling out that NOI either in the electronic handbook or if you're a lookalike and you're having to download that spreadsheet, just double check that the the codes you're using with HRSA, your grant ID at the organization level, and your site IDs at the site level are the same in your NOI as they are in, QPass, and then you won't have any issues running into approvals there. Just to let you know, our next office hours, just gonna get the extra, for on value based care will be Thursday, July twenty third at two o'clock. Not sure if the registration has been posted yet on the website, but it will be soon. But, again, we'll be talking about value based, care and how to, maximize, your quality indicators under those types contracting arrangements, which are becoming more popular. So that is, again, July twenty third at two o'clock in the afternoon. There are no other questions. I'm happy to give you guys back a half an hour of your day. It's sort of a shorter office hours here. Again, if you have, questions that come that arise after this, you can always go to my dot n c q a dot o r g. That's our central customer support portal. You can ask a question, and, you indicate that it's a HRSA specific question, those will come to my team. Alright. Well, have a great day, everyone, and, enjoy the summer weather.