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Seaside ND Practice Achieves Tier 3 Level in PCPCH Credentialing Process

Sunday, March 15, 2015   (0 Comments)
Posted by: Brook Schales
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Seaside ND Practice Achieves Tier 3 Level in PCPCH Credentialing Process


A Natural Path Clinic is now recognized as a Patient Centered Primary Care Home by the Oregon Health Authority


To those familiar with Clatsop County, the economic news is not good. State health experts consider it impoverished with more than 45% of children on free or reduced lunch programs. But these conditions haven’t proved to be daunting for Dr. Kathleen Flewelling and her office manager, Wendy Stafford. With an awareness that more than one-third of their patients were on the Oregon Health Plan, the two women decided a year ago that it was time to become a Patient Centered Primary Care Home.


Dr. Flewelling has operated a general practice clinic in Seaside for the past sixteen years and Stafford has been with her for more than seven years. She treats a lot of patients with hormone issues but also sees people of all ages, including children.


"Our main motivation was to help our patients because most of them see Dr. Flewelling as their primary care physician,” noted Stafford. "Their Oregon Health Plan card lists a different clinic but they don’t go there. It just made sense that we should take steps to become their primary care physician with the Oregon Health Plan.” 


Their current status with the PCPCH process is that they’re listed as Tier 3 and have completed the first step: the Oregon Health Authority recognizes them as a Primary Care Home. Now they move to the next step of contracting with Columbia Pacific Coordinated Care Organization.


"Columbia Pacific previously reimbursed us at a specialist rate which is lower than the rate paid to Primary Care Physicians,” Stafford said. "Once we officially sign with Columbia Pacific, we’ll have to start tracking patient records a lot more and provide evidence every three months that we’re acting as the patient’s PCP. Before doing that, though, we want to be sure all of our tracking systems are in place because we know they will be auditing us,” Stafford noted.


To manage the tracking component, they invested in an electronic health recording system. With the help of a medical assistant student from Clatsop Community College they’ve made faster progress (just over six months) with step two and plan to be in contracting mode by the summer. "Just learning the electronic system and juggling my part-time workload was all I could manage during most weeks,” Stafford added.


"In the end, it will have been worth all of our time,” Stafford continued. "Once we get the pay increase, we can serve more people, and we can grow the practice.”


"Considering how busy their practice is, and the fact that Stafford is only a part-time office manager, it’s quite an accomplishment that they’ve gotten this far in the process. I really applaud their efforts,” noted Laura Farr, OANP Executive Director.


With Stafford’s help, Flewelling has established contracts with two area hospitals, Seaside Providence in Seaside and Columbia Memorial in Astoria. They’ve also found another ND and a MD to back them up with emergency 24-hour call coverage.


In the end, it’s more work for NDs to get credentialed because MDs and NPs qualify for tens of thousands of dollars in grants but NDs are not eligible. "With the way that heath care is going, we feel we should do it now before it’s a requirement,” Stafford said. "Once we’re through with this, we’ll start working on contracting with other insurance carriers to stay on top of where medicine is going now.”


Resources recommended by Dr. Flewelling & Wendy Stafford:

·      Oregon Health Authority Training Manual

·      Electronic Health Recording

·      OANP – Laura Farr






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