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TurningPoint Healthcare Solutions

Absolute Total Care is pleased to announce the launch of a new and innovative Surgical Quality and Safety Management Program, effective July 1, 2019. The program is designed to work collaboratively with physicians to promote patient safety through the practice of high quality and cost-effective care for Absolute Total Care members undergoing Musculoskeletal Surgical Procedures.

Program highlights include:

  • Administrative Tools to support an efficient, user-friendly authorization process for procedures requiring precertification, in addition to recommended medical necessity determinations for procedures, which do not require precertification. Easy and efficient post-procedural documentation submission, which will be shared with Absolute Total Care to facilitate timely claims payment.
  • Specialized “Peer-to-Peer” Engagement, where a TurningPoint physician (from the same specialty) engages the provider regarding authorization requests that require additional clinical discussion to validate the clinical appropriateness of the procedure specific to the patient’s needs and current condition.
  • Clinical Support Tools to assist in the tracking and monitoring of patient outcomes and education around patient risks and preventive measures to better coordinate care for the member and reduce infection rates and complications due to patient comorbidities.
  • Provider Performance Incentives for providers who comply with program requirements to practice high quality, cost-effective care.
  • Reporting and Analytics that give providers and practice administrators greater visibility and transparency into their performance compared to the practice as a whole, as well as the rest of the market.
  • FDA Recall Tracking and Monitoring to facilitate timely and consistent notification to the provider, patient, and to BHP when a member has received or needs a revision surgery due to a Class I or II FDA device recall.

CPT Codes

22552

22554

22556

22558

22585

22586

22590

22595

22600

22610

22612

22614

22630

22632

22633

22634

22800

22802

22804

0275T

22533

22808

22810

22812

22818

22819

22830

22840

22841

22842

22843

22844

22845

22846

22847

22848

22849

22850

22852

22853

22854

22855

22856

22857

22859

22861

22862

22864

22865

22899

23130

23333

23334

23335

23410

23412

23415

23420

23470

23472

23473

23474

23616

23800

23802

24160

24164

24360

24361

24362

24363

24365

24366

24370

24371

25332

25441

25442

25443

25444

25445

25446

25800

25805

25810

25820

25825

27033

27090

27091

27120

27122

27125

27130

27132

27134

27137

27138

27280

27299

27360

27405

27407

27409

27412

27415

27416

27437

27438

27440

27441

27442

27443

27445

27446

27447

27486

27487

27488

27700

27702

27703

27704

27870

29826

29827

29860

29861

29862

29863

29866

29867

29868

29870

29871

29873

29874

29875

29876

29877

29879

29880

29881

29882

29883

29884

29885

29886

29887

29888

29889

29899

29914

29915

29916

29999

36260

36563

36583

61215

62287

62350

62351

62360

62361

62362

62365

62367

62368

63001

63003

63005

63011

63012

63015

63016

63017

63020

63030

63035

63040

63042

63043

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63045

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63064

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63101

63102

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63170

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63180

63182

63185

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63196

63197

63198

63199

63200

63250

63251

63252

63265

63267

63268

63270

63271

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63275

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63280

63282

63285

63286

63287

63290

63300

63301

63302

63303

63304

63305

63306

63307

63308

63650

63655

63661

63662

63663

63664

63685

63688

 

HCPCS Codes

C1767

C1772

C1778

C1787

C1820

C1883

C1891

C1897

C2626

E0783

E0785

E0786

G0289

J7330

L8679

L8680

L8681

L8682

L8683

L8685

L8686

L8687

L8688

L8689

L8695

S2112

S2118

S2348

S2350

S2351

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