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ACC Provider Information

Information for Primary Care Medical Providers (PCMP)

 

This page is designed to inform providers by answering frequently asked questions and present providers with contract resources. If you have specific questions about your PCMP contract, or are interested in becoming a PCMP, please contact ACC contract manager Marty Janssen (303) 866-4095. 

 

Primary Care Medical Providers (PCMPs) are a key part of the success of the ACC. The PCMP acts as a medical home and coordinates a client's health needs across specialities and along the continuum of care. In addition to the fee-for-service payments for the medical services supplied, PCMPs receive a per-member-per-month (PMPM) for the medical home services they provide.

 

For updates on all of the Department's programs, please see the Provider Bulletins.

 

Letter regarding providing services and submitting claims for Accountable Care Collaborative (ACC) program members

PCMP Provider Rates

Letter to urgent care providers

 

Interested in Becoming a PCMP in the ACC?

 

In order to enroll as a PCMP in the ACC Program, you must be an enrolled Medicaid provider that meets any one of these criteria: 

 

  • Certified by the Department as a provider in the Medicaid and CHP+ Medical Homes for Children program; OR 

 

  • A Federally Qualified Health Center (FQHC), Rural Health Clinic (RHC) or a clinic or other group practice with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics, or obstetrics and gynecology; OR  

 

  • An individual physician, advanced practice nurse or physician assistant with a focus on primary care, general practice, internal medicine, pediatrics, geriatrics, or obstetrics and gynecology

 

If you meet the any of the above criteria, please read and follow the step-by-step PCMP Online Contract Instructions and complete the following documents.  The Department strongly encourages providers to complete an online contract; however, if you are unable to do so because of technical issues, please read and follow the PCMP Paper Contract Instructions.

 

 

Please note all three documents must be completed for the State to process your contract. You will also need to contact the RCCO in your area to complete a separate contract with the RCCO. 

 

*For contracted PCMP's only: to review the recent changes made to the PCMP State Contract, please read the PCMP State Contract (Red Line Version) or the Summary of PCMP Contract Changes.

 

How are clients enrolled into the ACC?

 

ACC Client Selection Fact Sheet

 

In addition, clients are sent an enrollment letter, and are provided the opportunity to select their own PCMP or to opt-out of the ACC program. Below are some sample enrollment letters:

 

Sample enrollment letter (English) 

Sample enrollment letter (Spanish)

 

What is the Statewide Data Analytics Contractor (SDAC)?