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Secondwave

Select Health is launching the Secondwave Risk Adjustment Clinical Documentation Integrity (CDI) Program to support your practice as part of the Quality Provider Plus (QPP+) Program.

What to Expect from the Secondwave Risk Adjustment Program:

  • CDI alert forms that identify:
    • Previously reported conditions requiring reaffirmation
    • Suspected conditions that may warrant assessment and management
  • Flexible Delivery Options - Alerts can be delivered in paper format, integrated into your EMR (if applicable), or accessed via the Secondwave portal. Your practice may choose the option that best fits your workflow
  • Use During Patient Visits - Providers review and complete the form during the face-to-face encounter
  • PCSS Network Manager – May work with you on behalf of other payers, but your primary point of contact for overall program coordination, program implementation, and ongoing guidance will be Select Health Risk Adjustment Strategic Partner, Shanni Baraki.
  • Secondwave Provider Consultant - Assigned in partnership with Shanni Baraki, this consultant will:
    • Address program-specific questions
    • Coordinate provider peer-to-peer education
    • Manage alert creation, delivery, and retrieval based on your form delivery method
    • Track and reconcile alert completion
    • Deliver key metrics reports and performance insights
    • Handle post-visit queries as needed
    • Support medical record retrieval for documentation and audits

Participation Expectations:

  • Medical Record Access: Remote EMR access is preferred. On-site access or scanning can also be arranged.
  • Designated Points of Contact: Please identify a primary and secondary contact at your practice to coordinate the program.
  • CDI Alert Form Process:
    • If you use the PCSS portal, this workflow will be discontinued. You will be presented with several options from Secondwave for CDI Alert delivery and return.
    • If using EMR Integration, ensure your team is trained and the integration is completed.
    • If using paper, ensure your team has a workflow to distribute and return completed alerts.

Bonus Opportunities:

Here are additional specifics about what will be changing for clinics within the program:

Current State
Future State
Secondwave manages the operations for complete and accurate documentation and coding of Risk Adjustment conditions with certain clinics on the QPP+ program.
No change.
PCSS manages the clinics' communication about QPP+/Risk Adjustment metrics, payments and issues.
Select Health Strategic Partners will take over managing clinic communications about all QPP+/Risk Adjustment program related-topics and PCSS will no longer meet with these clinics with Select Health or on SH's behalf (though PCSS could meet with clinics on behalf of other payers they work with).
Select Health Strategic Partners have guided PCSS and Secondwave in Risk Adjustment Strategy and helped answer deeper questions from clinics that PCSS could not answer.
See above.
Clinics are using PCSS's portal to receive QPP+ data alerts from Secondwave and also to return responses and submit medical record documentation.
Clinics will stop using PCSS's Provider Portal to receive/submit QPP+-related documentation and will instead use Secondwave's processes/tools (multiple different options).
Select Health Strategic Partners have been meeting with PCSS Network Managers with Clinics in a separate QPP+ meeting from the Select Health Quality team.
Select Health Risk Adjustment Strategic Partners will meet with SH's Quality Team with clinics for a comprehensive QPP+ meeting.

 

If you have any questions or would like to learn more about the program, please contact: