2025 November Network Connection

REQUIREMENTS: 1. DOCUMENTATION PRIORITY (Immediate): Providers must prioritize documenting at least one compliant blood pressure reading (under 140/90 mm Hg) for every patient visit with hypertension diagnosis. Billing and clinical teams should update encounter templates and EMR reminders to flag hypertension patients for BP documentation. Ensure clinician-taken readings (not patient self-reported) are documented in the chart. 2. BY DECEMBER 12, 2025: All contracted providers must attend ONE required Provider Education Conference & Webinar Series training. Behavioral health providers: Register at phs.swoogo.com/2025PEC (Dec 11, 5-7 PM or Dec 12, 10 AM-Noon). Physical health/long-term care/IHS providers: Register at phs.swoogo.com/2025PEC (Dec 11, 9-11 AM or Dec 12, Noon-2 PM). Billing team should track attendance compliance and flag providers who do not complete by deadline. Non-compliance may affect network participation. 3. IMMEDIATE: Update claims submission workflow to prioritize electronic submission over paper claims. When resubmitting previously denied claims, use correction indicators and frequency codes (do not create new claims). Billing team must review the Administrative Claims Edits Guide at phs.org/providers/claims and subscribe to claims update emails at phs.org/enews to stay informed of future changes. 4. ONGOING: Prepare for upcoming NCQA pilot measure 'Blood Pressure Control for Patients with Hypertension (BPC-E)' that will use electronic clinical data only. Ensure EHR/billing system can support electronic data submission without manual chart review and verify pharmacy data integration for denominator calculations.