Provider Manuals, Training & Outreach

Presbyterian hosts annual conferences throughout New Mexico for all contracted physical health, behavioral health and long-term care providers for all lines of business, including Commercial, Medicare and Centennial Care. The sessions feature updates on policies, procedures, state and federal regulations, and initiatives of Presbyterian Health Plan.

Please find upcoming conferences and materials below.

• Upcoming Provider Education Webinars
  
• Provider Education Webinar Training Presentation and 2023 Packet Information

Presbyterian Dual Plus (HMO D-SNP) is a Medicare Advantage plan that seamlessly combines both Medicare (as primary) and Medicaid (as secondary) to improve care and decrease costs for the frail, elderly, and disabled through improved coordination of care.

This is an annual required training for all medical, behavioral health, and long-term care providers (e.g., MDs, physicians, therapists, advanced practice clinicians, etc.) who render services to Presbyterian Dual Plus members.

Depression in Adults: Diagnosis and Treatment Guidelines

View an on-demand training video on treating and diagnosing adults with depression at the link below.

Depression in Adults Training Video

Town Hall Meetings

We are pleased to invite behavioral health providers to attend quarterly town hall meetings. These town halls are designed to present information to all areas of a practice, including administrative, billing, quality and clinical.

Behavioral Health Town Hall Meetings

Treatment Record Reviews (TRR) Training

View an on-demand training video on the TRR process and how to assist Presbyterian in meeting Clinical Practice Guideline (CPG) documentation standards.

Treatment Record Reviews Training Video

Through the myPRES Provider Portal, contracted providers with myPRES access can view a general Centennial Care Training and Centennial Care Cultural Sensitivity training under the Resources Links tab. If you do not have access to myPRES, you can request access by following the link below.

Request Access to myPRES

Long-Term Services & Supports (LTSS) Training

In collaboration with the other Centennial Care managed care organizations and the New Mexico Human Services Department, Presbyterian developed the following training materials for nursing facilities and agency-based providers.

• Nursing Facility Forms and Packets
• Nursing Facility Level of Care Criteria Training
• Nursing Facility Community Reintegration Training
• ABCB Provider Enrollment FAQs

Electronic Visit Verification System

The Electronic Visit Verification (EVV) System is used to track and report home visits by Centennial Care personal care services provider agencies and caregivers. The EVV system allows Presbyterian and the long-term care provider community to better serve our members and ensure they are receiving the services they need.

For questions about using the EVV system, view the documents below or contact Carlotta Cornelius, EVV manager, at (505) 923-7240.

• Electronic Visit Verification Implementation
• Electronic Visit Verification Implementation Timeline
• Electronic Visit Verification Tablets
• Presbyterian Tablet Stipend Update and Member Attestation Form
• EVV AuthentiCare® User Manual
• Mobility Exchange Tablet Ordering and Monitoring System
• Electronic Visit Verification Implementation Delay

Nursing Facility Payment Concerns and Resolution Meetings

Please join Presbyterian for upcoming Nursing Facility Payment Concerns and Resolution Meetings. These meetings are intended to answer questions and address concerns regarding nursing facility payments. To view upcoming meeting dates, register and learn more about submitting discussion topics, please use the link below.

Upcoming Nursing Facility Payment Concerns and Resolution Meetings

Indian Health Services and Tribal Providers Quarterly Conversations

All Indian Health Services and Tribal 638 providers and staff are encouraged to attend the Indian Health Services and Tribal Conversations trainings.

Upcoming Indian Health Services and Tribal Providers Conversations

• Critical Incident Reporting Reminders

Behavioral Health Critical Incident Reporting Training

Each year, Presbyterian hosts four live Critical Incident Reporting (CIR) training webinars that are specific to behavioral health providers. Please join us for any of the four dates at the following link. Please note that providers are contractually required to participate in one of these annual CIR trainings.

Upcoming Critical Incident Reporting Training Dates

Personal Care Services (PCS) Critical Incident Reporting Training

Presbyterian invites Centennial Care providers to attend annual Critical Incident Reporting Training. This training will cover critical incident reporting related to Personal Care Services and Support Broker agencies. This training is collaboratively presented by all Centennial Care Managed Care Organizations (MCOs) and the New Mexico Human Services Department (HSD).

Please note that attendance at this training is required annually for all Centennial Care providers that report in the HSD Critical Incident Reporting Portal.

Training dates are coming soon.

Presbyterian is pleased to offer our network educational opportunities to become even more culturally competent while earning up to nine hours of free Continuing Education Units (CEU). As you know, being culturally sensitive and competent is extremely important in healthcare – and especially in the state of New Mexico.

Continuing Education courses include:

• A Physician’s Practical Guide to Culturally Competent Care
• Culturally Competent Nursing Care: A Cornerstone of Caring

Supported by the Office of Minority Health at the United States Department of Health and Human Services, and accredited by Ciné-Med Inc., these online competencies are designed to healthcare professionals deliver culturally competent care to an ever-increasing diverse population of members.

During registration, you will choose an appropriate program in which to earn up to nine free CME credits (Physicians and Physician Assistants) or nine free CEU hours (Nurse Practitioners). Since these competencies are made available via the web, you can earn free CEUs at your convenience.

Register for CEU Classes

Presbyterian is committed to an inclusive and equitable environment that reflects the diversity of our community. We seek to learn from all perspectives as we provide affordable, accessible and culturally appropriate healthcare and champion health equity for our New Mexico communities.

Join our Health Equity Training Courses to explore related topics, including how to identify health inequities, the importance of cultural sensitivity, effective cross-cultural communication, eliminating racism and other forms of oppression, and trauma-informed care. Courses are open to all providers, Presbyterian employees and community partners, and some courses also offer the opportunity to earn Continuing Education Units (CEUs).

View and register for upcoming Health Equity Training Courses today

First-Tier, Down Stream, and Related Entities (FDRs) are responsible for training their workforce on fraud, waste and abuse to comply with Medicare expectations and regulations. Presbyterian is providing the following presentation to ensure FDRs have the compliance information they need to provide their staff the appropriate training.

• General Medicare Compliance Training for First Tier, Downstream and Related Entities (FDRs)
  

The Office of Inspector General (OIG) has several short video and audio presentations discussing compliance topics that are important to healthcare providers. The videos from the Health Care Fraud Prevention and Enforcement Action Team (HEAT) webcast are designed to guide healthcare providers in further enhancing their compliance efforts to help prevent fraud, waste, and abuse.

View Provider Compliance Training