Description: The article gives us some information about the provider portal, a web accessible database that includes claims data for community care of North Carolina Medicaid patients.
Welcome to the provider portal, a web accessible database that includes claims data for all North Carolina Medicaid patients. The portal is for community care of North Carolina, also known as ccnc providers and their partners to provide information that will improve the efficiency and quality of care for our patients, partners of ccnc primary.
Care providers include local mental health entities, health department’s, Hospital providers and other care providers who have system access agreements with ccnc for the use of portal. I want to show you how the provider portal looks to providers as well as how we use it by going through a few scenarios.
I work as a family physician in a rural clinic, but these scenarios are all fictional. However, they are based on real folks. I don’t have much historical data on him. In my chart, he is here because on a dare, he has stuck pees in his ears and no one at home had been able to get them out with my alligator forceps.
I was able to get them out in a few seconds, I find myself with a few minutes to spare with Johnny and his mom. so I look him up in provider portal. I see the name of his old PCP in case I need any immunization records or any other records, and I look into his visit history to find out if there are any gaps in care that I need to address.
Today I looked to see what other kinds of care he’s had and I find that little johnny has some problems with putting some things where they don’t belong foreign body in ear foreign body, in his gastrointestinal tract. And I find he’s due for a well-child visit. So I’m able to do that, for he has a cancellation.
Johnny’s family has trouble getting to my office and I’m able to save them some time, some money and we get him the care that he needs in a timely manner. I’m staying at 53 year old whose recent routine labs sure to be newly and kidney failure for no reason. I can tell from my office notes when she comes in, I asked her about her other medicines and she says that she only takes what’s prescribed from here, nothing over the counter.
So I’m wondering whether I need to start doing a referral to the kidney doctor, some more labs and imaging something because something new is obviously going on. I know that in the recent past, we’ve tried multiple different and and plan Tori’s. But if she insists that, she has not been taking multiple intent flama Tori’s at a time.
I can go into provider portal and see what she has filled, I can do a sort by the types of medications that she has picked up. This shows me what she has in her home, she has other pain medicines because she’s not controlled on the anti-inflammatories and I find that indeed, she has been taking three different anti-inflammatories at the same time, which can definitely be damaging to her kidneys.
I need to do better patient education and definitely insist on having all of her medications at every visit. Now I can go forward addressing or acute renal failure here in my office, this is about the only way I can get the information about what a patient has at home, unless they bring every single medication with them to their office visit.
I’m working in a hospital emergency department with a patient with abdominal pain whose boyfriend mentions that she’s recently been to another hospital near his home and had quote something surgical down there. They tell me they don’t know exactly what was done, what I’m concerned is based on the amount and position of pain she seems to be having that she might have a complication from that surgery though the scars on her belly, don’t appear to be as recent issues describing.
I find nothing on my exam of her other than apparent exquisite pain, when I touch anywhere near her belly and the old surgical scars, so I go to my desktop computer to order some blood tests and pain medicines for her and a CT scan of her belly to see if I need to call our surgeon. While I’m at my computer, I log into provider portal, and go to the visit history tab to see if I can find out what was done at that other Hospital.
I find that this patient was in another ed, last week, this is the middle of December now and I find that she has had 218 ED visits in the past 15 months. I scroll down because my question originally was about whether she’d been in a hospital for surgery, and all I’ve seen his ED visits and imaging office visit. I find that she has been to a family practitioner, once this for a headache, but generally seems to seek care in emergency departments.
And I’m noticing that she’s had so many CT scans that I’m concerned about her radiation exposure as well as a behavioral pattern that might indicate an addiction. When I go back in the room, she looks calmer, so I take this opportunity to confront her about these findings and what appears to be various emergency departments. If we were in the true provider portal, you would see the actual provider names the phone numbers would be correct and the provider names would be ones that you would recognize.
I’m concerned about the pattern of behavior, I offer to set her up with an addictions counselor, and she nods to me. I go back to my desktop, call her social worker on the phone go into the portal to find out the phone number of this patients local mental health entity based on her county of residence, getting that phone number should be able to get that here as well as other providers that she has seen for her problems.
When I returned to her, bedside she and her boyfriend are gone. Now the case had gone another way, and this patient had seemed more in need of medical care for her belly or head. I could go to the visit history tab hover over this provider name and get the information I need to get the results of that of the scans she had to see.
If I need another one with our intervention today, courtesy of provider portal, we saved the patient from being exposed to extra radiation made what might be the first to offer that she had substance abuse to help save my emergency department team from having to do in a necessary work up, and save some Medicaid dollars from being spent unnecessarily.
So you see that the provider portal can help medical providers to deliver the right care at the right time for our patients, we hope this system will be a model for other states and feel proud lucky and thankful to have it. Thanks.