Close more care gaps for your Sunshine Health members
Care gap reports—updated daily for your Sunshine Health patients!
Sunshine Health and Availity have teamed up to make it easy for you to work with us online. The new Care Gaps – Daily View report tool on the Availity Provider Portal gives you insight into your members’ care gaps. The care gaps are updated daily through Sunshine Health’s partnership with Interpreta.
Q: Why does Sunshine Health want me to use the Availity Portal?
A: Sunshine Health and Availity are working to streamline healthcare processes wherever possible. By using the multi-payer Availity Portal, you can access information and transactions from Sunshine Health and other payers on one website, with only one login and one password to remember.
Q: Who is Interpreta?
A: Interpreta’s analytics engine continuously updates, interprets, and synchronizes clinical data, creating a personalized roadmap and enabling the orchestration of timely care. These real-time insights provide physicians and care managers with the patient-specific information needed for quality improvement and patient prioritization.
Q: How does the Interpreta care gap data differ from what’s on the Sunshine Health secure provider portal?
A: Interpreta's information is based on HEDIS specifications and is updated daily. Sunshine Health's Provider Portal displays information powered by analytics from QSI that is updated monthly.
Q: What’s used to calculate the Sunshine Health pay for performance?
A: The basis for the Sunshine Health's pay for performance is QSI. Updates on practice performance are still available through our secure provider portal.
Q: Why is Sunshine Health providing the Interpreta care gap information?
A: We are responding to requests from our providers to provide care gap information in a timelier fashion.
Q: Why does Sunshine Health want me to use the care gaps tool?
A: We hope that providers will use this daily care gap data to drive outreach to patients in order to schedule appointments, encourage care plan compliance, and close care gaps.
Q: What specific data will I see in the care gap tool?
A: The Care Gaps – Daily View overview page will show you the member’s name, age, their PCP, and care gaps. On this page, you can select a member’s record and drill down to review the recommended actions to close a care gap.
Q. How can I access the care gap information outside of Availity?
A. An export feature allows you to download the report data to support your daily workflow.
Q: Will I still have access to view the monthly reports on the Sunshine Health portal?
A: Yes, at this time, the monthly reports will remain available.
Q: What is Sunshine Health’s relationship with Availity?
A: Availity was formed as a joint venture with multiple payers in an effort to improve efficiency and reduce administrative complexity in the healthcare industry, with the ultimate goal of improving healthcare outcomes. Sunshine Health collaborates with Availity developing and improving online tools for our healthcare providers. If you have questions about Sunshine Health and the partnership with Availity, please email SunshineContracting@Centene.com.
Q: What should I do if my organization is not registered to use the Availity Portal?
A: Go to https://www.availity.com/resources/support/web-portal-registration and click “Let’s get started!” to begin registration. Before starting the process, make sure you have basic information about your practice readily available, including your federal tax ID and NPI.
Important: By submitting the registration you agree to be one of the administrators for your organization, and you attest that you have authority to enter into agreements for your organization.
After you complete the registration, Availity will send you an email that includes the user name you created, temporary password, and instructions for next steps. You may then begin registering other users for your organization.
Q: As an administrator, how do I register additional users in my organization?
A: In the Availity portal, click Help & Training | Find Help and navigate to the Add User topic under Administrator. This help topic explains how to add one user at a time or upload multiple users from a spreadsheet.
Q: Who do I contact if I need additional help registering or have questions about my organization’s Availity account?
A: Call Availity Client Services at 1-800-AVAILITY (282-4548). Assistance is available Monday through Friday from 8 a.m. to 7 p.m. Eastern time (excluding holidays).
Q: What do I do if I get locked out of my Availity account?
A: Review the Can’t Log in to the Availity Portal help topic for the solution to your problem.
Availity offers live and on-demand training via the Availity Learning Center (ALC). Log in to the Availity Portal and click Help & Training | Get Trained. There you’ll find in-depth product training as well as continuing education via national industry experts.
To access training specific to Sunshine Health, search by keyword Sunshine.