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NIATx-SI Business Practices for the Future Learning Collaborative Fee-for-Service Level II Funding provided by: CSAT . Overview. NIATx Staff. Co-Deputy Directors Kim Johnson and Todd Molfenter Project Director Jeanne Pulvermacher Educational Services Director Amy McIlvaine
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NIATx-SI Business Practices for the Future Learning Collaborative Fee-for-Service Level II Funding provided by: CSAT Overview
NIATx Staff Co-Deputy Directors Kim Johnson and Todd Molfenter Project Director Jeanne Pulvermacher Educational Services Director Amy McIlvaine Outreach Specialist Helena Gilbertson JBS Staff Project Liaison Janet Zwick
Seven regional teams chosen and assigned to one of two levels in the NIATx Fee-for-Service Capacity Pyramid: • Ideally each provider in a team will fit in the same level.
Fee-for-Service OBJECTIVES Develop the capacity to bill third-party payers. • Training on the core components of implementing third-party billing systems • Identify common areas where billing systems function poorly • Learn improvement techniques that work • Know and understand The NIATx Third-party Billing Guide
Level II Aim = Improve Collections • Perform a walk-through of their billing process • Create a flow chart and assign staff to each process • Work to improve at least one step in their process (utilization review, accuracy of record keeping) and increase collections • Increase collections by a specified amount (will vary by provider) • Document the billing procedures and include all policies and procedures in a billing manual
Results from Cohort I Prezi
Level II Participants • Derrick West-Sonoma County Department of Health Services, Behavioral Health Division , Santa Rosa, CA Coach: Don Holloway • DeAnn Decker-Iowa Department of Public Health/Division of Behavioral Health, Des Moines, IA Coach: Jay Ford • Lynn Posze-Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities, Frankfort, KY Coach: Elizabeth Strauss • Mollie Green-Department of Human Services, Division of Mental Health and Addiction Services (DHS DMHAS), Trenton, NJ Coach: David Moore • Mark Drennan-WV Behavioral Healthcare Providers Association, Charleston, WV Coach: Eric Haram
1.5 day Kick-Off MeetingJanuary 2011 • NIATx staff, coaches, conveners, and providers will attend Providers will learn: • NIATx Process Improvement 101, • System design and change strategies • Review the NIATx Third-party Billing Guide. • Each team will develop an organization-specific “Business Practice Implementation Plan.”
Preparing for the regional meeting 1. Review the NIATx PI 101 webinar http://www.niatx.net/Content/ContentPage.aspx?PNID=2&NID=15 2. Review the NIATx Billing Guide http://www.niatx.net/PDF/BillingGuide/2011NIATx_Third-partyBGuideLR.pdf 3. Attend your regional coach calls
Monthly Interest Circle Calls • Each level will have a content specific call • 60 minutes (Presentation and Q&A) • Led by content experts and peers from around • the country Demonstration Period December 2011 – August 2012
We recommend that the following people attend Convener, Change Leader, Executive Sponsor, CEO, CFO, Chang Team Members and Accounting staff attend In addition: • NIATx will facilitate project review and skill-building calls with coaches and conveners. (every 4-6 weeks) Your feedback on these calls is critical to success!
Demonstration Period November 2011 – August 2012 • Facilitate monthly calls to review provider’s progress • Participate on monthly interest circle and skill builder calls • Attend the face-to-face meetings Coaching “Lifeline” to the project
April 2012 Mid-project Review • Formal check-in and review of project outcomes • Identifying timelines and milestones needed to achieve • project goals. • 2 people from each region, NIATx staff and coaches will attend
Close Out Meeting & SustainabilityAugust-September 2012 • Convener will present their regional change project story at an in-person closeout session. (Place TBD) • Each local convener and key providers from the regional team will present their change projects during one of two scheduled webinars for all members of the collaborative. • Each convener will submit a completed project charter of outcomes and outline next steps for sustainability and dissemination to at least five additional provider sites.
E--mail communication From: Subject: NIATx FFS II (detail webinar call reminder) To: Cc:
The Dashboard Fee-for-Service Webinar Dec. 2011 Elizabeth Strauss Overview
Purpose of the Dashboard • To give you a snapshot of your agency’s financial situation • To help define and focus on your aim • To capture baseline data, against which you can track results
Priorities 1. Revenue by Payer - Level I and Level II 2. Denial Rate – Level II Collection Rate – Level II 3. Cost/UOS – when relevant 4. Other – if possible • For explanations, see Definitions/Formulas and Why?
Customize • To be determined within your collaborative and for your agency • The key thing is to document how you capture the info and do it the same way in the future.
How to capture information • If financial indicators are available from financial reports, enter info directly into the Dashboard. • If not, complete Raw Data worksheet, and the anything in italics will be calculated automatically.
Frequency To be determined within your collaborative, for example, • At the beginning of FFS project • Select your aim and one measure to track • Set target goal • Track on a small scale, rapid cycle basis • At the end of FFS project
Next Steps? Face to Face kick off meeting California Iowa Kentucky-January 26 & 27, 2012 New Jersey-January 30 & 31, 2012 West Virginia Next call: Wednesday, February 8, 2012 Coding for services and other nuisances that get in the way of providing helping people Best Practices and Common Pitfalls