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GAHSC SHINES Overview Colleen Mousinho Patrick Coogan

GAHSC SHINES Overview Colleen Mousinho Patrick Coogan. September 10, 2008. Agenda. Georgia SHINES Facts Key Benefits Deployment Schedule How SHINES Affects Payment Processing Key Facts for Providers Questions and Answers. Georgia SHINES Facts. Web based SACWIS system

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GAHSC SHINES Overview Colleen Mousinho Patrick Coogan

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  1. GAHSC SHINES OverviewColleen Mousinho Patrick Coogan September 10, 2008

  2. Agenda • Georgia SHINES Facts • Key Benefits • Deployment Schedule • How SHINES Affects Payment Processing • Key Facts for Providers • Questions and Answers

  3. Georgia SHINES Facts • Web based SACWIS system • Primary data management system for the entire case lifecycle. • Supports resource recruitment and maintenance • Replaces several separate legacy systems: • IDS • “Risk Assessment" • CPRS (for DFCS users) • ADAM (from December 2008) • Supplements information in other current systems • SMILE • KidStar

  4. Deployment Schedule • Pilot: 59 users • September 2007 • Phase 3: 1256 users • April 2008 • Phase 1: 164 users • December 2007 • Phase 4: 1278 users • June 2008 • Phase 2: 1036 users • February 2008 SHINES supports approximately 3,800 users 4

  5. Key Benefits SHINES brings together in a single system all relevant information about a case: Intake and Investigation Placement Eligibility Services authorized and provided Case Plan Available resources Consistency is enforced – child can only be paid for their correct current eligibility, in their correct current placement, and for services the case manager has approved. There is no longer conflicting information leading to incorrect payments. 5

  6. How SHINES Affects Payment Processing • Georgia SHINES interfaces with SMILE for payment processing. • Checks will continue to come from SMILE. • Pre-bills will continue to be generated in SMILE. • Accounting contacts are the same. • Accounting workers are actually working in SHINES to update invoices and then send them through the interface; SMILE primarily only prints the checks. • SHINES maintains information on the contracted services, rates and RBWO programs for all providers.

  7. SHINES Payment of Care Page RBWO Program 7

  8. How SHINES Affects Payment Processing (Cont.) Because SHINES brings together in a single location information for clients, resources, services, and placement, invoices are generated based off of the information in SHINES: Invoices for placement services are based directly on the placement and payment information entered in SHINES, not any other system. Invoices for delivered services are based directly on the service authorizations entered in SHINES. Up to date information must be in SHINES to be paid. Providers may only be paid for services for which SHINES contracts have been entered. 8

  9. Key Facts for Providers Communication is key – since payments are based on SHINES data, it is critical that you keep case managers and DFCS provider relations up to date with relevant information: New CPA foster homes Placement moves Waivers and RBWO program changes– must be in SHINES to be paid If providing delivered services, confirm any service you provide against the service authorization. You must first contact the case manager for additional authorization if you wish to provide additional services. 9

  10. Questions and Answers

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