1 / 27

Mental Health Waiver Provider Meeting

Mental Health Waiver Provider Meeting. October 22, 2019. Agenda. Introductions Waiver Update Transition to direct billing EVV Credentialing updates Critical Incidents Medical issues and emergencies Transportation CSP Direct and Indirect Services Housing budget

bcraft
Download Presentation

Mental Health Waiver Provider Meeting

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Mental Health WaiverProvider Meeting October 22, 2019

  2. Agenda • Introductions • Waiver Update • Transition to direct billing • EVV • Credentialing updates • Critical Incidents • Medical issues and emergencies • Transportation • CSP Direct and Indirect Services • Housing budget • New Format for Recovery Plans • Maintaining Husky C Eligibility = Timely Provider Payment • NOA • HIPAA • Notes/Documentation • Billing/ Audits • MHW Advisory Council

  3. Waiver Update (as of 10/21/19) • Active clients on the waiver:598 • Actively planning for admission to waiver (MHW & MFP): 48 • Referrals pending disposition (MHW & MFP): 51 • Waitlisted referrals for MHW community: 44 • Community Census for Waiver Year 11: 615 • Additional Slots for MFP clients Waiver Year 11: 60

  4. Average Enrolled by Month

  5. Transition to direct billing through DXC • Enrollment for the new portal began at the end of May 2019. If you have not already completed the enrollment process, please do so ASAP! You will not be able to bill for services rendered after the conversion until your enrollment is completed. If you need the workshop slides to help with the enrollment, please email Chastity. • The following services will continue to be billed through ABH: • Highly Skilled Chore service • Assistive Technology • Specialized Medical Equipment • Home Accessibility Adaptations

  6. Electronic Visit Verification • EVV has been postponed until June 2020 • If you agency is not already utilizing Sandata, there will be workshops scheduled in the future to assist you. • We will keep you posted with any updates we receive.

  7. Credentialing Updates • Please remember that in order to complete your online credentialing with DXC, you must obtain a follow up document from ABH. Please contact Chastity Holloway after you complete your online application to receive this letter. • ABH will continue the same credentialing process for providers • Please remember to update your program contact information with ABH. A new form can be submitted to Chastity Holloway at cholloway@abhct.com any time there are changes. The form can be located on the ABH website.

  8. Provider Contact Info Survey • Please fill out the survey monkey with your agency’s contact information for each department • https://www.surveymonkey.com/r/8TH9HWP

  9. Critical Incidents (CI) • Please submit a CI for clients who have violated a behavioral contract put into place by the waiver team. • We now have an email address where Critical Incident reports for the Mental Health Waiver can be sent. If you are able to securely email reports, you may send them to mhwcriticalincident@abhct.com. • You may also fax Critical Incident reports to 860-920-4456. • If your agency was required to submit a DMHAS Critical Incident Report, please inform us and we will obtain that report instead of your agency needing to file one with us.

  10. Medical Issues and Emergencies • Clients should be encouraged to use clinics instead of emergency rooms for non-urgent care • Staff should not be transporting clients in a true emergency situation. • Please review with staff what to do in case of medical emergency: • Call 911 or push PERS • Contact Home Health Agency • Contact supervisor • Direct care staff should not be making medical decisions on whether client needs to seek help • Falls • Hitting head

  11. Transportation • As transportation is not a covered service we allow providers to decide their own transportation policy. • Please make sure CSCs and clients are aware of your agency’s transportation policy. • 2 weeks notice is requested when changing your transportation policy. • CSP should be assisting client with locating and obtaining available transportation options. If it is not in the recovery plan, please ask for it to be added.

  12. CSP Direct and Indirect service • CSP is reimbursed at a higher rate to include the time needed for the indirect service duties of the position. • Please factor this indirect time in when determining staff caseloads. • The RA rate does not include indirect service time. CSP staff should not be asking RAs to assist in traditional CSP duties. (ie. Entitlements, hospital follow up, etc) • If you agency also provided DMHAS CSP, please remember that we do not follow the same standards in terms of service per month. Waiver CSP should be provided according to what is authorized in the plan.

  13. Housing Budget • Housing budget is being reviewed by the state. • All clients receiving a DMHAS subsidy must place themselves on a permanent subsidy list. All clients have been requested to sign a form regarding this, and it will be a requirement in all new subsidy cases. • CSP should be assisting clients apply for state supplement to lessen need for subsidy. • Requests for subsidy and housing items are not guaranteed and are being reviewed more closely. Must show efforts made in contacting other community resources, budgeting for needed items, etc. • Partial funding may be approved in some cases. • Staff should not be making promises to clients that “DMHAS will pay for it.”

  14. New Format for Recovery Plans In order to comply with the format of the new portal, recovery plans will have only one intervention per service. The intervention will contain everything that is to be worked on with the client and the full amount of time. Services will continue to be authorized for a 6 month period allowing for some flexibility in provision of services. Providers must be careful not to go over authorized time for the 6 month period or contact CSC prior to end of authorization to discuss clinical need for increased authorization.

  15. Medicaid Husky C = Timely Provider Payment • Please make sure assisting clients with Medicaid coverage is a priority with CSP staff. • ABH and DMHAS cannot guarantee payment if coverage is inactive • Many eligibility issues have been resolved but waiver clients continue to lose coverage for not submitting redetermination and/or supporting documents.

  16. Medicaid Coverage issues • IF staff are going to a regional DSS office with a client, please make sure to ask for the LTSS eligibility worker and let them know the client is on the Mental Health Waiver • Per DSS, re-determination paperwork is now mailed 40days in advance of expiration. Paperwork mailed in before system letter is generated will not be accepted. Recommendation is that paperwork be mailed within one week of receipt of letter to insure continued coverage. • Please make sure you include income verification, bank statements and other assets with the application.

  17. Sending in Redetermination Paperwork • Please make sure clients are submitting their DSS redetermination paperwork to the Scanning Center with the cover sheet. • DSS ConneCT Scanning Center P. O Box 1320 Manchester, CT 06045-1320 Fax: 860-812-0022 • www.connect.ct.gov • Clients can create online account, print new cover sheet, get forms, etc.

  18. Notice of Action forms • Clients will be send a Notice of Action Form giving them 30 days notice when they are to be discharged from the Mental Health Waiver. This includes clients who have become ineligible due to their benefits lapsing. • If clients file for an appeal within the 60 days, their spot on the waiver will be held until a hearing is held and DSS renders a final decision. If no appeal is filed, the client will be discharged from the waiver after the 60 days and will need to go to the bottom of the waitlist. • Please make staff aware of the process so they can assist clients with the appeal process if necessary

  19. HIPAA – Privacy Rules • ABH’s Fax is secure (860-920-4456) • ABH sends secure (Zix Mail) email • If you receive a secure email and can not open it please contact the sender • Identifiable Client information should not be used in email subject lines • All communications that include Client Identifiable information should be sent securely • This includes: • Name (Including initials) • Social Security Number • Medicaid ID • WOS 4 Digit Client ID numbers are unique to our program and do not need to be sent securely

  20. Monthly Progress Notes • Due by the 10th day of the following month • e.g., April notes due by May 10th • This means by the 10th, not the Monday following the 10th… • CSP notes include two sections, both required • Individual interventions • General summary • Monthly Note is required for any month where there is an open authorization

  21. Monthly Progress Note If you are unsure of the start and end dates for a care plan, consult the Authorization tab Only write a note for the most recent care plan.

  22. CSP Monthly Note Step 1 Respond to each individual intervention Step 2 Complete a general Monthly Notes Summary For additional instruction, refer to WOS user guide on ABH website: http://www.abhct.com/Customer-Content/WWW/CMS/files/Mental_Health_Waiver/ABH_WISE_Online_System_Manual-_PROVIDERS.pdf

  23. Encounter Notes • Encounter notes must either be located in a client’s home or securely stored at the agency. • You must be able to supply notes for auditing purposes to ABH, DMHAS, DSS or CMS • Must have an encounter note for any billing. • Please make sure the supervisor is reviewing encounter notes for quality (both RA and CSP). Notes should contain all required elements and be using skill building language.

  24. Updated Documentation Standards • Encounter note still required for each visit • Notes with missing information will be considered incomplete and will be recouped • Please make sure handwritten notes are legible! • A complete note includes the following information: • Client full name • Date of service • Staff full name • Service provided • LOA score • Goal • Comments • Time In • Time Out • Total Time • Staff signature • Client signature • Or, document if client refuses

  25. Billing Reminders • Next three week cycle is November 8th • Check Run Schedule posted on ABH website • July 2019 – December 2019 • CLEAN claims will be paid within a 30 day period from the date of submission • A claim is not considered “clean” when it requires further investigation prior to processing • Eligibility issues, insurance issues or the initial activation of a client onto the waiver may delay payment beyond the expected 30 day period

  26. MHW Advisory Council • Meets twice a year in April and October • Open to any MHW provider to send a representative • We encourage staff to identify MHW clients who might be interested in participating. Staff can bill for time spent with client at meeting.

  27. ABH Contact Information • Ann Marie Luongo, Program Manager • (860) 704-6211 aluongo@abhct.com • Lori-Lynn French, Quality Assurance Supervisor • 860-704-6177 lfrench@abhct.com • Chastity Holloway, Program Specialist • (860) 638-5341 cholloway@abhct.com • Cathy Parente, Claims Coordinator • 860-704-6201 cparente@abhct.com • Vacant, Utilization Review Support • NEW FAX NUMBER 860-920-4456

More Related