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FQHC/RHC Enhancement into Managed Care Rates April 24, 2014

FQHC/RHC Enhancement into Managed Care Rates April 24, 2014. Today’s Topics. Recap of past two webinars and information available Update on posting of webinars Focus on enhancement payments What happens in May 2014? What happens in June 2014 and after?

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FQHC/RHC Enhancement into Managed Care Rates April 24, 2014

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  1. FQHC/RHC Enhancement into Managed Care Rates April 24, 2014

  2. Today’s Topics • Recap of past two webinars and information available • Update on posting of webinars • Focus on enhancement payments • What happens in May 2014? • What happens in June 2014 and after? • Requests for additional sessions on specific topics (e.g., correct submission of rosters, etc..)?

  3. What happens in May 2014? • Client assignment files for April 2014 already received by HCA • HCA will use April 2014 files to determine payment per clinic • Clinic amounts will be aggregated based on MCO • HCA will pay each MCO by second week of May 2014 • MCO then has 30 days to pay each clinic for June 2014 • MCO will submit roster files for May 2014 as usual • HCA will pay enhancements to clinics for May 2014 as usual • MCO will use payment received in May 2014 from HCA to make June 2014 payments to clinics • HCA will provide each MCO a list of amount due to each clinic • Clinics should receive June 2014 payments by second week of June 2014 • Payment to clinics from MCO for June will be based on April assignments

  4. What happens in June 2014 and after? • Client assignment files for May 2014 already received by HCA • HCA will use May 2014 files to determine payment per clinic • Clinic amounts will be aggregated based on MCO • HCA will pay each MCO by second week of June 2014 • MCO then has 30 days to pay each clinic for July 2014 • MCO will submit roster files for June 2014 as usual • MCO will use payment received in June 2014 from HCA to make July 2014 payments to clinics • HCA will provide each MCO a list of amount due to each clinic • Clinics should receive July 2014 payments by second week of July 2014 • Payment to clinics from MCO for July will be based on May assignments

  5. Updated Payment Flow

  6. HCA Contact InfoOffice of Rates Development Please direct questions regarding this process to: Melissa Usitalo – Encounter Payment Manager melissa.usitalo@hca.wa.gov All other program-related questions should continue being sent to: FQHCRHC@hca.wa.gov General questions on professional rates should be sent to Unit Manager Madina Cavendish: madina.cavendish@hca.wa.gov

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