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Overview
NIATx-SI Business Practices for the Future Learning Collaborative
Fee-for-Service Cohort IIConvener Call
Jeanne Pulvermacher, Project Director
Funding provided by: CSAT
NIATx Staff
Co-Deputy Directors
Kim Johnson and Todd Molfenter Co-Executive Sponsors for the project Oversees Contract and Budget Assist with curriculum development
NIATx Staff
Project Manager – Jeanne Pulvermacher Oversees the entire project Primary liaison with funder Sends out communication and
announcements Coach support and communication
NIATx Staff
Educational Services Director – Amy McIlvaine Develop content and curriculum for webinars
and meetings Primary Liaison with Technical Experts Web Resources and Blog content
NIATx Staff
Outreach Specialist – Helena Gilbertson Coordinates webinar and call information NIATx Liaison for planning and meeting details
for face to face meetings
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 IAim = Design a third-party billing system
• Routinely request insurance cards and verify coverage
• Request prior authorization and document authorization limits
• Provide and document services using correct billing codes and amounts
• Submit at least six invoices for payment, noting if bill was paid, denied or no response given
• Make corrections and resubmit
• Document the billing procedure for those steps and write up a policy and procedure to be included in the agency billing manual
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
Insert Prezi
Level 12 minute Introductions
• Derrick West-Sonoma County Department of Health Services, Behavioral Health Division , City, State
Coach:
• Financial and reimbursement structure in your state
key points
• Name 2 things that are keeping you awake at night
Level 12 minute Introductions
• Mary Booker-Florida Alcohol and Drug Abuse Association (FADAA, City, State
Coach:
• Financial and reimbursement structure in your state
key points
• Name 2 things that are keeping you awake at night
Level 12 minute Introductions
• Kelley Hobbs-NH Alcohol and Other Drug Service Providers Assn.
City, State
Coach:
• Financial and reimbursement structure in your state
key points
• Name 2 things that are keeping you awake at night
Level 22 minute Introductions
• DeAnn Decker-Iowa Department of Public Health/Division of Behavioral Health, City, State
Coach:
• Financial and reimbursement structure in your state
key points
• Name 2 things that are keeping you awake at night
Level 22 minute Introductions
• Lynn Posze-Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities, City, State
Coach:
• Financial and reimbursement structure in your state – key points
• Name 2 things that are keeping you awake at night
Level 22 minute Introductions
• Mollie Green-Department of Human Services, Division of Mental Health and Addiction Services (DHS DMHAS), City, State
Coach:
• Financial and reimbursement structure in your state
key points
• Name 2 things that are keeping you awake at night
Level 22 minute Introductions
• Mark Drennan-WV Behavioral Healthcare Providers Association, City, State Coach:
• Financial and reimbursement structure in your state
key points
• Name 2 things that are keeping you awake at night
Timeline
Dates Activity Format Who participates?
October 2011 Convener Pre-work and Orientation to Collaborative
Webinar Conveners, NIATx
November 2011 Coaches Pre-work and Orientation to Collaborative
Webinar Coaches, NIATx
December 2011 Kick-Off Meeting Face-to-face in each region
Coaches, Conveners, Providers, NIATx
December 2011-August 2012
Demonstration Period Monthly Interest Circle Calls. Coaching Assistance , Skill Building Calls
Coaches, Conveners, Providers, NIATx
Timeline
Dates Activity Format Who participates?
April 2012 Mid-Project Review Webinar Coaches, Conveners, Providers, NIATx
August 2012 Wrap-Up Webinar Coaches, Conveners, Providers, NIATx
September 2012 Conclusion Meeting Face-to-face meeting, location TBA
Coaches, Conveners, NIATx
1.5 day Kick-Off MeetingNovember-December 2011
• Meetings typically take place at a convener’s or provider’s office building.
• Convener responsible for securing the meeting space and other local costs associated with the meeting.
• 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.”
Secure the meeting space
• Invite providers – 2-3 people from each site
• Reserve a meeting space and audio visual equipment
• NIATx will send a logistics sheet to each convener
Preparing for the regional meeting
Attend the “pre-meeting” webinar call(s)1. Understanding and Filling out the Dashboard
• CFO, CEO, Directors, Executive Sponsors
2. Making the most of your NIATx coach and
Technical Assistance• Change Leaders, Change Team Members, Exec.
Sponsors, Conveners
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 November 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
Coaching“Lifeline” to the project
Facilitate monthly calls to review provider’s progress
Participate on monthly interest circle and skill builder calls
Attend the face-to-face meetings
15 days of technical assistance allowed
Mid-project Review
Formal check-in and review of project outcomes Identifying timelines and milestones needed to achieve project goals.
April 2011
2 people from each region, NIATx staff and coaches will attend
Close Out Meeting & SustainabilityAugust-September 2012
• Each convener will present their 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 I (detail webinar call reminder)
To:Cc:
Subject: NIATx FFS II (detail webinar call reminder)
From:
To:Cc:
On the NIATx website the project is calledNIATx SI: Business Practices for the Future
Web Demo
Next Steps? Next call is __________
“Understanding the Dashboard” led by Elizabeth Strauss
Schedule the kick off meeting
Coach and convener schedule a call Review expectations and project aim
Participant final rosterTemplate will be e-mailed to convener to fill out
Send back to Jeanne by ----
