Conversion of CCW programs from contracts to FFS ABCD Alliance November 9, 2017

Electronic Health Records Recommend having a comprehensive EHR system that maintains billing and service data Review and ensure information is accurate prior to billing EHR system has the capability to bill on a weekly basis to ensure proper cash flow

Medicaid Eligibility Mechanism in place to check client eligibility Maintain individual’s entitlement

Policies Needed Contribution to Care Policy Absentee Policy

Residential Ensure Individual/Families/Guardians are aware of the SC agencies and educated on the process They need to have a first choose and a second one Recommend SCA meet and greets

SC Meeting Preparations Copy of Current IHP to refer to Current Medication List Current Physician List Family Information Day Program Name Policies signed by the person/family/guardian/payee

What SC’s Need to enroll Individual ***samples of each on next slides**** Participant Enrollment Form Mental health Form Worksheet Completed Supported Employment Form if applicable Clinical Needs form if applicable (acuity) SC will also need to identify if the person is retired

Important!!! The plan approval date is different then the start date An SCA will want to approve the plan ASAP but you can put in a reasonable start date for services

Worksheet MUST BE Correct

Long Plan: completed prior to meeting date ABS Assessment Unsupervised Time Assessment Community Care Waiver- Self-Care Assessment Self Medication Assessment Individual Fire Assessment Fire Evacuation Plan Have prepared goals and objectives to present at ISP meeting ***These may change with Licensing Reg. Updates***

Short Plan: completed prior to meeting date Ensure goals and objectives match outcomes Ensure all information is correct on ISP

After ISP meeting Ensure you have one point person for the agency that ALL SCA send draft so you can review and send back Ensure Goal Tracking Form is finalized and in your EHR System Ensure that the units are correct for each outcome If you have exceptions for Day Program make sure they are captured

Billing Ensure all Licensed location have unique NPI numbers Must register with NPPIS and maintain its registration in order to obtain new NPI or modify current ones Make sure you connect your NPPIS to your provider number Ensure Taxonomy codes are correct before submitting billing to Molina Delay first billing till you get the authorizations from Molina

Billing Ensure the plan received from SCA is accurate Ensure address is correct under outcome for residential service Ensure Correct billing NPI number is on service billing report Main NPI number NOT the doorknob number Address must be correct for doorknob on the SDR SDR pulls from the address on the outcome