Overview NIATx-SI Business Practices for the Future Learning Collaborative Fee-for-Service Cohort II Level I Jeanne Pulvermacher, Project Director Funding provided by: CSAT

NIATx Staff Co-Deputy Directors Kim Johnson and Todd Molfenter Project Director Jeanne Pulvermacher Educational Services Director Amy McIlvaine Outreach Specialist Helena Gilbertson JBS Staff Project Liaison Janet Zwick

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 I Aim = 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

RESULTS from Fee-for-Service Cohort I (prezi)

Level 1 2 minute Introductions Mary Booker-Florida Alcohol and Drug Abuse Association (FADAA) Tallahassee, FL Coach: Amy McIlvaine DISC Village, Inc Agency for Community Treatment - ACTS Susan B Anthony Recovery Center Tri-county Human Services, Inc Westcare-The Village, Guidance Care Center The Transition House Human Services Associates Better Way of Miami Broward Addiction Recovery Center – BARC Tampa Crossroads, Inc The concept House

Level 1 2 minute Introductions Kelley Hobbs-NH Alcohol and Other Drug Service Providers Assn. Concord, NH Coach: Lynn Madden Serenity Place Optimistic Youth Counseling Child and Family Services Headrest NH Granite House Farnum Center Keystone Hall Southeastern NH Services The Upper Room Seacoast Youth Services Families in Transition

Timeline DatesActivityFormatWho participates? October 2011Convener Pre-work and Orientation to Collaborative WebinarConveners, NIATx December 2011Coaches Pre-work and Orientation to Collaborative WebinarCoaches, NIATx January 2011Kick-Off MeetingFace-to-face in each region Coaches, Conveners, Providers, NIATx December 2011-August 2012 Demonstration PeriodMonthly Interest Circle Calls. Coaching Assistance, Skill Building Calls Coaches, Conveners, Providers, NIATx

Timeline DatesActivityFormatWho participates? April 2012Mid-Project ReviewWebinarCoaches, Conveners, Providers, NIATx August 2012Wrap-UpWebinarCoaches, Conveners, Providers, NIATx September 2012Conclusion MeetingFace-to-face meeting, location TBA Coaches, Conveners, NIATx

1.5 day Kick-Off Meeting January 2012 NIATx staff, coaches, conveners, JBS staff 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.” 2-3 people from each organization’s change team should plan to attend

Preparing for the regional meeting 1. Review the NIATx PI 101 webinar 2. Review the NIATx Billing Guide partyBGuideLR.pdf 3. Attend your regional coach calls

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 December 2011 – August 2012

Who should attend? Convener, Change Leader, Executive Sponsor, Change Team Members In addition you may want to invite -Accounting/Billing Staff and Clinicians and Administrative staff. 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 December 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

Mid-project Review  Formal check-in and review of project outcomes  Identifying timelines and milestones needed to achieve project goals. April people from each region, NIATx staff and coaches will present

Close Out Meeting & Sustainability August-September 2012 Conveners will present the change project story for their region 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:

NIATx Website

Project Resources on the NIATx website

Overview The Dashboard Fee-for-Service Webinar Dec Elizabeth Strauss

Purpose of the Dashboard To give you a snapshot of your agency’s financial situation To help define and focus on your aim To capture baseline data, against which you can track results

Priorities 1. Revenue by Payer - Level I and Level II 2. Denial Rate – Level II Collection Rate – Level II 3. Cost/UOS – when relevant 4. Other – if possible For explanations, see Definitions/Formulas and Why?

Customize To be determined within your collaborative and for your agency The key thing is to document how you capture the info and do it the same way in the future.

How to capture information If financial indicators are available from financial reports, enter info directly into the Dashboard. If not, complete Raw Data worksheet, and the anything in italics will be calculated automatically.

Frequency To be determined within your collaborative, for example, At the beginning of FFS project Select your aim and one measure to track –Set target goal –Track on a small scale, rapid cycle basis At the end of FFS project

Next Steps? Face to Face kick off meeting Orlando, Florida – January 17-18, 2012 New Hampshire – January 26 & 27, 2012 Next call: February 14, 2012 Are you leaving money on the table? Asking for Insurance Information  What do you need to know?  Sharing Best Practices