ValueOptions ® December 15, 2009
ValueOptions® - Recognized Public Sector Leader Currently manages more public sector behavioral health contracts than any other company. More than 4.5 million covered lives across 13 states. Many of these contracts have Member populations exceeding 400,000, and several exceed 1 million covered lives.
Overview of the ValueOptions® Contract Approved by the Board of Public Works on June 3, Two year contract with 3 one-year renewal options. Includes a16.6% participation by minority businesses. Responsible for managing inpatient and outpatient mental health services for Maryland’s Public Mental Health System (PMHS) for approximately 99,000 Medicaid and Uninsured individuals. Responsible for facilitating the recoupment of all available Federal Fund Participation (FFP). Began on September 1, 2009.
Customer Service: How are we doing ? GoalSeptOctNov Total ACD calls N/A11,85414, Call abandonment (percent) 3%33.99%2.25%1.83% Call abandonment (count) N/A6, Wait time less than 3 minutes for referrals 90%94.92%99.23%98.85% Wait time less than 5 minutes for authorizations 90%36.55%94.67%99.77% Wait time less than 5 minutes for provider customer service 90%53.95%97.45%98.95%
Claims Processing: How are we doing ? GoalSeptOctNov Electronic claims paid within 14 days (percent) 100%98.71%89.62% Electronic claims paid within 14 days (count) Paper claims paid within 21 days (percent) 99%99.80%83.24% Paper claims paid within 21 days (count) Paper claims paid within 30 days (percent) 100%100.00%96.24% Paper claims paid within 30 days (count)
Claims Payments: How are we doing ? Paper Claims - $41,707, Electronic Funds Transfers (EFT) - $96,039, Adjustments - ($243,828.60) Total Claims Payments* - $137,502, * as of 12/1/09
Claims Payments: Contract with ACS contracted with ACS, the prior claims processing vendor, to pay claims for dates of service before September, ValueOptions® contracted with ACS, the prior claims processing vendor, to pay claims for dates of service before September, MonthSourcePAPEREFTADJUSTMENTAmount SEPACS$14,197,671.66$18,880,257.38($3,165.25)$33,074, SEPVO$2,019,031.66$7,702,409.87$0.00$9,721, OCTACS$3,874,387.39$1,683,432.00($2,319.05)$5,555, OCTVO$8,635,775.41$28,239,147.70$0.00$36,874, NOVACS$2,534,479.05$2,284,684.89($238,344.30)$4,580, NOVVO$8,741,537.37$28,779,330.47$0.00$37,520, DECVO$1,704,346.29$8,469,909.46$0.00$10,174, TOTAL$41,707,228.83$96,039,171.77($243,828.60)$137,502,572.00
Staffing Update Over 60 ValueOptions®Over 60 ValueOptions® staff, managers, directors and National Leadership participated in the start-up planning and implementation. Over 20 additional National staff have assisted with the daily operations during implementation. ValueOptions® currently has of its budgeted FTE’s hired.ValueOptions® currently has of its budgeted FTE’s hired.
Provider Trainings ValueOptions® Maryland offered over 30 Provider Connect Trainings via Webinars as well as face-to-face trainings in several regions statewide. Topics included: Inpatient/Higher Levels of Care Residential Treatment Centers Outcomes Management System (OMS) Standard Outpatient Psychiatric Rehab Program (PRP) & Residential Rehab Program (RRP) Case Management
Core Service Agency Trainings Introduction to Service Connect / Care Connect Member Files/Eligibility (What to find there) Provider Files (What to find there) Creating Reviews Authorizing Reviews Managing Your Work Queue Hospital Diversion Process
Questions?