1. Partnering with a New Payer Catholic Charities Services Diocese of Cleveland, Ohio Change Team Members: Maureen Dee, Ruth Abel, Keith Johnson, Catherine Bixenstine, Vikki Chinchar, Lois Calderwood, Roszella McCoy

2.  To become a network provider for Medical Mutual of Ohio by 12/31/12.  Our intent is to increase our private insurance contracts from 0 to 1. We had only been billing Medicaid, and pursued Federal, State, County grants. We had invoiced private insurance as out-of-network on a limited basis.

3.  We now require all licensed staff to apply for an NPI number and to become providers under our new contract.  A Steering Committee was created to develop change in infrastructure to centralize behavioral health billing depts.  Learned to track success in reimbursements and started to roll out procedures to our sites – our goal is to have a standard approach at 12 sites.

4.  Met Goal before deadline. Now have contract with Medical Mutual.  Fee Scale for services higher than Medicaid.  In some cases, receive 20% above fee scale if services provided within 30 days.  Attracted secondary contract with Medical Mutual for State Medicaid Waiver program. Referrals come from County Hospital.  Have a Steering Committee which will continue to meet to assist with reaching out and supporting new contracts

5.  Build infrastructure to manage authorizations and reauthorizations.  Track the success. Refine tracking form through Billing User Group  Continue to reach out to new Managed Care Orgs.  Learn from other parts of our system (nursing homes) which do business with Mgd Care.

6.  Now accept clients with Medical Mutual and are paid at higher rate than public dollars.  Number of referrals from County Hospital for Behavioral Health Services has potential to increase by hundreds.  Project has educated/impacted large social service agency that helps many. Thank you!!