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ValueOptions ®

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.

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ValueOptions ®

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  1. ValueOptions® December 15, 2009

  2. 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.

  3. Overview of the ValueOptions® Contract • Approved by the Board of Public Works on June 3, 2009. • 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.

  4. Customer Service:How are we doing ?

  5. Claims Processing:How are we doing ?

  6. Claims Payments:How are we doing ? • Paper Claims - $41,707,228.83 • Electronic Funds Transfers (EFT) - $96,039,171.77 • Adjustments - ($243,828.60) • Total Claims Payments* - $137,502,572.00 * as of 12/1/09

  7. Claims Payments:Contract with ACS ValueOptions® contracted with ACS, the prior claims processing vendor, to pay claims for dates of service before September, 2009.

  8. Staffing Update • 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 84.75 of its 87.50 budgeted FTE’s hired.

  9. 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

  10. 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

  11. Questions?

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