Let s make a deal
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Let’s Make A Deal. Milwaukee County Behavioral Health Division Milwaukee WIser Choice November 2010 – July 2011. The Convener Team. David Moore - Coach Janet Fleege – WIser Choice Project Director/Convener WIser Choice Providers: ARCW -Benedict Center

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Let’s Make A Deal

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Let s make a deal

Let’s Make A Deal

Milwaukee County Behavioral Health Division

Milwaukee WIser Choice

November 2010 – July 2011


The convener team

The Convener Team

  • David Moore - Coach

  • Janet Fleege – WIser Choice Project Director/Convener

  • WIser Choice Providers:

    • ARCW -Benedict Center

    • Brighter Days-Empowerment Clinic

    • Guest House-Harambee/IMANI

    • Horizon, Inc.-Meta House

    • Recovery Network-United Community Center


Project description

Project Description

  • This collaborative supported the work of preparing 10 providers for healthcare reform in 2014

    • Medicaid track (5)

      • Aim was to become Medicaid certified

    • Increasing billing revenues track (4)

      • Aim was to increase already existing revenue sources

    • One wasn’t able to complete (1)


Activities

Activities

  • 2 Face to Face meetings

    • Outside of Kick Off meeting

    • Coach was able to attend due to close geographic proximity

  • Project conference calls

    • 2 tracks, focused on unique needs of each group

    • Ended with group call to support the work accomplished by each provider and to share lessons learned


Activities cont

Activities cont.

  • One-on-One Coaching Calls

    • Providers benefited from individually identified support from coach and/or convener

    • Change project charter forms used to monitor progress and keep on track

  • Focused training provided

    • Medicaid 101

      • An introduction to CPT & ICD-9 codes

      • Medicaid modifiers and fee schedules

      • Overview of Forward Health portal

      • Claims processing


Activities cont1

Activities cont.

  • One-on-one meetings with Agency Directors (when requested)

    • Help ‘ask’ the right questions to further project progress

      • Remove internal agency barriers

    • Support, encourage, validate work being done on behalf of fee for service initiative


Medicaid track

Medicaid Track

  • Medicaid Track

    • Start from beginning

      • Searching to see if they had an NPI #, obtain one if they didn’t

    • 4 of 5 obtained Medicaid certification

      • One agency had several staff enroll in college to pursue degrees in Social Work/Human Services

    • One project experienced a 62% increase in billable revenue


Increasing billing revenues track

Increasing Billing Revenues Track

  • Of the 4 providers

    • All had at least 2 contracts outside of Medicaid

    • All in various stages of billing

      • Searching to see if they had an NPI #, obtain one if they didn’t

    • Created new internal audit sheet to capture and monitor collection


Lessons learned

Lessons Learned

  • As a convener

    • Strong relationships with providers

    • Much to learn about medicaid certification and billing as well as 3rd party revenue sources

  • Providers weren’t aware of their own bottom line

    • Heavy emphasis on county funding

    • Need to decrease dependency of county funding and increase 3rd party billing

    • More hopeful

      • We can do this!


Lessons learned cont

Lessons Learned, cont.

  • Strong group of providers who can mentor others

    • Strong value in working with other providers and learning from each other, to encourage other providers

      • Cross pollination

      • There is no competition

      • The need will always be there, but we may not be

      • Not necessary to recreate the wheel


Lessons learned cont1

Lessons Learned, cont.

  • Existing relationships needed strengthening

    • Providers did not have strong relationships w/contractors

  • Marketing, Marketing, Marketing

    • We’ve been around, people know about us

      • Changing world, changing climate, changing field

        • Need to respond to change


No longer one door

No longer one door!

Door 1-WIser Choice/County

Door 2-Medicaid

Door 3-UBH

Door 4-Icare

> # of Doors – greater choice


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