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Alaska Demonstration Project

Alaska Demonstration Project. Overview. Joint Venture Initiatives Joint Venture Business Office (JVBO) Goals Itemized Billing VA Workload Credit New VA Clinic Integrated Planning. JV Initiatives.

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Alaska Demonstration Project

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  1. Alaska Demonstration Project

  2. Overview • Joint Venture Initiatives • Joint Venture Business Office (JVBO) Goals • Itemized Billing • VA Workload Credit • New VA Clinic • Integrated Planning

  3. JV Initiatives • 3 MDG & Alaska VA selected as Demonstration site for Coordinated Budget & Financial Management System (Joint Venture Business Office) • 3 MDG & Alaska VA selected for Joint Incentive Fund • CT/MRI Enhanced Services

  4. Major JVBO Goals • Develop a unique & itemized bill for every patient episode of care • Research & analyze itemized actual VA costs for appropriate reimbursement • Develop systems/processes so all VA patient workload costs & payments are individually tracked • Develop systems/processes to capture and authorize all VA workload at the JVMTF into the VA computerized fee program • Identify services/functions that are possible candidates for further integration

  5. Itemized Billing Previous Billing Process • Monthly billing report accomplished on excel spreadsheet • Submitted to VA for reimbursement using per diem rate • VA approves or denies charges • DoD rectifies monthly summary report & resubmits corrected Form 1080 to VA • Reimbursement received 60 to 90 days

  6. Itemized Billing Conversion to Itemized Billing • Streamlined current processes with each department • Installation & training of Just Claims Software • Retains patient billing claims & demographic information • Enabled us to process UB92 billing forms • Uses CHCS adhoc reports to collect ICD9 and CPT codes • Access to CHCS reporting system to run monthly billing reports • ER billing reports are processed, audited and billed weekly

  7. Itemized Billing Implementation of Itemized Billing • Itemized bills created using phased approach • Emergency Dept • Outpatient • Inpatient • Lab & Radiology experienced a delay • ICD9 codes unavailable in Lab & Radiology systems • CHCS Administrator created report to include ICD9 codes • Anticipated completion date: April 06

  8. Itemized Billing New Billing Process • CHCS billing reports generated & submitted to VA for review • Disputed charges reviewed and joint decision made by DoD & VA JVBO • UB92 billing forms are generated for each patient episode of care • Claims are batched and forwarded to VA Biller for processing • Claim totals are balanced with monthly summary • Form 1080 submitted to VA for payment • Reimbursement – 14 to 45 days turnaround

  9. VA Workload Credit • Use of VA fee package for authorizations • Create consults in CPRS • Scan medical documents into CPRS generated auth • $554,570 in outpatient fee captured (since 4/05) • $691,399 in inpatient fee captured (since 7/05)

  10. New VA Clinic • Current clinic in leased space at Alaska Regional Hospital • Significant space constraints • Lease expires 2007 • New clinic approved for construction outside Muldoon gate adjacent to 3 MDG Hospital • Design funded in 2004 • Construction begins – FY07 • Open for Business – FY09

  11. JV – Proposed VA Clinic

  12. Integration Initiatives • Library • Warehouse • Central Sterile Supply • Laboratory

  13. Questions?

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