slide1 l.
Skip this Video
Loading SlideShow in 5 Seconds..
Overview PowerPoint Presentation
Download Presentation

Loading in 2 Seconds...

play fullscreen
1 / 17

Overview - PowerPoint PPT Presentation

  • Uploaded on

NIATx-SI Business Practices for the Future Learning Collaborative Fee-for-Service Cohort II Informational Call Jeanne Pulvermacher, Project Director Funding provided by: CSAT . Overview. Fee-for-Service Cohort II November 2011-October 2012.

I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
Download Presentation

PowerPoint Slideshow about 'Overview' - kelvin

An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.

- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript

NIATx-SI Business Practices for the Future Learning Collaborative

Fee-for-Service Cohort II

Informational Call

Jeanne Pulvermacher, Project Director

Funding provided by: CSAT


fee for service cohort ii november 2011 october 2012
Fee-for-Service Cohort II November 2011-October 2012

Develop the capacity to bill third-party payers.

  • Training on the core components of implementing

third-party billing systems

  • Identify common areas where billing systems function poorly
  • Learn improvement techniques that work
  • Know and understand The NIATx Third-party Billing Guide

Six regional teams will be chosen and will be assigned to one of two levels in the NIATx Fee-for-Service Capacity Pyramid:

  • Ideally each provider in a team will fit in the same level.
regional team
Regional Team
  • A Convener – someone from the state, county, provider association, health system, or intermediary
  • 10 to 12 local non-profit, community-based addiction treatment providers
  • Coach – NIATx Process Improvement expert
  • NIATx staff – liaison and support for each team
  • Jeanne Pulvermacher, Project Manager
  • Amy McIlvaine, Educational Services Director
expected outcomes
Expected Outcomes
  • Each team will gain a greater understanding of the changes anticipated with healthcare reform.
  • Coaching and monthly calls will help teams develop or improve their systems for billing third-party payers.
  • Treatment providers within each team will develop or improve their collections performance.
  • Conveners will build their teams’ capacity for peer-to-peer mentoring and sharing best practices.
  • Each team will achieve locally specific milestones to build better and more robust business models.
level i aim design a third party billing system
Level IAim = Design a third-party billing system
  • Routinely request insurance cards and verify coverage
  • Request prior authorization and document authorization limits
  • Provide and document services using correct billing codes and amounts
  • Submit at least six invoices for payment, noting if bill was paid, denied or no response given
  • Make corrections and resubmit
  • Document the billing procedure for those steps and write up a policy and procedure to be included in the agency billing manual
level ii aim improve collections
Level II Aim = Improve Collections
  • Perform a walk-through of their billing process
  • Create a flow chart and assign staff to each process
  • Work to improve at least one step in their process (utilization review, accuracy of record keeping) and increase collections
  • Increase collections by a specified amount (will vary by provider)
  • Document the billing procedures and include all policies and procedures in a billing manual
1 5 day kick off meeting november 2011
1.5 day Kick-Off MeetingNovember 2011
  • Meetings typically take place at a convener’s or provider’s office building.
  • Convener responsible for securing the meeting space and other local costs associated with the meeting.
  • NIATx staff, coaches, conveners, and providers will attend

Providers will learn:

    • NIATx Process Improvement 101,
    • system design and change strategies
    • review the NIATx Third-party Billing Guide.
  • Each team will develop an organization-specific “Business Practice Implementation Plan.”
demonstration period november 2011 august 2012
Demonstration PeriodNovember 2011-August 2012
  • Monthly Interest Circle Calls for Level 1 and 2

NIATx will provide content experts for these calls.

  • Coaching: each region is assigned a NIATx coach to
    • Facilitate monthly calls to review each provider’s progress
    • Participate on monthly interest circle and skill builder calls
    • Attend the face-to-face meetings
    • 15 days of technical assistance allowed
  • NIATx will facilitate Level I and Level II monthly project review and skill-building calls with coaches and conveners.
mid project review webinar april 2012
Mid-ProjectReview Webinar April 2012
  • Two people from each local project, their coach, and NIATx staff will attend a mid-project review webinar
    • check-in and review of project outcomes to date
    • identifying timelines and milestones needed to achieve project goals.
close out meeting sustainability august september 2012
Close Out Meeting & SustainabilityAugust-September 2012
  • Each convener will present their change project story at an in-person closeout session. (Place TBD)
  • Each local convener and key providers from the regional team will present their change projects during one of two scheduled webinars for all members of the collaborative.
  • Each convener will submit a completed project charter of outcomes and outline next steps for sustainability and dissemination to at least five additional provider sites.
contact information
Contact Information

Jeanne Pulvermacher