Overview

1. NIATx-SI Business Practices for the Future Learning Collaborative Fee-for-Service Cohort II Convener Call Jeanne Pulvermacher, Project Director Funding provided by: CSAT Overview

2. NIATx Staff Co-Deputy Directors Kim Johnson and Todd Molfenter • Co-Executive Sponsors for the project • Oversees Contract and Budget • Assist with curriculum development

3. NIATx Staff Project Manager – Jeanne Pulvermacher • Oversees the entire project • Primary liaison with funder • Sends out communication and announcements • Coach support and communication

4. NIATx Staff Educational Services Director – Amy McIlvaine • Develop content and curriculum for webinars and meetings • Primary Liaison with Technical Experts • Web Resources and Blog content

5. NIATx Staff Outreach Specialist – Helena Gilbertson • Coordinates webinar and call information • NIATx Liaison for planning and meeting details for face to face meetings

6. Seven regional teams chosen and 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.

7. Fee-for-Service OBJECTIVES 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

8. 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

9. 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

10. Insert Prezi

11. Level 12 minute Introductions • Derrick West-Sonoma County Department of Health Services, Behavioral Health Division , City, State Coach: • Financial and reimbursement structure in your state key points • Name 2 things that are keeping you awake at night

12. Level 12 minute Introductions • Mary Booker-Florida Alcohol and Drug Abuse Association (FADAA, City, State Coach: • Financial and reimbursement structure in your state key points • Name 2 things that are keeping you awake at night

13. Level 12 minute Introductions • Kelley Hobbs-NH Alcohol and Other Drug Service Providers Assn. City, State Coach: • Financial and reimbursement structure in your state key points • Name 2 things that are keeping you awake at night

14. Level 22 minute Introductions • DeAnn Decker-Iowa Department of Public Health/Division of Behavioral Health, City, State Coach: • Financial and reimbursement structure in your state key points • Name 2 things that are keeping you awake at night

15. Level 22 minute Introductions • Lynn Posze-Kentucky Department for Behavioral Health, Developmental and Intellectual Disabilities, City, State Coach: • Financial and reimbursement structure in your state – key points • Name 2 things that are keeping you awake at night

16. Level 22 minute Introductions • Mollie Green-Department of Human Services, Division of Mental Health and Addiction Services (DHS DMHAS), City, State Coach: • Financial and reimbursement structure in your state key points • Name 2 things that are keeping you awake at night

17. Level 22 minute Introductions • Mark Drennan-WV Behavioral Healthcare Providers Association, City, State Coach: • Financial and reimbursement structure in your state key points • Name 2 things that are keeping you awake at night

18. Timeline

19. Timeline

20. 1.5 day Kick-Off MeetingNovember-December 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.”

21. Secure the meeting space • Invite providers – 2-3 people from each site • Reserve a meeting space and audio visual equipment • NIATx will send a logistics sheet to each convener

22. Preparing for the regional meeting Attend the “pre-meeting” webinar call(s) 1. Understanding and Filling out the Dashboard • CFO, CEO, Directors, Executive Sponsors 2. Making the most of your NIATx coach and Technical Assistance • Change Leaders, Change Team Members, Exec. Sponsors, Conveners

23. Monthly Interest Circle Calls • Each level will have a content specific call • 60 minutes (Presentation and Q&A) • Led by content experts and peers from around • the country Demonstration Period November 2011 – August 2012

24. We recommend that the following people attend Convener, Change Leader, Executive Sponsor, CEO, CFO, Chang Team Members and Accounting staff attend In addition: • NIATx will facilitate project review and skill-building calls with coaches and conveners. (every 4-6 weeks) Your feedback on these calls is critical to success!

25. Demonstration Period November 2011 – August 2012 • Facilitate monthly calls to review provider’s progress • Participate on monthly interest circle and skill builder calls • Attend the face-to-face meetings • 15 days of technical assistance allowed Coaching “Lifeline” to the project

26. April 2011 Mid-project Review • Formal check-in and review of project outcomes • Identifying timelines and milestones needed to achieve • project goals. • 2 people from each region, NIATx staff and coaches will attend

27. 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.

28. E--mail communication From: Subject: NIATx FFS I (detail webinar call reminder) To: Cc: From: Subject:NIATx FFS II (detail webinar call reminder) To: Cc:

29. On the NIATx website the project is calledNIATx SI: Business Practices for the Future

30. Web Demo

31. Next Steps? Next call is __________ “Understanding the Dashboard” led by Elizabeth Strauss Schedule the kick off meeting Coach and convener schedule a call Review expectations and project aim Participant final roster Template will be e-mailed to convener to fill out Send back to Jeanne by ----

32. Contact Information Jeanne Pulvermacher Jeanne.pulvermacher@chess.wisc.edu 608-513-9430