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Fee-For-Service Cohort II

Fee-For-Service Cohort II. FFS Cohort II Participants. Eleven Agencies (all provide outpatient services) 2 Community Mental Health Centers 5 Adult Residential Programs (serving all 99 counties) 2 Adolescent Residential Programs (serving all 99 counties) 1 Opioid Treatment Program

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Fee-For-Service Cohort II

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  1. Fee-For-Service Cohort II

  2. FFS Cohort II Participants Eleven Agencies (all provide outpatient services) • 2 Community Mental Health Centers • 5 Adult Residential Programs (serving all 99 counties) • 2 Adolescent Residential Programs (serving all 99 counties) • 1 Opioid Treatment Program • 3 provide IDPH funded Women and Children’s Programming Serve 61 of Iowa’s 99 counties Represent 48% of IDPH funded Substance Abuse Treatment programs 7 participated in Cohort I

  3. Increase Collection - Changes Staff/Personnel • Prepared “script” for Counselors to explain fees and billing procedures to clients • Prepared “script” for Office Manager to explain fees and billing procedures to clients • Developed expectations for frequency and amount of client payments • Developed “Contract” for Counselors to help Clients establish financial goals • Financial Goals became monthly “recovery topic” in treatment groups • Follow up during individual sessions (Counselors received current client balances weekly) • Staff Incentives

  4. Increase Collection - Changes Technical • Transitioned to using full capability of Electronic Medical Record (EMR) for billing • Credit/Debit Card processing Policy/Procedure/Praxis • Changed outdated policy/procedure to reflect discovered “best practice” for agency • Included postage paid envelopes with monthly statements • Agreement for merchant account • Advertise availability of credit/debit card machine • Orientation Packet, flyer in monthly statement • Weekly reports to staff • Request Payment at time of service • Located billing staff in the highest volume locations

  5. Reduce Denial Rate - Changes Establish system to monitor and correct insurance concerns in a timely manner Educate team about insurance issues • Pre-authorization (collect needed information when scheduling appointment) • Monitor and communicate key changes • Training (e.g., billing codes, rate structure, authorization) Utilizing electronic client records and associated billing data to their fullest

  6. Reduce AR - Changes Advertise to clients Offer postage paid envelopes Target the “20% who represent the 80%” 30 minute weekly briefing with key administrative staff and managers of current fiscal reports. Billings completed twice monthly versus once monthly Electronic Billing implemented

  7. Impacts or Lessons Learned Improved communication with clients Enhanced staff confidence in talking about $ Developed standard process Poised to tackle further projects to increase revenue and decrease denials Teamwork is important/Better teamwork Not all change is successful Improved staff ownership of process which lead to increased morale and confidence Increased Revenue! Made a profit!

  8. Take away lessons Be flexible Listen to staff What works in one agency may not in another Informing staff impacts awareness and improves motivation Share concretely with staff the cost of billing errors to increase engagement Overcome staff resistance to asking for $ and balance against clients thinking that they do not need to pay.

  9. Next Steps Continue to monitor caseload payments to ensure utilization of process and continued increase in collection of fees. Discounts for timely payments • Free session if balance paid and punch card full • 25% discount for payment in full for clients no longer in services Track employer insurance products Ongoing training of staff on new billing codes Monitor impact of EMR go live on denials Implement incentive plan for counselors Build upon staff skills and cross-train to allow more flexibility and a greater focus to accomplish future change projects

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