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Future Reimbursement Changes: DHHS & Molina Collaboration

Summary of upcoming secondary reimbursement changes for claim processing partnership between DHHS and Molina Healthcare. Detailed data on impacts, financial estimates, and completion timelines discussed in confidential draft from January 2013 meetings with PAG, TAG, and Hospital Association.

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Future Reimbursement Changes: DHHS & Molina Collaboration

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  1. Future Secondary Reimbursement Changes for Claim Processing DHHS & Molina HealthCare Collaboration Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  2. Summary of COB work efforts in progress: Total TR (system defects) = 4 Total CR (change requests) = 4 Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  3. Specific data by TR and CR: • Provider types impacted • Tracking number • Change type & description • Estimated financial impact • Estimated date of completion • Communication plan for provider community as work is completed Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  4. TRHospital & Hospital Based Physicians affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  5. TRAll provider types affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  6. TRDental Providers affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  7. TRAll provider types affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  8. CR All provider types affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  9. CRAll provider types affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  10. CRAll provider types affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  11. CRAll provider types affected Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

  12. Provider Notification process • As each TR or CR is completed, a Provider Portal ListServ will be drafted for approval by the Molina/DHHS communication committee prior to adjustments being made: • TR/CR number & brief description • The date/schedule (may be completed over several weeks based on adjustment unit capacity) • Adjustment process options if determined adjustments are going to be required Confidential Draft: January 2013 PAG TAG & Hospital Association Meetings

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