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

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

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

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

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

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.

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

Level I Aim = 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 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

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Level 1 2 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

Level 1 2 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

Level 1 2 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

Level 2 2 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

Level 2 2 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

Level 2 2 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

Level 2 2 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

Timeline DatesActivityFormatWho participates? October 2011Convener Pre-work and Orientation to Collaborative WebinarConveners, NIATx November 2011Coaches Pre-work and Orientation to Collaborative WebinarCoaches, NIATx December 2011Kick-Off MeetingFace-to-face in each region Coaches, Conveners, Providers, NIATx December 2011-August 2012 Demonstration PeriodMonthly Interest Circle Calls. Coaching Assistance, Skill Building Calls Coaches, Conveners, Providers, NIATx

Timeline DatesActivityFormatWho participates? April 2012Mid-Project ReviewWebinarCoaches, Conveners, Providers, NIATx August 2012Wrap-UpWebinarCoaches, Conveners, Providers, NIATx September 2012Conclusion MeetingFace-to-face meeting, location TBA Coaches, Conveners, NIATx

1.5 day Kick-Off Meeting November-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.”

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

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

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

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!

Demonstration Period November 2011 – August 2012 Coaching “Lifeline” to the project 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

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

Close Out Meeting & Sustainability August-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.

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

On the NIATx website the project is called NIATx SI: Business Practices for the Future

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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 ed to convener to fill out Send back to Jeanne by ----

Contact Information Jeanne Pulvermacher