Reduce Waiting & No-Shows  Increase Admissions & Continuation Reduce Waiting & No-Shows  Increase Admissions & Continuation FEE FOR SERVICE COLLABORATIVE Level 1: New Hampshire October 9, 2012

Reduce Waiting & No-Shows  Increase Admissions & Continuation PARTCIPATING AGENCIES Child & Family Services Families in Transition Farnum Center Keystone Hall Seacoast Youth Services Serenity Place Upper Room

Reduce Waiting & No-Shows  Increase Admissions & Continuation Two agencies- Farnum Hall and Child & Family Services were already experienced in billing insurances and chose to focus on improved revenues. The other five organizations focused on creating capacity for fee-for-service billing.

Reduce Waiting & No-Shows  Increase Admissions & Continuation a.) The agencies that had never done fee for service billing were unclear whether they provided billable services and/ or had staff who were eligible to bill for their services. Completed an inventory of staff and their current licensing levels, as well as an inventory of services currently being provided and cross walked those pieces of information to Medicaid and commercial fee for service requirements. This exercise allowed organizations to model the potential business case for billing and helped them to select a starting point. CHALLENGES & STRATEGIES

Reduce Waiting & No-Shows  Increase Admissions & Continuation CHALLENGES & STRATEGIES b.) Enrollment with Medicaid and commercial carriers. Since many organizations were paid by grants and the New Hampshire Medicaid program has not historically reimbursed for substance use services at the agency level, organizations had not previously credentialled their organizations or staff. Obtain NPI numbers for staff and agencies. File enrollment applications for the New Hampshire Medicaid program and commercial payers. Evaluate usefulness of CAQH.

Reduce Waiting & No-Shows  Increase Admissions & Continuation CHALLENGES & STRATEGIES c.) Charting and Compliance. Identify the billing codes that described delivered services. Create charting templates that ensured compliance with billing code. Train staff to use them.

Reduce Waiting & No-Shows  Increase Admissions & Continuation CHALLENGES & STRATEGIES d.) Lack of Electronic Health Record (EHR) and electronic billing systems. Create encounter forms. Research available and affordable billing software. Collect and evaluate insurance information from customers.

Reduce Waiting & No-Shows  Increase Admissions & Continuation RESULTS Everyone has NPI numbers for organization and staff Everyone is collecting insurance information. Everyone has applied for enrollment in the New Hampshire Medicaid program. Everyone has aligned current services with a potentially billable event(s). Some agencies are being paid!

Reduce Waiting & No-Shows  Increase Admissions & Continuation NEXT STEPS The New Hampshire Provider organization will consider implementing centralized billing to be offered to its members. New Hampshire Medicaid is in the process of selecting third party administrator and moving to a managed model that agencies will have to understand and create processes to accommodate.