Tag: Integrated Care

Materials from IMC Behavioral Health Provider Symposium

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On October 8 and 9, Amerigroup, Community Health Plan of Washington, Coordinated Care and Molina Healthcare are hosted a symposium for Behavioral Health providers that were previously contracted with the Spokane BHO. The purpose of this event was to provide detailed instructions on the clinical and operational requirements and processes for providers in the Spokane region in making the change to Integrated Managed Care, which has a go live date of January 1, 2019.

Available materials from the symposium are below.

Operations Session slide deck

Clinical Session slide deck

MCO Behavioral Health Provider Symposiums – updated!

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Location & registration announced!

Amerigroup, Community Health Plan of Washington, Coordinated Care and Molina Healthcare are hosting a symposium, offered on two days, for Behavioral Health providers that were previously contracted with the Spokane BHO. The purpose of this event is to provide detailed instructions on the clinical and operational requirements and processes for providers in the Spokane region in making the change to Integrated Managed Care which has a go live date of January 1, 2019.

These are the same sessions, repeated on two days.

Monday, October 8
8:30-9:00 am Registration/Breakfast
9:00 am-12:00 pm Morning Session: OPERATIONS
12:00-1:00 pm Transition/Lunch
1:00-4:00 pm Afternoon Session: CLINICAL

Tuesday, October 9
8:30-9:00 am Registration/Breakfast
9:00 am-12:00 pm Morning Session: CLINICAL
12:00-1:00 pm Transition/Lunch
1:00-4:00 pm Afternoon Session: OPERATIONS

Location
Spokane Valley Event Center
10514 East Sprague Ave.
Spokane Valley, WA 99206
Note: Venue entrance is on E. Appleway Blvd. Free parking is available.

For more details on location, content, and who should attend, follow the registration link below! 
https://www.eventbrite.com/e/spokane-imc-bh-provider-symposiums-registration-50626045866
NOTE: Please register each staff attendee INDIVIDUALLY!

Who should attend?
It is very important that the individuals that perform the operational and clinical work for your organization attend the symposium. We recognize that many people hold multiple responsibilities and we are dedicated to making this a good use of time

For the Operational Component:
·       Billing staff
·       Front Office Staff
·       Back Office Staff
·       Compliance Staff
·       Operations Staff

For the Clinical Component:
·       Clinical Leads/Managers or Program Managers
·       Office Managers/Staff (if they complete Prior Authorizations)
·       Any clinicians or other direct service providers interested in connecting with MCO Case Management and Utilization Management Departments

 Main topics that will be covered in each session:
Operational Component
·       Credentialing
·       Access to Care & Appointment Standards
·       Websites, Portals, & Directories
·       Claims and Billing
·       Prior Authorizations
·       Resources
·       Questions and Answers

Clinical Component
·       Utilization Management Overview
·       Common Prior Authorization Standards
·       Case Management Overview
·       Questions and Answers

FIMC Funds FAQ

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Last updated: 10.3.2018

Who is receiving FIMC funds?

The first round of FIMC funding goes to BHO contracted Medicaid Providers and Tribal BH Providers.

What are the funds for?

To help Medicaid providers and Tribal BH providers who are currently contracted with the BHT prepare for financial integration by January, 1 2019. Read more about this decision here.

How much money is there?

Because our region opted to be mid-adopter, we received an $8.7M investment to accelerate the effort to move to whole-person care.

How much money has been allocated to date?

  • $25,000 for signed Letter of Commitment to participate in the transition to FIMC

  • $20,000 for completion of the Qualis FIMC Readiness Assessment

  • $30,000 for completion of behavioral health Partnering Provider Transformation Plan

  • $5,000 for readiness to contract for FIMC on January 1, 2019

Changes Coming to Washington Apple Health

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Apple Health is shifting to whole-person care.

What does this mean?

Starting in 2019, Apple Health (Medicaid) Managed Care plans will cover behavioral health treatment services, in addition to the already covered physical health services.*  (You may have heard this referred to as integrated managed care or IMC transition.) This is great news for Apple Health clients because it means that folks can more easily get the help they need, for both physical and behavioral health, which includes mental health and substance use disorder (SUD) treatment.

As part of this transition, the number of managed care plans available in Adams, Ferry, Lincoln, Spokane, Stevens, and Pend Oreille counties will be decreasing. Beginning January 1, 2019, there will be three Apple Health plans in our region: Amerigroup, Community Health Plan of Washington (CHPW), and Molina Healthcare. UnitedHealthcare and Coordinated Care will no longer be available in our region, with the exception that Apple Health Foster Care will continue to be provided by Coordinated Care (Apple Health Core Connections).

It is important to note that this change will not reduce any benefits for Apple Health clients, nor will any clients lose their coverage. Most clients will stay with the same health plan. However, for those whose plan will no longer be an option in our region, the Health Care Authority (HCA) will auto enroll clients to one of the three available plans. There is no open enrollment period for Medicaid—clients may choose to change plans at any time.

What’s the next step?

Some Apple Health clients are already hearing about these changes and—as you can imagine—this news could cause some confusion and angst. Below you will find this information condensed into simple and clear bullet points. We strongly encourage you to share this message with your organization’s staff so they are equipped to handle questions and concerns.

Below you will find the Communication Toolkit which has links to materials for organizations to print and use. There will also be versions created in Spanish later this month. Additionally, the HCA intends to produce an educational webinar for providers and the MCOs are planning a symposium for October. Better Health Together will continue to provide updates and resources via email and on our website as soon as they become available. Click here to add your email address to our distribution list.

Communication Toolkit

Important Dates

October 1, 2018 – HCA sends a letter to Apple Health clients to summarize the changes
November 20, 2018 – HCA begins enrollment process for Jan. 1, 2019
Late November-early December – HCA sends a letter to clients with the name of their health plan, a link to their benefits booklet, and how to change their plan.
December 1, 2018 – HCA’s website and customer service phone lines become available to assist clients

The Facts

  • Clients will not lose coverage

  • Benefits will not be reduced

  • There will be no changes for clients currently on one of three available plans (Amerigroup, CHPW, Molina)

  • Clients on UnitedHealthcare and Coordinated Care will be automatically reassigned

  • Apple Health Foster Care will continue to be provided by Coordinated Care

  • Clients can choose to change their plan anytime

  • This affects Medicaid managed care clients, not Medicare or Medicaid fee-for-service 

Questions?
Health Care Authority • 1-800-562-3022 • askmedicaid@hca.wa.gov
Better Health Together • 509-960-8593 • admin@betterhealthtogether.org

*This change applies to Apple Health managed care programs. This does not apply to individuals receiving Apple Health coverage without a managed care plan (i.e. individuals on a fee-for-service plan, including those dually eligible for Medicaid and Medicare). These individuals will continue to receive physical health services as they do today. For more information about access to behavioral health services for these individuals, view the BHSO fact sheet at www.hca.wa.gov/assets/program/bhso-fact-sheet.pdf

MCO Meet & Greet contacts

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On Sept. 12, the four MCOs in the BHT region – Amerigroup, CHPW, Coordinated Care, and Molina – hosted a Meet & Greet for behavioral health and Tribal providers to get to know their MCO billing and clinical representatives. Slides from that day, which include contact information for those MCO representatives, are below.

Introductory Slides

Amerigroup presentation

CHPW presentation

Coordinated Care presentation

Molina presentation