News from Rehabilitation & Community Providers Association
RCPA is pleased to report that the first meeting of the statewide HealthChoices Behavioral Health Managed Care Organization (BHMCO)/RCPA task force was extremely productive. The first meeting was held on July 16 and all BHMCOs attended, along with numerous oversight bodies. As previously reported, the purpose of this task force is to identify any operational compatibilities among the BHMCOs that exist or can be created, in areas such as credentialing, authorizations, procedure codes, billing, and
forms. Members working with numerous BHMCOs with wide-ranging differences in operational procedures causes significant confusion and frustration among the providers. The differences also cause increased errors and ultimately increased costs for all involved. The response from the BHMCOs and oversight bodies was encouraging. Below are the 14 areas identified by the task force that need to be addressed to seek consistency and clarification:
- Credentialing
- Authorizations
- Procedure Codes
- Billing
- Forms
- Promise Applications
- Interpretation of Medicaid Regulations
- Overall Compliance Issues
- Corporate Compliance
- Treatment Record Reviews
- Statewide Licensure for BS
- ICD-10
- Precertification Process
- BH/PH Integration Data and Co-location
In response to a request from the BHMCOs, RCPA has agreed to develop a survey for the membership to determine which of the areas above are the most troublesome, and to request ideas on how to improve the process. In the meantime, it was decided that two work groups will be organized right away, to address credentialing and procedure codes. These work groups will meet several times between now and the next task force meeting, which will be held September 22.