Capital Area BHRS Providers Meeting

1. Capital AreaBHRS Providers Meeting January 15, 2008

2. Presenters Keven Cable, Provider Relations Trainer and Quality Reviewer Mollie Seifert, Provider Relations Representative Bonnie Clark, Quality Improvement Program Manager Kim Town, Clinical Care Manager Deb DeVivo, Supervisor of Clinical Support & Processing

3. AGENDA Quality Improvement Updates Clinical Updates Provider Relations Claims Reminders Website & Portal ProviderConnect Provider Relation Updates Discussion Next STAP Meeting: March 19, 2008 Next Meeting date: April, 2008

4. QI Updates New QI program manager- Bonnie Clark, RN, M.Ed. Corrective Action Plans BHRS Exception Reports Quick Tip #2 & #3 available on Website

5. Clinical Updates BHRS Authorization Staff Initial Service Request when BHRS is already in place. ISPT Process Clarification ISPT invites for CBHNP Provider Choice forms on website

6. Claims Reminders Timely filing limit Original submission - 60 days from date of service Resubmissions - 60 days from CBHNP EOB date COB Claims - 60 days from primary insurance EOB date

7. Claims Reminders Claims questions Customer Service Helpdesk - Telephone: 1-888-700-7370 (Monday - Friday 8:00am - 4:30pm) Providers can check claim status through ProviderConnect https://ecurapc.cbhnp.org/ Electronic billing questions should be directed to edi@cbhnp.org

8. Claims Reminders Claim Submissions CPT code on claim should match CPT code on authorization MPI Numbers must be on all claim forms CMS 1500 -block 33b UB04 - block 57 CPT codes should be billed on CMS-1500 Revenue codes should be billed on UB-04 Do Not Staple Claim forms - all claims are scanned

9. Claims Reminders Primary Insurance Providers should transition members before 1/1/08 if they do not participate with their primary insurance EOB from primary insurer must be attached If primary denies the claim the denial explanation must be included with the EOB CBHNP can but is not obligated to pay the co-pay up to the contracted or FFS amount

10. Website & Portal: Please check the CBHNP website WWW.cbhnp.org for: Provider Manuals Provider Directory Soon to come: School Based Outpatient Directory Provider Portal: Current forms Instructions Trainings and Meetings 10

11. Provider Portal Update Fully functional except for e-registering for meetings or trainings After 2/1/08 no forms or policies will be located on the website as they will all be located on the Portal.  There is a control on the top of all pages in the provider portal called “My Account”.  Going into this section allows a provider to update/change information in their account including the LOC they need information on.  The only thing they cannot do, at this point, is change their password.  Issues/concerns/Questions www.CBHNP.org 11

12. ProviderConnect Provider Web Access ProviderConnect allows authorized providers in-network to: Check status of all authorizations Check status of claims Review Provider Profile and Address Information 12

13. ProviderConnect Update Updates Any issues/concerns/questions? 13

14. Provider Relations Updates Plan of Cares A reminder about the evaluator meetings MT, TSS, BSC: How services are provided, claimed & paid. Provider Type 34/340 (BHRS exception services) STAP time lines: letters of intent & budgets 14

15. Discussion What are the barriers to quickly accessing BHRS treatment, i.e. Lack of Providers in Upper Dauphin…what else? Any other issues? Stipend for trainings: Recovery, Co-Occurring Autism Spectrum Disorders

16. Next Meeting Next STAP Meeting: March 19,2008 at CBHNP Next BHRS Meeting: April 2008-TBD 16