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Medicaid Reimbursement for telepsychiatry

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NHS: northern half of NH with 8% of the population ... staff become familiar with the equipment and the process (educate and control) ... – PowerPoint PPT presentation

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Title: Medicaid Reimbursement for telepsychiatry


1
Medicaid Reimbursementfor tele-psychiatry
  • Northern Human Services
  • The NH experience

2
Program Overview
  • NHS northern half of NH with 8 of the
    population
  • Multiple sites services to DD Substance Abuse
    populations
  • No child psychiatry available within the region
  • HRSA grant to develop the technical capacity and
    clinical service and to ensure its sustainability
  • Gaining board of directors support
  • Required building the talent within IT department
  • Convincing clinical staff that it could work
  • Assuring financial staff that it would not
    inflate expenses

3
Process for engaging State partners
  • NH is a laboratory environment (geographic and
    population)
  • With the award notified potential partners and
    launched a good will tour.
  • Good Will Tour to outline the process, discuss
    the value, offer to be a resource for other CMHC,
    ask for their help in achieving sustainability
  • Tour included Bureau of Behavioral Health,
    Commissioner of the Department of Health Human
    Services, UNH (Health Management and Policy
    Institute), Dartmouth Medical Center the
    Department of Psychiatry, other NH CMHC who was
    attempting to initiate tele-health
  • Outlined a role for each of the potential players
    and key contact person
  • Provided brief updates as we progressed through
    the project.
  • Once the technical challenges were achieved and
    with a clinical partner, engaged in an intensive
    reimbursement planning effort with the Bureau of
    Behavioral Health (MH is carved out to BBH in NH)
  • BBH agreed to a pilot for one year

4
Successes Challenges
  • BBH required to assure the new service codes
    would be budget neutral
  • High visibility. Tracking via a modifier code on
    the bill satisfaction/outcomes.
  • No change was required to the State Plan
    (different delivery vehicle)
  • Other interested parties wanting to join the
    pilot.
  • Pressure to accelerate and expand (both internal
    external)
  • BBH Commissioners office outstanding partners
    as they view this as a portable model that will
    enhance services

5
Outcome of the partnership
  • We share the failures as well as the successes
    (commitment testimony)
  • Viewed as a partner to assist with other
    transformative issues.
  • Builds expectations that are not always achieved
    (electronic supervision)
  • Use of the technology grants permission to
    conduct other business (eligibility reviews etc.)
  • Establishes a platform for other innovation.

6
How do you maintain the relationship
  • We are the contracted entity for our region
  • Built in review of progress and problems re the
    tele-health project with BBH
  • Semi-annual meeting with the Commissioner BBH
    on the project

7
Lessons Learned
  • More extensive research on what is in place
    earlier. UNH was helpful in retrieving this
    information
  • Building in local grassroots support (other
    healthcare providers and legislators etc.) to get
    to the next level of other third party
    reimbursement
  • Let the staff become familiar with the equipment
    and the process (educate and control)
  • Engage billing and A/R staff early on

8
Resources Tools
  • Build the case for the value added
  • Share the data/information (proposal and the
    process)
  • Face to face initial meetings
  • Support from the top (Board, Medical Director and
    CEO)

9
Current Future
  • Bringing down the cost of transmission
  • Negotiating a longer term relationship with
    Dartmouth (provider)
  • Partnership with BBH, UNH to pursue legislation
    to require other third party reimbursement
  • Explore other clinical uses for the equipment
    (internal external)
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