On November 29, 2017, at a gathering of behavioral health service providers, Barnes Dennig’s not-for-profit team guided a conversation on key topics that leaders in the industry face day-to-day. Currently, providers are vigorously working through file testing with the state of Ohio for Behavioral Health Redesign (BHR), related to coding and service changes, effective January 1, 2018. Of those surveyed, a “clean” file has yet to be achieved, but outlooks were overall positive as providers are learning from the process.
Some larger providers are contracting with smaller providers to perform their coding and billing “back office” functions as the burden on many smaller providers is too great.
Several providers have indicated not yet making an attempt at submitting a testing file through Ohio’s system. With the deadline fast approaching, we expect the Ohio Department of Medicaid will be inundated with questions, as providers work through their final phases of implementation.
While the January 1, 2018 deadline has providers on alert, the bigger concern remains how the negotiation and roll out of the managed care contracts directly with insurance providers will unfold in the coming year. Some Kentucky behavioral health providers joined in the discussion to offer their experiences on the negotiation process with insurance providers, average payment terms, and other insights as Kentucky is already setup to contract directly with insurers. Some of the highlights from the conversations include:
- Providers shared stories about their budgeting process, assumptions and shortfalls for the 2018 and 2019 as a result of BHR.
- The overwhelming consensus was that the 2019 year is:
- Providers are trying to ramp up their working capital and improve liquidity to provide for flexibility, should there be the significant payment delays that are suspected
- Based on the experiences of other states undergoing this implementation, funding under the new system could take up to a year to receive from date service was provided
If you would like more information on BHR, Barnes Dennig can help. For additional information, please call 513-241-8313 or click here to contact us. We look forward to speaking with you soon.