DCS Presentation 2.ppt beneficial for students

study materials

1. DCS PresentationDCS Presentation
Doug Weinberg, CFO - DCSDoug Weinberg, CFO - DCS
Rick Crawley, CEO - WVHRick Crawley, CEO - WVH

2. Explanation of ProcessExplanation of Process
•Please hold all questions till the end.Please hold all questions till the end.
•A lot of information to cover in this A lot of information to cover in this
session session
•You have been handed index cards to You have been handed index cards to
write questions onwrite questions on
•Hand questions to ICCMHC staff Hand questions to ICCMHC staff

3. OVERVIEWOVERVIEW
•Background InformationBackground Information
–History of County StructureHistory of County Structure
–Conversion to State BudgetConversion to State Budget
–Projected ExpendituresProjected Expenditures
–Budget ForecastBudget Forecast
–Preferred Provider StatusPreferred Provider Status
–Changes in TimelineChanges in Timeline

4. DATA ANALYSISDATA ANALYSIS
•Targeted PopulationTargeted Population
•Wards and FostersWards and Fosters
–County ExpendituresCounty Expenditures
–County NumbersCounty Numbers
–ProbationProbation

5. Public AnnouncementPublic Announcement
•Need to Keep this Discussion InternalNeed to Keep this Discussion Internal
•Timeline for Discussion to Timeline for Discussion to
–DCS County ManagersDCS County Managers
–DCS County StaffDCS County Staff
–DCS Contract ProvidersDCS Contract Providers
–Other Affected PartiesOther Affected Parties
–22
ndnd
week of June – CMHC’s week of June – CMHC’s

6. DCS ISSUESDCS ISSUES
•CMHC CapacityCMHC Capacity
•CMHC Response TimeCMHC Response Time
•Collection History with Referred ClientsCollection History with Referred Clients
•Reporting RequirementsReporting Requirements
•CMHC Staff ExpertiseCMHC Staff Expertise
•Court TestimonyCourt Testimony
•Uniform Problem ResolutionUniform Problem Resolution
•Transition ProcessTransition Process

7. DISCUSSION AREASDISCUSSION AREAS
•Referral & IntakeReferral & Intake
•CommunicationsCommunications
•ServicesServices
•BillingBilling
•Match ProcessMatch Process
•Center ContractsCenter Contracts

8. REFERRAL & INTAKEREFERRAL & INTAKE
•““NEW” DCS Referral FormNEW” DCS Referral Form
–Will have a ICWIS Case #Will have a ICWIS Case #
–Will serve as authorization for DCS match paymentWill serve as authorization for DCS match payment
•Closing FormClosing Form
–DCS to stop servicesDCS to stop services
–CMHC to notify DCSCMHC to notify DCS
•Appointment ExpectationsAppointment Expectations
–Referrals must be offered appointment w/i 10 daysReferrals must be offered appointment w/i 10 days

9. REFERRAL & INTAKE -cont’dREFERRAL & INTAKE -cont’d
•Verification ProcessVerification Process
–Must verify if referral has MedicaidMust verify if referral has Medicaid
–ICWIS Case # in systemICWIS Case # in system
–Follow-up if not eligible and indicated on Follow-up if not eligible and indicated on
referralreferral

10. COMMUNICATONSCOMMUNICATONS
•11
STST
Appointment Feedback Appointment Feedback
•Standard DCS Monthly ReportStandard DCS Monthly Report
–One report from Center StaffOne report from Center Staff
•Standard DCS Visitation ReportStandard DCS Visitation Report
•DCS communication of Court DatesDCS communication of Court Dates
–One staff per Center to testifyOne staff per Center to testify

11. SERVICESSERVICES
•Service MenuService Menu
–DCS menu of servicesDCS menu of services
–Crosswalk to Medicaid EligibleCrosswalk to Medicaid Eligible
–Some services not Medicaid EligibleSome services not Medicaid Eligible
•Statewide ContractStatewide Contract
•CMHC Indicates Services to be ProvidedCMHC Indicates Services to be Provided
•CMHC Lease other agency employeesCMHC Lease other agency employees
•CMHC may not have the expertise CMHC may not have the expertise
•P/A for testingP/A for testing

12. SERVICE EXPECTATIONSSERVICE EXPECTATIONS
•Services will be provided timely with Services will be provided timely with
certain expectationscertain expectations
•If CMHC cannot provide someone willIf CMHC cannot provide someone will
•DCS has choice of CMHC providersDCS has choice of CMHC providers
•If service expectations not meet then If service expectations not meet then
providers may be changedproviders may be changed
•Medicaid rates for Non-Medicaid servicesMedicaid rates for Non-Medicaid services

13. BILLINGBILLING
•Services are eitherServices are either
–Non-Medicaid recipientNon-Medicaid recipient
–Medicaid recipientMedicaid recipient
•Eligible ServiceEligible Service
•Non-covered ServiceNon-covered Service
•Prior Authorization ProcessPrior Authorization Process
–P/A w/ referral form to get packageP/A w/ referral form to get package
–Simplified process w/ all diagnosis covered (DCS only)Simplified process w/ all diagnosis covered (DCS only)
•Billing form changesBilling form changes

14. BILLING -cont’dBILLING -cont’d
•DCS Referral #DCS Referral #
•DCS billing form to be modifiedDCS billing form to be modified
•DCS instructions to match changes to DCS instructions to match changes to
referral formreferral form
•May choose to bill one client per formMay choose to bill one client per form
•Limit of 48 lines per invoiceLimit of 48 lines per invoice

15. MATCH PROCESSMATCH PROCESS
•Referral form creates DCS match liabilityReferral form creates DCS match liability
•ICWIS # to be used to track DCS matchICWIS # to be used to track DCS match
•CMHC verify ICWIS in verification processCMHC verify ICWIS in verification process
•Electronic process to track and calculate Electronic process to track and calculate
matchmatch
•OMPP to run DCS match and collect from OMPP to run DCS match and collect from
DCSDCS

16. MATCH PROCESS -cont’dMATCH PROCESS -cont’d
•OMPP to run match report for total OMPP to run match report for total
center liabilitycenter liability
•DMHA to net bill CMHC for match DMHA to net bill CMHC for match
liabilityliability
•Both center and DMHA to get match Both center and DMHA to get match
report from OMPPreport from OMPP
•DCS to transfer match directly to OMPPDCS to transfer match directly to OMPP

17. CENTER CONTRACTSCENTER CONTRACTS
•All Centers have contracts that range All Centers have contracts that range
from 6 to 31 different servicesfrom 6 to 31 different services
•Standard DCS contract w/ center for Standard DCS contract w/ center for
Preferred Provider statusPreferred Provider status
•All Services offered to centerAll Services offered to center
•Center may elect to not provide some Center may elect to not provide some
servicesservices
•MOA - BHMIMOA - BHMI

18. QUESTIONS ?QUESTIONS ?