Babies Can’t Wait Data Application & Enterprise Billing December 14, 2010

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Babies Can’t Wait Data Application & Enterprise Billing December 14, 2010. Project Status. Anthony James Project Manager \ Debbie Cheatham Business Owner. DCH Mission. RESPONSIBLE. HEALTHY. ACCESS. Access to affordable, quality health care in our communities. - PowerPoint PPT Presentation

Transcript of Babies Can’t Wait Data Application & Enterprise Billing December 14, 2010

Anthony James Project Manager \ Debbie Cheatham Business Owner

Babies Can’t Wait Data Application & Enterprise Billing

December 14, 2010

Project Status

ACCESS

Access to affordable, quality health

care in our communities

RESPONSIBLE

Responsible health planning

and use of health care resources

HEALTHY

Healthy behaviors and

improved health

outcomes

DCH Mission

Project Status:

1. Contract Award 12-3-10

2. Contract Signing 12-6-10

3. 1st Vendor Meeting 12-8-10

4. Onsite Vendor Engagement 1-10-11

5. Detailed Project Schedule Announcement 2-14-11

6. Target Implementation 7-1-11

* Tentative Schedule

District Tasks:

1. Complete Data Cleanup

2. Communicate Project Schedule to Your Organization

3. Communicate Issues / Concerns to Project Team

4. Collect contact information for your providers

5. Consider Your Districts Training needs

6. Complete BCW Survey

7. Share Communication with Program Director

Change Management

Communication:

1. Communication with Districts will be Bi-Monthly starting in January.

2. Site visits will be made to the districts to meet with district staff to discuss district tasks, prepare for training, share new business process. (*Schedule TBD*)

Note: Frequency of information distributed may change if warranted.

Resource Management

Additional Project Resources:

1. Additional project resources will be provided to assist the districts with implementing new business processes and training for the new application.

2. We will be leveraging the expertise within the districts to meet with the vendor and provide information about their billing process.

Selected Vendor

(*CSC*)

Computer Science Corporation

Lori Barrett, Principle Leader of Business DevelopmentLead the Procurement Process and Contract Negotiations

Jay Saunders, Principle Leader of Early InterventionLead the Service and Software Delivery

Vince Forcier, Sr. Account Manager of Early InterventionSubject Matter Expert and Coordinates Account Management

Early Intervention Experience

1996 2009

Summary of CSC HealthcareFederal GovernmentUS Department of Defense Military Health SystemDepartment of Health and Human ServicesNational Institutes of HealthFood and Drug AdministrationCenters for Disease Control and PreventionOffice of the National Coordinator for HITCenters for Medicare and Medicaid ServicesUS Army Medical DepartmentUS Department of LaborUS Department of Energy, Richland Operations

Proprietary/Nonprofit Health Ins & HMOsAetna/US HealthcareBlueCross/BlueShield of TexasBlueCross/BlueShield of VermontCIGNA Health PlansHumana Puerto RicoPacifiCare/FHP InternationalHarvard Pilgrim Health CareKaiser PermanenteFoundation Health SystemBlueCross BlueShield AssociationMercer/CFP ConsortiumHealth Care Service Corporation

State GovernmentNew York State Department of Health (EI and Medicaid Programs)State of Maryland Department of Health and Mental Hygiene (Medicaid Program)Arizona Health Care Cost Containment System (Medicaid ProgramAlabama-WIC BankingArkansas-WICCalifornia-WIC Banking (Farmers Market)Chickasaw Nation (SPIRIT) and 13 Tribal Organizations in Oklahoma and New Mexico-WICConnecticut-WIC BankingDistrict of Columbia-WIC BankingFlorida-WIC Banking (Farmers Market)Georgia-WIC and WIC BankingIllinois-WIC BankingIndiana-Early Intervention, WIC and WIC BankingKansas-WIC BankingLouisiana-Early InterventionMaine-WIC BankingMassachusetts-WIC BankingMinnesota-WIC and WIC BankingMissouri-Early Intervention, WIC and WIC BankingNew Jersey-Early InterventionNew Mexico State Dept -WIC and WIC BankingOhio-WIC BankingRhode Island-WICSouth Carolina-WIC and WIC BankingTennessee-WIC BankingVirginia-WIC BankingWashington-WIC BankingWest Virginia-Early Intervention

Providers and Integrated Delivery NetworksNew England Healthcare Electronic Data Interchange (EDI) Network (NEHEN)Massachusetts-Simplifying Healthcare Among Regional Entities (MA-SHARE)Partners HealthCareHenry Ford Health SystemBon Secours Health SystemCatholic Health InitiativesHCAOhioHealthCatholic Healthcare WestTexas Children’s HospitalMedStarUniversity of Texas, SouthwestCatholic Health EastAscension Health

Public Health Experience

Fiscal Agent Services

Claims Processing

• Paper HCFA• HIPAA Compliant 837 Files• Direct Online Data Entry• Scanned Images

SPOE Software generates and authorization via the IFSP

Claims are received and adjudicated according to your rules

Payments to Providers are generated electronically or on paper

Funds Management

Manage Bank AccountPerform Coordination of BenefitsThird Party ClaimingReporting

Whether your organization’s methodology is the payer of last resort or if you utilize a “pay and chase” concept, CSC can make a positive impact on the funds recovered and made available for rendering future services. Through the coordination of benefits activities combined with the interaction of other public sector entities you can expect to:

• Reduce payment cycle timeframes• Increase funds recovered• Enhance reporting capabilities• Obtain superior analysis information

With State and Federal budget constraints increasing more each year, it is imperative that government programs have access to all available funding sources. CSC will custom tailor a payment cycle to fit your organization’s needs.

Hosting / Service Models

• Hosting Options – CSC offers complete application hosting services from facilities in Lenexa, KS– Disaster recovery and business continuity options– Secure hosting environment with multiple redundant

systems to prevent outages– Ability to integrate with State finance systems (State

managed accounts)– Ability to provide program data to State data warehousing

or data management systems

If you have any questions or concerns please feel free contact the Project Manager

Anthony James at ajjames1@dhr.state.ga.us