Post on 05-Feb-2016
description
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