This blog is dedicated to early intervention therapy providers, i.e., OT, PT, and SLP, who work within the BabyNet system. It will be moderated and updated regularly with information, questions, links, and other resources related to best practices in early intervention service delivery. The intent is to share common experiences and questions, learn, educate, make constructive suggestions, and to create a dialogue between early interventionists. We encourage Netetiquette in all postings.
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3 comments:
Anonymous
said...
Does anyone have any information about a letter to Medicaid providers I just received from the Dept. of HHS? The letter refers to Medicaid recipients signing up for managed care. It refers me to the website SCchoices, but information here is primarily for patients. In selecting my own health care plan I have always been wary of managed care plans, and I am wary of joining one. Can I continue to bill Medicaid for my services to Babynet Medicaid patients? Do I have to join a managed care plan? Would joining result in a reduction in my fee or a delay in payment? At my current $40 per hour rate for ST, I do not feel I can take a reduction in pay or delay in payment. Can I remain a Babynet provider without joining a managed care plan? I need answers quickly because according to the website my area is already using managed care.
To answer your questions, you can remain a Babynet provider without joining a managed care organization (MCO); BabyNet providers are exempt from having to join at this time; so you have the option to sign up with an MCO or remain Fee-For-Service.
Here is some more information: At this time, MCO providers are carved out of the contracts. the provider will continue to bill Medicaid as usual. If you sign on as a MCO provider, you are required to bill your claims with that MCO. If you should have billing questions, you will call them for help with claims.
MCO can negotiate their own rates so the monies could be more or could be the same. MCO providers must have prior authorization for all services. As you investigate the MCO option, you can contact the provider liason at the MCO with questions.
I hope this helps and will be glad to followup as needed.
3 comments:
Does anyone have any information about a letter to Medicaid providers I just received from the Dept. of HHS? The letter refers to Medicaid recipients signing up for managed care. It refers me to the website SCchoices, but information here is primarily for patients. In selecting my own health care plan I have always been wary of managed care plans, and I am wary of joining one. Can I continue to bill Medicaid for my services to Babynet Medicaid patients? Do I have to join a managed care plan? Would joining result in a reduction in my fee or a delay in payment? At my current $40 per hour rate for ST, I do not feel I can take a reduction in pay or delay in payment. Can I remain a Babynet provider without joining a managed care plan? I need answers quickly because according to the website my area is already using managed care.
I'm following up and will post info tomorrow.
To answer your questions, you can remain a Babynet provider without joining a managed care organization (MCO); BabyNet providers are exempt from having to join at this time; so you have the option to sign up with an MCO or remain Fee-For-Service.
Here is some more information: At this time, MCO providers are carved out of the contracts. the provider will continue to bill Medicaid as usual. If you sign on as a MCO provider, you are required to bill your claims with that MCO. If you should have billing questions, you will call them for help with claims.
MCO can negotiate their own rates so the monies could be more or could be the same. MCO providers must have prior authorization for all services. As you investigate the MCO option, you can contact the provider liason at the MCO with questions.
I hope this helps and will be glad to followup as needed.
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