Altruis Blog

NatCon17: Behavioral health advocacy, Medicaid reimbursement, and enhancing revenue.

Apr 13, 2017 11:24:13 AM / by Altruis

Washington State Convention Center - NatCon17

In the air around NatCon17 in Seattle there was gratitude, hope, and determination. Gratitude to the behavioral health community for making their voices heard regarding the AHCA. Hope that progress will continue. And determination to make sure it does.

Behavioral health’s more prominent role across healthcare—increasingly integrated into primary care, and forming the true backbone for responding to the opioid crisis—means that those on the front lines face unique challenges, both financial and operational. In that vein, here are a few things that stood out to us this year. Cheers to everyone who had a chance to stop by the booth—great conversations, and great to see you there!

Self-pay patients enroll in Medicaid after care is provided—then what?

Behavioral health providers serve all patients—insured, underinsured, and self-pay. Yet within the latter group, there are often patients who later become eligible for (or enrolled in) Medicaid or managed care after care is provided.

What then?

Altruis RetroPay - turn self-pay balances into retroactive Medicaid reimbursement.Well, with no way to know a previous care encounter had become eligible for Medicaid or managed care reimbursement, providers often write off these self-pay balances. After all, the cost-to-collect is high, the likelihood of collection is low, and there’s even the risk of alienating patients who might worry they can’t return for needed follow-up care due to an outstanding balance.

Providers and behavioral health leaders are certainly familiar with the challenge—and at NatCon17, they were looking for fresh ideas that would help capture more revenue without adding costs or risking their relationships with patients in need. That’s one reason we had so many good conversations around RetroPay—and why we’re looking forward to helping more behavioral health organizations turn self-pay write-offs into paid Medicaid claims.

The need to enhance revenue and meet quality metrics—without drowning in more work

Behavioral health providers are also finding that, as they work to serve more patients and grow the services they offer, they need solutions that don’t add new layers (and hours) of administrative work. Little wonder then that so many are looking for the right type of technology. In some cases, that’s an EHR built for behavioral health. In others, communication tools that are truly patient-friendly.

Electronic behavioral health screenings on a tablet

Or a way to electronically screen patients for behavioral-health concerns without adding to the already heavy workload of front-office staff.

Self-administered, electronic behavioral-health screenings can give patients who aren’t comfortable or ready to discuss concerns face-to-face have another avenue to make their voice heard. Done right, the impact on provider workload is low. The screenings can be automatically scored for insight into patient well-being—and electronic behavioral health screenings are reimbursed at a higher rate that paper-based assessments.

The real key? These screenings catch behavioral health issues before crisis stage—enabling providers to uncover concerns that might otherwise have gone unnoticed. Staff can view the scored results immediately, while the patient is still on site for care. Patients are better served—while the provider gains incremental revenue as well as a foothold in the effort to meet quality measures and reporting requirements.

Bringing together the tech, services, and insight needed for behavioral health reimbursement

One thing was clear at NatCon: the need for collaboration in the convoluted world of behavioral health reimbursement. Dollars in the door translate to more patients served—and the already tight operating models of behavioral health make maximizing the collection of owed reimbursement essential. With the right approach, behavioral health providers can bring in more revenue to help grow their mission—and expand the services they offer to those in need.

Interested in continuing the conversation? Get started today!

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Topics: Behavioral Health


Written by Altruis

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