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In case you missed it: Next steps in BHR assistance for BH Providers


Source: ODM and OhioMHAS


ODM and OhioMHAS are evaluating the early effects of Behavioral Health Redesign and managed care integration on the comprehensive behavioral health system. We are focusing immediate efforts on addressing payment and policy challenges and look to design solutions aimed at best serving Ohioans with mental illness and addiction treatment needs. We appreciate the work of our managed care plans to implement strategies that continue to support our partners and providers.

As part of those efforts, we would like to thank the behavioral health providers who completed our brief survey. The survey responses were instrumental in helping us understand the status of implementation and helped us develop next steps. For your convenience we have made a recent PowerPoint presentation available on our Behavioral Health Redesign website which highlights results of the survey and some data analysis that we have recently completed.

Immediate Next Steps for Accounts Receivable
While we continue to work on a more comprehensive set of strategies to continue to offer on-going assistance to providers, we have taken the following action steps:

• Managed care plans will not be seeking involuntary recoupment of any contingency payments until further notice. ODM will work with the MCPs to determine a future recoupment timeline based on the analysis of provider account receivables and other data regarding the progress and stability of the system. However, providers may elect to repay contingency payments at any time at their discretion.

• The departments are currently working with the MCPs to analyze data for the months of July, August, and September 2018. This information will then be used to determine outstanding accounts receivables due to underpayments and incorrect denials that are owed to the provider. In an effort to get dollars out the door quickly, outstanding accounts receivables for July dates of service will be paid by the appropriate managed care plan to each provider by March 1, 2019. There may be the need for reconciliation or additional scrutiny for some claims and in those instances, ODM will work closely with MCPs and providers to resolve those issues.

• We have established an email address for providers to inquire about the amount of dollars to expect. Beginning Tuesday, February 19, you may send an email to Please include your Medicaid provider ID and NPI in the request. A response will be sent within two business days which indicates your July amount by MCP.

• This process will be repeated for August and September in the very near future, followed by next steps regarding October, November, and December.

Policy Review
ODM and OhioMHAS have begun reviewing and implementing targeted policy changes focused on assuring critically needed services continue to be available to individuals with mental illness and substance use disorders. We have received helpful input from providers, advocates and other partners that will guide our initial conversations, but all individuals, advocates, providers, and plans are encouraged to provide us feedback regarding their individual experiences.

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