Practice Management Insight

July 2010

A report on events affecting Oklahoma providers

As the State implemented the new Consolidated Claims Processing System (CCPS) this July 1, clinical directors across Oklahoma scrambled to get their centers on board and clinicians flooded the phone lines with questions for OHCA, APS, ODMHSAS and their EDI providers as the new system and all the questions it brought with it went live on July 1.

Centers with ThinkHealth continue billing successfully, while
various problems still plague many after the July 1 update

July 1

State’s Consolidated Claims Processing (CCP) System goes into effect

July 4

Independence Day

July 7-28

Mother’s Day Out in July

Every Wednesday

Club Soda, OKC

More Information

July 8

OHCA Board Meeting

July 12-16

NAMI Oklahoma Peer Recovery Support Specialist

Amber Guerrero, 405.522.3908

More Information

July 14

Family Night Out

Club Soda, OKC

More Information

July 19

Oklahoma Board of Licensed Alcohol and Drug Counselors Board Meeting

Oklahoma City

More Information

July 20

Bonding and Boundaries

Lawton

More Information

July 21

Oklahoma Therapeutic Foster Care Association Board Meeting

More Information

July 22-23

SOC Wraparound 101

Tulsa Tech Center,

Lemley Campus

More Information

July 27-28

Case Management Training

Oklahoma City

More Information

Consolidated Claims Payment System (CCPS) Frequently Asked Questions and Helpful Hints, and Other Updates from APS, OHCA and ODMHSAS:

CDC transaction date and request for authorization start date           -July 16

Consolidated Claims Payment System (CCPS) Frequently Asked Questions and Helpful Hints                      -July 14

Request for Provider Input—OHCA Provider Letter and Proposed Master Manual                                       -July 12

Outpatient requests submitted prior to July 1                                     -July  7

CDC and CALOCUS manuals available                                    -July  6

Consolidated Claims Payment System issues and reminders -July  2

CCP/CDC go live - 1/7/2010   -June 30

Garth Splinter Returns to OHCA
as State Medicaid Director

“OKLAHOMA CITY—Garth L. Splinter, M.D., is Oklahoma’s new Medicaid director, Oklahoma Health Care Authority CEO Mike Fogarty announced. …

“He anticipates that some of the major tasks awaiting him as state Medicaid director are assisting with the federal health reform’s impact on Oklahoma and the effects of the ongoing state budget shortfall on OHCA.

“Splinter’s diverse education and professional background will give him a unique perspective when dealing with complexities facing the agency. He earned a bachelor’s degree in industrial engineering from OU and a master’s in business administration from Harvard before returning to OU for his M.D. …”

To read the full article, click here.

Problems still affecting centers after the July 1 update:

Who is keeping YOU informed of all these issues with the latest update? Centers with ThinkHealth had 2 training sessions in June to make sure everyone was prepared for July 1. After the update, they continue to keep their members informed of the latest news on the update.

ThinkHealth hosts training to prepare for July 1

- PAs denied eligibility even though they were eligible—OHCA error

- CDC transaction dates must be equal to or earlier than the requested PA start date

- The “Psychosocial Stressors do not match Level of Care” error message. The CAR still drives the overall level of care, however, for auto-auth, the CAR scores can help you in rating the Psychosocial Stressors so you will quit getting this error. For more information on Psychosocial Stressors and other suggestions to improve chances for auto-auth, please see: http://www.soonerpro.com/Files/Manuals/CCImproveAutoAuth.pdf

- The “service requested does not match the level of care selected. Please reconcile and re-submit” APS error

- Hold PA request status even when CDC has been submitted. If you have submitted a request for outpatient authorization and submitted a CDC but the request is still in Hold_PA status with no authorization number assigned, you will need to ensure the following: the PA should match the Agency/Organization on the CDC, and the CDC Transaction Date/Time must be equal to or earlier than the requested PA start date.

Clyde Wafford,  president and owner of OrionNet Systems