NJAMHAA Winter 2020 News
Council Members help Strengthen (Mental Health) Providers’ Businesses
The LTC Contracting staff guides mental health providers through licensure and business setup procedures and ensures compliance with all regulations, whether the providers are opening new organizations or adding new service lines to their existing businesses.
“We have helped many providers set up their businesses. They often come back to us when they want to add other service lines,” said Steve Shain, COO.
“The integrated license is very exciting. We don’t often see licensing reform in health care,” Shain said, referring to single licensure that will soon be available for providers to offer mental healthcare, substance use treatment and primary healthcare services. “We anticipate it will be a smoother process for providers: a streamlined process with everything managed under one roof.” He noted that LTC is already working with its clients to prepare for the integrated license.
LTC’s services also include getting providers credentialed and on the Managed Care Organizations’ (MCOs’) networks, which is especially important now that the MCOs are covering substance use services for special populations (Managed Long-Term Services and Supports clients, individuals served by the Division of Developmental Disabilities and people who are Fully Integrated Dual Eligible for Special Needs Plans [FIDE-SNP]) and additional populations will inevitably be covered by MCOs.
“Providers who have worked with commercial MCOs out of network are realizing that the market is shifting to in network, so they’re trying to get into networks as soon as possible,” Shain stated. “Some are playing it by ear. By waiting, they’re losing their leverage with MCOs and not helping to create adequate networks.”
“Providers need to constantly verify and re-verify their clients’ eligibility, not just at admission,” Shain advised.
He explained that if providers are not aware when their clients switch MCOs, they could experience problems in reimbursement and disruptions to delivery of care. For those providers already participating with MCOs’ Medicaid plans, LTC helps with “anything on the financial end,” Shain said. “LTC partners with a company that does the billing and utilization review for LTCs’ client facilities, and LTC looks at this from a financial approach to ensure accuracy.”
LTC Consulting Services is the long term care industry’s premier medical billing service and off-site central business office. LTC’s custom business management packages for health care facilities offers peace of mind while substantially increasing and maximizing their revenues.