Medicaid

By Gary Humble | September 16, 2019 | Pinnacle Partners

Ohio’s Behavioral Health Community Medicaid Redesign: What are the Opportunities Revisited?

Community Medicaid Behavioral Health services have now been carved into the clients' Medicaid Managed Care Plan (MCP) for well over a year. As the system continues to move away from the the implementation phase of these Community Medicaid Redesign initiatives, behavioral health agencies must also continue to analyze these changes and its impact on their [...]

By Gary Humble | February 17, 2019 | Pinnacle Partners

Where is the Puck Going in Our New World of Medicaid Managed Care?

Hockey Legend Wayne Gretzky was once quoted as saying a good hockey player plays where the puck is.  A great hockey player plays where the puck is going to be.  This is exactly the mindset that needs to be developed by the Community Behavioral Health community. With the implementation of carve in of the Community Medicaid [...]

By Gary Humble | February 5, 2018 | Pinnacle Partners

Developing a Managed Care Mindset: What are Medicaid MCOs Looking for in a Partner?

The smoke has cleared and Ohio's Behavioral Health Design initiative is now reality.  The new code sets, new Medicaid covered services and billing requirements are now in place.  But there is no rest for the weary! As of this writing, Community Behavioral Health Medicaid services are scheduled to be carved into the Medicaid MCOs as [...]

By Gary Humble | November 15, 2017 | Pinnacle Partners

BH Redesign Coding Changes: Is Your Organization Preparing for the New Codes?

There has been a tremendous amount of discussion regarding the State of Ohio's Medicaid Behavioral Health Redesign initiative.  This blog focuses on a major aspect of Behavioral Health Redesign: The National Correct Coding Initiative (NCCI). This change in billing will be more than just substituting one service code for another.  For some providers, it will require a [...]

By Gary Humble | October 30, 2017 | Pinnacle Partners

Ohio Community Behavioral Health Agencies: Is Your Organization Preparing to Become a Medicare Provider?

We wanted to continue to update your organizations to the various changes coming to State of Ohio's Medicaid Behavioral Health System.  This Blog addresses the State's future requirement that Medicaid be the payer of last resort, particularly as it relates to clients who are also covered under Medicare. As of this writing, the State plans to "turn on" their Third Party [...]