The Mississippi Hospital Association Health, Research and Education Foundation is pleased to provide this two part virtual education, in partnership with JBS and the RCORP-TA project.
This event is registration for part 1 of the 2 part series. You must also register for the August 24 session (part 2 of 2).
PRESENTED AS VIRTUAL EDUCATION THROUGH ZOOM
Documentation, Coding, and Billing for SUD/OUD via Medication Assisted Treatment:
In partnership with JBS and through the RCORP-TA project, the Association for Rural & Community Health Professional Coding (ArchProCoding), has developed a training course on clinical documentation, professional coding, and compliant medical billing for substance use disorder/opioid use disorder (SUD/OUD) treatment services with a focus on medication-assisted treatment (MAT). This educational session will focus on how grantees can ensure their financial sustainability and continued service provision by maximizing reimbursement for SUD/OUD treatment and primary care and mental and behavioral health encounters. ArchProCoding, the nation’s only organization devoted solely to rural and community health, will help grantees understand proper documentation and coding as well as billing across insurance. This training course will be provided to grantees and their consortium partners virtually for the foreseeable future.
The audience for this training includes Rural Health Clinics (RHCs), Federally Qualified Health Centers (FQHCs), Critical Access Hospitals (CAHs), mental health care providers, and primary care organizations that provide SUD/OUD screening, MAT services, and behavioral health services. The training will differentiate between RHC, FQHC, CAH, and traditional provider coding and billing requirements and will speak to the unique billing challenges stemming from RHCs, FQHCs, and CAHS having to bill using different claim forms and receiving different types of payments from Medicare, Medicaid, and commercial insurers than traditional providers. We strongly believe in team-based training where the following groups train together to make the most positive impact:
· All clinical staff members who document activities in medical records
· Appropriate administrative, practice managers, medical directors, and program and grant staff who manage people, processes, and technologies related to the revenue cycle
· Revenue cycle staff (i.e., coders and billers)
The full course lasts a total of 4 hours and can be taken in one 4-hour session or two 2-hour sessions (as a grantee needs), allowing for ample time to review the following topics:
· Overview of the opportunities and challenges associated with variable reimbursement mechanisms, including coding and billing for Medicare, managed care, Medicaid, and other third-party payors
· Compare diagnostic terms used in the DSM-V versus the ICD-10-CM.
· Tools for identifying and screening individuals who are at risk of SUD/OUD (e.g., SBIRT)
· Reporting MAT screening, pre-induction visits, induction visits, and stabilization/maintenance visits
· Administrative requirements for obtaining DATA 2000 waivers and recent exclusion options
· Understanding Medicaid H-code options for SUD, OUD, and MAT treatments
· Overview of the ICD-10-CM’s “2023 Official Guidelines for Coding and Reporting”
· Proper documentation for psychiatric diagnostic evaluative services, health assessments, and psychotherapy
· Limitations and opportunities related to reporting group therapy
· Reporting of non-face-to-face services including telehealth, virtual communication services, online digital visits, Behavioral Health Integration (BHI), and the Psychiatric Collaborative Care Model (Psych CoCM)
· Transitional care management, telehealth, online digital Evaluation and Management (E/M), and virtual check-ins
There are several benefits that grantees and their consortium members get from participating in this training, including:
· Understanding the roles of each team member and their relationships in the coding/billing process
· Determining service code billing options based on payor requirements
· Learning about services that can be billed between patient visits
· Learning how to increase evaluation and management (office visit) reimbursement opportunities
This project is supported by the Health Resources and Services Administration (HRSA) of the U.S. Department of Health and Human Services (HHS)
as part of an award totaling $1M with 0 percentage financed with non-governmental sources. The contents are those of the author(s) and do not necessarily represent
the official views of, nor an endorsement, by HRSA, HHS or the U.S. Government.