RAVI’S PROVIDER UPDATES

Dear Summit County Mental Providers,

Thank you to those of you who attended our Provider Insurance Webinar. This email is a recap and also contains resources shared in this event.

1. Zoom event recording link: 

https://us02web.zoom.us/rec/share/18waFgWJRo8fD3oLQ7F9mi4bNuUA3EI3vKNn06opApSdcbZpHISLqr89RrFxPf2C.SlDIMLSWdVlPzwFT

2. Key takeaways from the event:

Medicaid:
TheraThink:
    • Make sure you verify benefits. Very important as last minute changes could have occurred or issues on the insurance company’s end can be uncovered.
      • Benefits Verification is a quote and not finalized, and Explanation of Benefits is the final receipt of service.
    • Denny will handle all phone calls to insurance companies except issues around credentialing (service location, rates, in-network status).
    • Get set up with Direct Deposit! This is not something TheraThink can help with, you will have to go through your credentialing contact.
      • Electronic payments are much faster than receiving a check.
    • Billing time frames can be severely impacted by “unclean” claims (up to 75 days). 30 days on avg for “clean” claims.
    • Reference attached PDF for what TheraThink does and does not do in terms of scope and boundaries.
    • Reach out to TheraThink as first contact over email in order to troubleshoot problems.
    • Check attached PDF for best practices when taking insurance: “Dos and Don’ts”
    • Input client appointments once every few weeks – use “add multiple appts”
Peak Health Alliance:
    • Peak is a “health insurance purchasing alliance” – negotiate rates directly with hospitals and insurance companies in order to reduce premiums, increase benefits, and increase reimbursement rates to providers.
    • The majority of Bright plans have a $0 copay except for the HSA and catastrophic plans.
    • Bright’s reimbursement will increase to $170 for a 60 min session starting in April 2021.
Bright:
    • Availity is a provider portal that is a helpful resource (in case you decide on to use TheraThink)
    • There are different payment methods available. If you DO NOTHING, you will get paid through the credit card. If you want to set up something else, call Vpay.
3. ***TheraThink’s Billing Guidelines Presentation*** (PDF attached)
Provides an overview of TheraThink’s roles and responsibilities and tips and tools for billing insurance.
4. **Peak’s Provider Quick Reference Guide for 2021** (PDF attached)
Provides simple details of Peak’s insurance offering for 2021
5. Three attachments from Bright Health:
Quick Reference Guide
Claims and Payments
Availity Registration
6. Medicaid Contact Info (PDF attached)
7. Contact info for Bright Health:
Provider Relations: Cindy Adamson <providerrelationsCO@brighthealthplan.com>, 720-353-9336
Credentialing support: Sandy Garson <sgarson@brighthealthplan.com>, 720-770-5137
8. Contact info for EBMS:
Nicole Powell: npowell@ebms.com
9. Registration for Transcranial Magnetic Stimulation
10. Provider Facebook page
Please let me know if you have any questions.
Thanks,
Ravi
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