October 23, 2008 — New Features for Behavioral Health Providers

In recent months, Horizon has been contacted by a flurry of agencies who serve clientele with issues related to mental health, substance abuse, and developmental disabilities. These providers of North Carolina Medicaid “Enhanced Benefits” were desperate for help with an overwhelming paperwork burden. They’d been getting by with homemade spreadsheets, entering visit data 2 or 3 places to generate billing and payroll – but the new July 1, 2008 requirement of filing a Medicaid Cost Report was the final straw! They knew there had to be a better way, so they went looking for relief and a comprehensive solution.

Happily, Horizon was able to meet the needs of these frantic providers right away — having worked for over a decade with home care agencies billing Medicaid CAP-C and CAP MR/DD, and having already enhanced our PROMISE system to address some of their unique reporting requirements when a few community mental health agencies sought us out in 2006.

With our mental/behavioral provider client base suddenly doubled, and realizing that lots of agencies are facing similar difficulty, Horizon Healthware has enacted a commitment to further enhance our systems for the particular needs of mental health providers. In the September PROMISE software release, we enabled pass-through billing to support the situation when the agency provides service and payment goes to the LME. Earlier in 2008, we added a robust Authorization Tracking feature that allows agencies to create and track payor-based rules (like limiting all recipients to a certain number of hours/units) and consumer-specific authorizations (for example, he/she can have 20 hours of service in the next 2 weeks but no more than 3 hours in any one day). PROMISE will print an authorization number on the claim, create multiple claims when authorization is renewed within a billing period, show you where you stand on using the authorized services, and alert you when a cap has been exceeded or a reauthorization is coming due.

Of course, transmission of electronic claims (without any duplicate entry of visits), tracking revenues and receivables, printing the CAP Cost report, checking Medicaid eligiblity for all recipients, counting hours of service provided, exporting staff activities to payroll systems (again – without duplicate data entry), and many other time-saving features, have been part of the core PROMISE system for nearly 25 years. In addition to the recent changes for LME billing and authorization tracking, other enhancements are planned that will make PROMISE an even more valuable tool for mental health and community support providers.

Now that we know how desperately agencies are struggling and how positive Horizon’s impact can be, we are delighted to say that we aim to become the software vendor of choice for this industry. See our new brochure (PDF) that identifies the difficulties faced by behavioral service agencies and lists some of the ways that Horizon Healthware’s solution can instantly make life a whole lot easier.

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