Payment
These training modules focus on equipping Colorado behavioral health providers with essential knowledge on billing and reimbursement processes, alternative payment models, and implementing value-based payment arrangements. Participants will learn how to navigate the reimbursement systems, bill for services, and engage in payment models designed to enhance care quality and efficiency within the behavioral health sector specific to Colorado's regulatory framework.
Cost-Reporting: Capturing What's Important for Your Business and for Your Patients
An overview of basic cost reporting concepts, existing resources for cost reporting, how cost reports inform the Prospective Payment System (PPS) rate, and timeline considerations for implementing a cost reporting process.
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Introduction to the APMs in Colorado Behavioral Health
An overview of the different behavioral health (BH) payment models available for different types of providers, how these models were developed, how they have been operationalized for provider payment, and provider responsibilities when participating in APMs.
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Introduction to Value Based Payment (VBP) for Behavioral Health Providers
An overview of APMs to support understanding of future payment models used by HCPF with BH providers, specific APMs outlined for Colorado specific provider types, and steps to take in preparation for discussions of value-based payment with MCEs.
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Medicaid Billing for Evidence-Based Practices and Intensive Services
An overview of coverage of Evidence-Based Practices (EBPs) and intensive services under Health First Colorado and the Behavioral Health Administration, including how to use available resources that describe how to submit encounters/claims.
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Paying Differently in Colorado
An overview of alternative payment models (APMs), how APMs vary from a fee for service payment approach, why models are shifting from volume to value driven payment, how changes align in clinical models, and provider roles in achieving quality outcomes.
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Prospective Payment System Reconciliation
An overview of the HCPF prospective payment system reconciliation process and relevant timelines, including when the reconciliation process applies and for which providers; the fiscal implications; and how providers work with MCEs to minimize potential financial challenges.
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