Certified Community, Clinic Prospective Payment System Technical Assistance, Consultation, and Implementation Support Services

The Vendor is required to provide behavioral health certified community, clinic prospective payment system technical assistance, consultation, and implementation support services for include:
1. Project management and communications
• Project kick-off meeting
• Technical assistance project plan and centers clinic demonstration launch (final)
• Ongoing project coordination (standing check-ins, ad hoc calls, email, cloud-based team collaboration and communication platform)
2. Billing and claims processing systems
• Readiness assessment of clinic billing and claims systems
• Data systems capacity to track outliers and outlier payment infrastructure
• T1041 encounter code processing with q2 modifiers
• Shadow billing processes and service-level encounter detail capture
• Designated collaborating organization (DCO) billing integration for crisis services
• Financial workflows to accurately bill for and pps-4 receive payments
• Provider billing manual for clinic pps-4 (draft and final)
• Plan, coordinate, and facilitate testing of pps-4 payments prior to centers clinic demonstration to ensure operational success
3. Quality measures and QBP program
• Readiness assessment of data system(s) and infrastructure to collect and report clinic-collected, state-collected, and QBP measures
• Accuracy of quality measure ingestion and configuration (i.e., EHR, dashboards, data warehouse)
• Verify clinic quality and quality bonus payments (QBP) measures reporting and submission infrastructure aligns with centers requirements
• QBP measure capture, calculations, and payment
4. Technical assistance on an hourly basis
• Claims reimbursement
• Medicaid
• Medicaid claims system (MMIS)
• Cost report.