04/01/2024
Hello everyone, just to update you on Better Innovations:
1. We are no longer providing Mental Health Skill Building for Adults...
2. As of March 8, 2024 we received our license to provide Mental Health Case Management for Adults.
3. We are currently trying to get everything updated and staff in place.
The Mental Health Skill Building Program to me became too much for the contracted Qualified Mental Health Professional-Adults (QMHPA) & the clients. The licensing entities/insurances wanted 40+ hour workdays ( and on call) but didn't want to approve enough hours for it to be worth the QMHPAs/Clients time.
They expected QMHPAs to "sideline" be responsible for transporting clients but didn't include mileage as part of the hours QMHPAs reimbursement. That cost was solely on the owners of each business. The clients expected to be transported too especially since none of them liked Medicaid Transportation.
The most hours they could get was 10 per week for each client but they were lucky if they got 7 & many times 3. Then they dictated how many OF THOSE HOURS daily you can use. Who driving an hour to see a client just to spend an hour? Sometimes it takes an hour to get the client mind set to work on their goals. Clients became more frustrated as well. If you spend 2 hours, on an hour day, the insurance companies will say the company overbilled that day even if they haven't went over the 10/7 hours that was approved.
So you telling us as QMHPAs and business owners, per say the rules and regulations you entities are expecting us during regular days and during a crisis to do all this extra work beyond the 7-10 hours you allocated.... but as soon as an QMHPA bill 2 of their 7-10 weekly hours on a day YOU say bill 1 hour, it's considered overbilling? Overbilling means you billed more than what you were approved for for the week, to me. It shouldn't be based on the billing schedule you are telling patients they need to be available.
So how is this program catered to the patients care and growth of his/her skills; when you say, "the client time is up" in the middle of skill teaching or an intervention?
Also, many clients that meet criteria for the Mental Health Skill Building program, are denied and said they need a lower level of service...*hint* Case Management. What they meant to say is they need to get out of this highly reimbursed program and go to the Case Management program so we don't have to pay as much.
If you don't know the rules and regulations and indicate in your policy and procedures that this is a Case Management program, not the Mental Health Skill Building program & not a Crisis program, they will try you. They will have you providing those highly reimbursed services at the Case Management rate... Stay Woke.. in my Policy & Procedures you will find this statement throughout.
The clients was never the issue..... so when we finalize things on our end and get our website and business information updated Better Innovations goal is to take Case Management to a new level in Virginia.
Stay Tuned!
Dr. LaShondrea D. Nixon
