ValueOptions Presents: Administrative Orientation: Military OneSource Program 1 2012
Agenda 2 Welcome and Introductions Military OneSource and ValueOptions Partnership Overview of ValueOptions Military OneSource Overview of Military Branches Key Issues related to Deployment Key Issues related to Reintegration Scope of the MOS Program Operational Areas Clinical Post Suicide Survivor Training Mandated Duty to Warn Case Activity Form Giving Value Back to Providers Overview of Essential Learning Provider Connect and PayFormance Questions and Answers
3 Welcome & Introductions
Panel of Speakers Ana McKenna, Director, Provider Relations, MOS Douglas Briskman, Manager, Provider Relations, MOS Cathy Gilbert, Vice President, Provider Relations Rich Paul, Senior Vice President Health and Performance Solutions Operations 4
The Partnership: Military OneSource and ValueOptions ValueOptions was chosen by the Department of Defense to administer the Military OneSource Program October 30, 2011 Why ValueOptions? Specialist in providing EAP services and networks Offer a robust national provider network On-line platforms designed to ease administrative burden for providers and enhance the member experience ValueOptions has over 24 years of continuous experience in supporting Military members and their families through the TRICARE/CHAMPUS programs 5
6 Overview of ValueOptions
ValueOptions Founded in 1986 Privately held and physician-owned Committed to principles of recovery Diverse client base covering 30 million lives Federal Division (TRICARE and MOS) Commercial Division Employer Groups Health Plans Public Sector Division 7
ValueOptions Nationwide National Headquarters National Support Centers Regional Service Centers 8 1 to 3 Million Lives 500,000 to 1 Million Lives 250,000 to 500,000 Lives Under 250,000 Lives
Overview of ValueOptions Military OneSource 9
Military Branch Components Active Component (AC): referred to as Active Duty military members who serve under the command of the President full time continuously until discharged or retire Reserve Components (RC): Army, Navy, Air Force, Marine Corps, & Coast Guard Reserves and the National Guard (NG) composed of Army NG and Air Force NG. RC normally trains one weekend a month and two additional weeks per year. They comprise 43% of the total DoD force but cost only 9% of total DoD budget 10
Military Branch Components Guard vs. Reserve: The Guard have both state (activated by Governor) and federal (activated by President) missions. The Guard trains and deploys as units rather than individuals. The Reserves are President controlled and have only federal missions Activated: Individuals or entire units of the RC may be called into active duty (also referred to as mobilized, activated, or called up ), under several conditions: Full or Partial Mobilizations; Presidential RC Call-Ups; 15 Day Statute; or Volunteer 11
Branches of the US Armed Forces Army: Navy: Main branch of the armed forces responsible for land-based military operations. Primary mission is to provide necessary forces and capabilities... in support of the National Security and Defense Strategies Largest and oldest (1775) of the five military services Total of 1.1M (active and reserve component) service members Naval warfare service branch of the armed forces responsible for deterring aggression and keeping sea lanes open Largest navy in the world; its battle fleet tonnage is greater than that of the next 13 largest navies combined Active Component: 328,516 personnel; Navy Reserve: 101,689. Operates 286 ships and more than 3,700 aircraft 12
Branches of the US Armed Forces Air Force: Aerial warfare service branch of the armed forces that until 1947 was part of Army. Most technologically sophisticated and largest air force in the world Operates 5,573 manned aircraft; responsible for cruise and intercontinental ballistic missiles Active Component: 330,159 personnel; 68,872 in the Air Force Reserves; and 94,753 in the Air National Guard Marine Corps: 13 It is the smallest of the US armed forces but is responsible for power projection of combat land forces from the sea Included under Dept of Navy and works closely with naval forces for training, transportation, and logistic purposes; but considered a separate branch of the military services Active Component: 203,000 and just under 40,000 Marine Corps Reserves
Branches of the US Armed Forces Coast Guard: They operate under Dept of Homeland Security unless assigned to the DoD by the President (or by Congress in war) Unique among the uniformed services in having a maritime law enforcement mission as well as a federal regulatory agency mission Active Component: 42,839 personnel; 7,963 in Reserves; and a large essential civilian employee population 8,304 Only those US Coast Guard personnel temporarily detailed to the DoD (and their family members) will be eligible for MOS services Remainder of the USCG population receive their EAP services through a program directed specifically by the US Coast Guard 14
Key Issues Related to Pre-Deployment Ensuring all family administrative affairs (DEERs, ID cards, insurance, wills, family care plan, etc) are put in order Making sure financial affairs are in order prior to deployment Making sure both warrior and spouse employment affairs preparations have been made Preparing spouse, children and parents for the upcoming deployment Making a communication plan and agreeing on how often they will communicate, how they will communicate, and what type of information they will share Preparing spouse and kids for assuming additional responsibilities Deciding whether to stay in military community or moving back home Identifying local and other organizations that will be available to provide support 15
Key Issues Related to Deployment Coping with separation- difficult for all concerned during deployments Even spouses or kids that have experienced a deployment before may react differently to the next one and experience new challenges Willingness and capacity to use existing or build new support systems by reaching out to others and getting involved in the community Anxieties of family members over the safety of the service member Coping with financial and medical emergencies during deployments Coping with deployment extensions Issues related to rest and recuperation leave during a deployment Safety of family members during a deployment Communicating with the Command and the deployed service member 16
Key Issues Related to Reintegration Understand stages of return and reunion: everyone changes; all must find a new normal post deployment Taking leave and addressing the administrative, legal, financial, and employment affairs tied to ones pre-deployment preparations Intimacy with spouse may take time to reestablish; arguments may arise over finances, spousal roles in home, and child-related issues Service members may find it difficult being away from their military buddies; may have difficulty reconnecting with certain family members and old friends Unresolved problems before deployment will not have gone away Returnees may have difficulty sleeping, feel less motivated, experience a wide range of emotions Post deployment health benefits, education and training benefits, wounded warrior benefits, and survivor benefits 17
Scope of MOS Services Non-medical counseling services : problem focused and limited in nature; Psycho-educational brief solution focused counseling not benefits or covered under health insurance or group or individual health benefit plans; and on a referral only basis when requested by ValueOptions Self-referral for non-medical counseling services by individuals is not permitted Self-referral for additional treatment under a members MHSA benefit plan is not permitted Payment for non-medical counseling services is limited to the number of sessions provided for in the referral request from ValueOptions and to the terms of the Military OneSource Program The benefit allows for up to 12 sessions per issue 18
Military OneSource Website For Information on the services available to Military Members and their families visit the Military OneSource website at: http://www.militaryonesource.com 19
20 Overview of Operational Areas
ValueOptions National Network Services Provider Relations Ensuring that members behavioral health care needs are met through a geographically and clinically robust network whose providers are readily available; Ensuring the maintenance of network composition by engaging in assertive retention strategies; Engaging in timely and appropriate recruitment; Engaging in professional, consistent, and educative communications with our provider community and staff. Provider Credentialing Completion of Credentialing Application required for network participation 21
ValueOptions National Network Services Military OneSource Specific Requirements Be a US Citizen Speak English Complete the following training requirements (with annual renewal) Offered through Essential Learning with CEUs for completion Military Culture Competency Met by Attendance at a ValueOptions Webinar or on Essential Learning Offered Orientation on the parameters of the program Standardized training on each service component: Army, Navy, Air Force, Marine Corps, Army National Guard, Army Reserve, Air National Guard, Air Force Reserve, Marine Corp Reserve and Navy Reserve ValueOptions Administrative Training of systems and forms Training regarding deployment and reintegration Post-suicide survivor training Mandated and Duty to Warn process and reporting 22
ValueOptions National Network Services Provider Contracting ValueOptions Provider Agreements. MOS Specific Amendments/Exhibits Provider Statement of Understanding Contract Exhibit/Amendment Questions about Contracting and Credentialing? Call 1-800-397-1630 (8am 5pm ET) 23
Military One Source Required Training 24
Course Information Training Required for participation: ValueOptions Orientation- Offered via Webinar or Essential Learning Military Culture Competence Offered via Webinar (no CEUs) or Essential Learning (with CEUs) Annual Required Refresher Trainings ValueOptions Annual Updates Military Culture Competence Optional Training The Impact of Deployment and Combat Stress on Families and Children, Part I: Understanding Military Families and the Deployment Cycle (CEU credit) Offered as a bonus to providers upon successful completion of required training 25
26 Essential Learning
Accessing Required Trainings Access the trainings on the ValueOptions Essential Learning portal at: http://vomilitaryonesource.training.essentiallearning.com/ This link is also available on www.valueoptions.com on the MOS network specific page Trainings available on this site are specific to MOS Training requirements Military Cultural Competence ValueOptions Orientation You will receive a welcome letter with your login and detailed instructions on accessing the site Essential Learning bonus session-the Impact of Deployment and Combat Stress on Families and Children, Part I: Understanding Military Families and the Deployment Cycle 27
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Need Assistance in Essential Learning? If you are experiencing any difficulties with Essential Learning please email the Provider Relations Team at: MOSproviderrelations@militaryonesource.com 35
ValueOptions Quality Management Quality Management Program Oversight is provided by Medical Director Key Quality Indicators include but are not limited to: Satisfaction Survey measures Access and Availability of Services geographic access; phone statistics; appointment availability; etc Complaints and Grievances tracking and reporting Member Safety (adverse incidents and quality of care) Quality Improvement Activities/Projects MOS Specific Quality Monitoring Case Activity Form Audits Collaborative Management of High Risk Cases Assure Adherence to Scope 36
37 Post Suicide Survivor Training
Aftermath: Types of Survivors of Suicide Spouse/Significant Other Survivor Parent Survivors Sibling Survivors Children Survivors Co-worker and Friend Survivors Both similar and unique needs and issues for each of these populations 38
Suicide Postvention Suicide postvention is immediate crisis intervention for those affected by a suicide or suicide attempt 39
Key Issues for Survivors of Suicide Normal Grief Magnified Discomfort of others Stigma and Shame Existential quandary Questions about Responsibility and Blame What could I have done Why did he/she do this to me Why didn t I see this coming Anger Person who died Authorities, helpers, family, friends 40
Key Issues for Survivors of Suicide Supportive Counseling Telling the Story Connect with Others Resources Support groups Peer led Professional led MHSA Services Normalize the Healing Process 41
42 Mandated Duty to Warn
Duty to Warn Follow all requirements of licensure Child Abuse Elder Abuse Vulnerable Adult Homicide Suicide Domestic Violence 43
Duty to Warn Additional Requirements Contact ValueOptions as well for each of these Child, Elder, Vulnerable Adult Abuse Homicide, Suicide risk Domestic Violence And for these: Sexual Assault Recent hospitalization (within 1 month) Present or future illegal activity 44
Duty to Warn Statement of Understanding Must be signed prior to services being delivered Military Resources Family Advocacy Program FAP SARC (Sexual Assault Response Coordinator) Victim Advocacy 45
46 Referral Process
Referral Process Triage consultants are available 24 hours a day/seven days a week for referral. Member referral process: Triage Consultants complete an assessment to determine that no urgent needs exist and that counseling is within scope of nonmedical parameters Member will be warmed transferred to the provider office If member information is left on a voicemail, provider must call the member back within 24 hours to schedule an appointment Providers are required to offer an appointment within 3 days or at the convenience of the member. If not able to schedule an appointment providers need to notify ValueOptions Two days after the referral ValueOptions will contact the member to verify an appointment is scheduled Providers can contact ValueOptions 24/7 for referral consultation if needed 47
Case Activity Form Two page form customized for Military OneSource Additional Fields related to Domestic Violence, Child Abuse/Neglect, Sexual Assault Identification of appropriate v-codes Confirmation of no other diagnosis High Risk Cases Goals Notes At first visit Statement of Understanding must be signed Military ID Card must be viewed but cannot be copied may defer to second visit if not available on first visit 48
Case Activity Form (CAF) 49
Case Activity Form (CAF) 50
Case Activity Form (CAF) Where can I submit my CAF Form? ValueOptions PO BOX 1317 Latham, NY 12110 Or via Fax 877-762-1356 Or Online through ProviderConnect CAF s have to be submitted 15 calendar days after the session Multiple sessions within the 15 calendar days of the initial session can be submitted on a single CAF 51
MOS Case Activity Form on ProviderConnect Network providers authorized to perform EAP services can now submit their CAF billing forms via. ProviderConnect 52
54 Giving Value Back to Providers
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62 Demonstration of ProviderConnect
MOS ProviderConnect (Provider Online Services) What is ProviderConnect? An online tool where providers can: Access ProviderConnect message center. Access and print forms. View authorizations. Download and print authorization letters. Submit CAF Forms and view status. Access Provider Summary Voucher. Submit customer service inquiries. Submit updates to provider demographic information. Submit re-credentialing applications. Increased convenience, decreased administrative processes. Disclaimer: Please note that ProviderConnect SM may look different and have different functionalities based on individual contract needs, therefore some functions may not be available or may look different for your specific contract. 63
MOS ProviderConnect Benefits What are the benefits of ProviderConnect? Free and secure online application. Access routine information 24 hours a day, 7 days a week. Complete multiple transactions in single sitting. View and print information. Reduce calls for routine information. 64
How to Access MOS ProviderConnect? Go to www.valueoptions.com, choose Providers All in-network providers can self register for MOS ProviderConnect using their provider ID number. Self-registration is only available to providers that do not have an existing MOS ProviderConnect electronic account If additional ProviderConnect log ons for that same provider ID number are desired, please do the following: Fill out the Online Provider Services Account Request Form and fax the completed form to 1-866-698-6032 Additional log on turnaround time is 2 business days MOS ProviderConnect registration questions or questions about the form referenced above please contact the ValueOptions EDI Helpdesk at 1-888-247-9311 (Monday to Friday, 8:00 a.m. - 6:00 p.m. ET) 65
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ProviderConnect Login Screen 67
User Agreement Page 68
ProviderConnect Message Center (Personalized!) 69
Inquiry Details 70
Review an Authorization 71
Search Authorizations 72
Authorization Search Results 73
Authorization Summary 74
Authorization Detail 75
Recent Authorization Letters 76
New Authorization Letters 77
Authorization Letter Sample 78
View Provider Summary Voucher 79
View Provider Summary Voucher 80
Provider Summary Voucher Results 81
Provider Summary Voucher Sample
My Online Registration Profile 83
Updating My Online Profile 84
85 Invoice and Payment Process
Solution: Electronic Submission Advantages: It s better, faster, and cheaper! Reduced Paper Files Reduced Labor and Postage Expenses Reduced potential of error or mishandling Faster claims processing improves cash flow 86
ValueOptions EDI (Electronic Data Interchange) You can access our ProviderConnect Helpful Resources site to access additional claims resources. http://www.valueoptions.com/providers/provider_connect.htm ValueOptions also has a dedicated Helpdesk 1-888-247-9311 (8am to 6pm ET) for EDI issues. 87
PaySpan Health PaySpan Health is a tool that will enable you to do the following: Receive payments automatically in the bank account of your choice. Receive email notifications immediately upon payment. View your remittance advice online. Download an 835 file to use for auto-posting purposes. 88
Why Register? PaySpan Health is a secure, self-service website. Improved cash flow through automated deposits. Access remittance data 24 hours a day. Access up to 18 months of historical remittance data. Ability to import payment data directly into the practice management systems. Mailbox functionality to automate the delivery of remittance data. Multi-payer solution. It s FREE! 89
Registering for PaySpan Health is easy! Register for PaySpan Health online using your registration code. The person who registers will become the Administrator of the account. The email address entered during registration will be the Administrators User Name. Add additional users and set levels of access by user. Create additional receiving accounts. Your registration code currently prints on your ValueOptions check voucher. If you do not have a registration code please email corporatefinance@valueoptions.com and you will receive your registration code within 3 business days. 90
What do I need to register? Internet connection. Valid email address. Your bank routing and account numbers. Registration Code. Your Pay-To Vendor Number (PIN). Tax ID Number. 91
Pay to Vendor Number What is a pay to vendor number? This is a vendor number issued by ValueOptions and indicates the mailing address for all your payments. Can a provider have more than one pay to vendor number? Yes. You will have an additional pay to vendor number to register with your PaySpan account for Military OneSource payments. Does each pay to vendor number need to be registered with PaySpan? Yes. 92
Visit our website at www.payspanhealth.com 93
PaySpan Provider Support We are available to assist you! To learn more about how to register for PaySpan please visit the educational PowerPoint at: http://www.valueoptions.com/providers/files/pdfs/payspan_general_training_inform ation.pdf Provider Support contact information: 1-877-331-7154. providersupport@payspanhealth.com Provider Support is available from 7am to 9pm Eastern time, Monday through Friday. 94
ValueOptions Green Program Provider Summary Vouchers (PSVs) are no longer being mailed to providers. Provider Recredentialing Applications can now be reviewed and submitted online. Providers will receive a telephonic reminder when recredentialing applications are due via ProviderPulse SM. Our Webinars introduced providers to ValueOptions self-service option, ProviderConnect. To listen to a recording of these Webinars please visit: http://www.valueoptions.com/providers/training/training_w orkshops_archives.htm 95
96 Questions & Answers
97 Thank You