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WCH News

December 31, 2014

Recap of ­presentation day!

Successful ­program ­MUST HAVE

 

1. Services that are consistent with the needs of the participants and community

  • Socialization – ACTIVITIES!! 
  • Personal care
  • Nutrition
  • Transportation
  • Optional services: enhancement of daily living skills, use of supplies, family involvement etc.

2. Administration Standards

  • Policies and Procedures
  • Qualified Personnel
    • Program Director
    • Service staff – Ratio staff to client (1:6)
    • Volunteers

3. Active Membership with NYSADSA

4. Focus on your referral sources – Get the word out!
  • Physicians, Social workers, nurses, therapists, religious groups, other aging disease organizations, etc.

MLTC Contracting

  1. Select & Contact as many MLTC listed in your County
  2. Prepare letter of intent with supporting documents
  3. Be ready for site visit – Get the facility ready
  4. Establish good relationship with provider representatives
  5. Complete application and Contract 
  6. Be on top for follow ups and keep ongoing log of all calls
  7. Keep in mind all time frames 
Today’s Challenges
1. Increased competition for Adult Day Care Providers
    • No set regulations for operating centers
    • Define your target population
    • Demonstrate Demand for Services
    • Hours and Days of Operation
    • Customer Satisfaction
2. Lengthy Contracting process
  • 6-8 Months before you can start billing
3. Panel are closing
  • Effects new providers & established providers planning expansion
4. Fraud & Abuse 
 
  • Reporting false claims!!!!
    • Overbilling visits
    • Billing wrong location
    • Billing for services not rendered
    • Billing for services for another adult day care center
  • Illegally soliciting patients
  • Paying for patients referrals 
  • Paying bribes to get into MLTC panels
 
 
 

 

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Need Help
Medical Billing Assistance
Phone: (718)312-8068
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Shabbat Time
Shabbat is the seventh day of the Jewish week and a day of rest in Judaism.