The Bureau of Elderly & Adult Services is hoping to break the logjam on Choices for Independence (CFI) redeterminations and service authorizations. HCANH has expressed concern to BEAS that redeterminations are being delayed and service authorizations are not being entered into the MMIS system in a timely manner, resulting in agencies providing services to long-time clients without reimbursement. BEAS recently hired another RN to complete re-dee’s and has redeployed staff to enter service authorizations. If your agency continues to experience CFI delays, please alert the Home Care Association.
In addition, many agencies have reported outstanding CFI claims dating as far back as April 1, 2013, which was the go-live date for the MMIS transition to XEROX. BEAS is committed to resolving these claims. HCANH representatives will meet with BEAS officials in early March to discuss a uniform process for claims resolution. In the meantime, agencies with large CFI accounts receivable can request a contingency payment by contacting Susan Lombard at BEAS.
Home Care Association has raised concerns with BEAS official about several issues related to the CFI program. One major concern is outstanding CFI claims dating back to 4/1/13 when the new MMIS system was activated. In a quick overnight survey two weeks ago, seven agencies reported over $250,000 in unpaid claims. Since I didn’t hear back from every agency, I assume this amount may be even higher.
BEAS officials are willing to work with agencies to resolve these old claims. In order to facilitate resolution of unpaid claims, BEAS needs the following information from each agency:
- Agency Name and Provider Number
- CFI Participant Name and Medicaid ID
- Service procedure code, number of units, date of service and (if available) TCN of the denied claim
Please fax this information to: Susan Lombard, BEAS, 603-271-4643. DO NOT email the information.
In addition, BEAS is willing to make contingency payments to agencies for which the A/R balance is affecting cash flow. To request a contingency payment, email firstname.lastname@example.org
In early March, several Home Care Association of New Hampshire staff and board members will be meeting with BEAS officials to discuss progress on: 1) outstanding CFI claims, 2) Delays in CFI redeterminations 3) Delays in CFI service authorization entry into the MMIS system and 4) late transmittal of CFI MED assignments to agencies. If your agency is continuing to experience problems with CFI, please let me know. It is hoped that this dialogue between HCANH and BEAS brings a quick resolution to the many complaints that have been raised by agencies.