Overpayment Protocol for Behavioral Health Federal Insurance Programs
To update the FY24-25 protocol (FY24-25), we reviewed the Medicaid and Medicare laws, regulations, contracts and agency manuals. In addition, we leveraged the feedback received from DHCS during their Acute Inpatient Psychiatric Hospital Triennial Review (December 2022/January 2023) SMHS Outpatient Triennial Review (February/March 2023).
To simply the protocol and process, we designed a flexible protocol that can be used for almost any funding stream (SMHS vs. DMC-ODS) and payer (Medicare vs. Medicaid).
We created a slide-deck presentation that describes the updated audit protocol and contextual.
In addition, we posted a 30-minute video to the BHS Vimeo channel - - it walks you through the slide-deck presentation.
Last updated May 8, 2024