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Inaugural Behavioral Health SWAT Program a Success

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On Thursday, more than 80 members participated in HANYS’ first Behavioral Health Strategies, Weapons, And Tactics (SWAT) program, which provided tools and information to assist them with serving behavioral health patients in the managed care environment.

Jeffrey Gold, Vice President, Managed Care and Special Counsel, HANYS, provided information on key managed care reform initiatives that HANYS has drafted and negotiated in recent years related to prompt payment, claim submission, coverage for emergency services, coordination of services, and external appeals.  Mr. Gold provided guidance to members on how each of these areas applies to behavioral health.

Robin Johnson, Esq., The Health Law Group, discussed negotiating managed care and insurance contracts with payers, denials and appeals rights, and mental health parity for behavioral health services.

Seth Rupp, Vice President and General Manager of Revenue Cycle Management, Netsmart Technologies, discussed specific revenue cycle management strategies, focusing on behavioral health and New York-specific trends.

Robert Holtz, Vice President of Behavioral Health Services, Capital District Physicians Health Plan (CDPHP), and Scarlett Clement-Buffoline, Assistant Vice President, Behavioral Health Services, Samaritan Hospital in Troy, discussed the collaborative relationship between CDPHP and Samaritan Hospital.  As a result of the collaboration, readmissions have been reduced, savings have been achieved, and patient response has been very positive.

HANYS plans to continue the dialogue with members related to behavioral health payer issues to further its behavioral health managed care advocacy agenda. Contact: Cindy Levernois

Published June 8, 2012