VIDES, EHBS & MARS
April 04, 2023
- As many of you know, the VIDES (the current version of the Level of Care determination) must be completed annually; if it is not, the renewal of the service authorization is “pended” and, in the worst case scenario, the provider can not bill for services provided. We had heard from several providers that this was an issue and set out to try to protect the provider from loss of revenue for something essentially out of their control.
- We discussed the issue at length with the relevant staff at DBHDS and on several occasions with Sara Craddock, the current Chair of the DD Council for VACSB. We were very pleased with the outcome of all of those discussions! But first, and foremost, it is possible for any provider to see the date of the most recent VIDES in WaMS and the date should be checked before the planning meeting. If the VIDES has not been updated, ask at the meeting when that will occur, monitor that it has been done and follow-up/escalate as needed before the plan is submitted.
- Our research, with the help of both DBHDS and the DD Council, indicates the delayed VIDES are not common, but do occur on occasion. To that end, Ms. Craddock and I requested and Heather Norton has agreed, that DBHDS will collect data on incidents for the next three months. When that data is available, in early July, we will review the data and decide next steps, if any. Thanks to both DBHDS and VACSB for their willingness to work with us to try to resolve this issue!
- The issue here is how to get appropriate assessment for the technology being requested from the level of professional required and have the professional appropriately paid. This has turned out to be slightly more complex than was anticipated when the regulations were drafted. With that in mind, we have started the discussion with DMAS and DBHDS and they are beginning the process to resolve the concerns and investigate options. Stay tuned!
- This is our acronym for a new initiative for VNPP – MCO Administration & Revenue Sustainability; we plan to discuss this at some length on the call on Friday morning. For those who struggle with MCOs for authorizations and billing – we hope that this new initiative will be a useful, and helpful tool especially for your billing staff!