Streamline’s SmartCare Can Implement Code Changes and Process Updates Required by the Ohio Redesign Initiative



Streamline’s SmartCare Can Implement Code Changes and Process Updates Required by the Ohio Redesign Initiative

Kalamazoo, MI – [August 31, 2017] – As Ohio’s behavioral health service delivery and payment systems change, Streamline will be the electronic health record partner for the future. SmartCare, our web-based platform for behavioral health, is ready for all Redesign Initiative changes today.

What is Redesign Attempting to do?

  • The Redesign Initiative is an integral component of Ohio’s comprehensive strategy to rebuild community behavioral health system capacity
  • The Initiative is based on key Medicaid behavioral health reforms
  • Most significant to use in Streamline is how it impacts the billing of services to Medicaid

Yes – SmartCare™ is ready!

  • Providing a batch uploading of procedure codes for the new services and rates that need to be set up
  • Service Completion Rules custom for the State of Ohio
  • Charge Rules custom for the State of Ohio
  • Tracking mechanism for staff degrees with billable degree by a date range, staff years of service, and staff Medicaid licenses/degrees
  • 837 file that meets Ohio Medicaid Billing Requirements
  • Authorization Management to track utilization of services to manage allowed frequencies of services
  • Flexible Procedure Code Setup
      • Allows for varying the billing code and modifier based on the Degree of the clinician/staff providing the service
      • When the system creates a charge to Medicaid, it looks at the staff’s degree to determine which rate to use for billing.
  • Service Note Signature Validations to Ensure Billing Requirements are Met
      • System identifies when the staff does not have the proper degree for the service being provided based on mapping that is setup in the system.
      • Staff will be required to fill out the Attending field to specify the supervisor of the service.
      • By adding this validation, we are able to ensure we have the Supervisor’s name to be included on the 837 file
  • Service Completion Rules to Verify all Billing Rules for Billing Ohio Medicaid are Met
  • Rolling up Services in Same Day
      • All services in a day that match in the following information are combined into one claim line on the claim file:
          • Client ID, Start Date of Service, Clinician, Clinician NPI, Attending (If one service has an Attending, all must have the same Attending to be combined), Attending NPI, Place of Service Code (from the Location on the Service), Billing Code and Modifier

We are looking forward to showing you how we make you successful with SmartCare today!

About Streamline: Streamline Healthcare Solutions (Streamline) delivers web-based software for healthcare organizations to provide and coordinate specialized behavioral service delivery processes. Streamline’s SmartCare™ solution was developed to truly integrate all departments; moving them to a more holistic service model. Streamline’s software solutions are well suited for organizations who wish to have a system that can incorporate its entire business processes into a single solution, with the ability to continue to grow as business-lines needs evolve.

Cristina Prince
Marketing Manager
Streamline Healthcare Solutions