DDS Payment Reform - Encounter Data Workgroup

Due to the uncertainties related to the current COVID-19 pandemic, the Department of Disabilities, Aging and Independent Living (DAIL) has decided that activities related to the Developmental Disabilities Services Payment Reform that involve provider agencies will be suspended until further notice.  Providers need to focus their energies and resources on the delivery of critical services for individuals and families.  DAIL has not yet decided whether to suspend work on DDS Payment Reform for the internal State team.  There may be some work that can continue to prepare to resume the project at a future date.  It is possible that State team members may be diverted to other critical functions in State Government as the situation evolves.  

Further updates will be provided as things change.  For this reason, all the Payment Reform meetings with members outside of the State will be cancelled except the April 3 Advisory Committee meeting.  This will be a Skype meeting only.  We will use that meeting to provide an update and answer any questions people have regarding the project.  We will also be posting a summary of the work that has been completed to date on the DDSD website.  

Feel free to email clare.mcfadden@vermont.gov if you have questions.

 

 

The Encounter Data Workgroup is focused on how provider agencies report report to the State information about services delivered to individuals.  It has been determined that the provider agencies will be reporting services through the Medicaid Management Information System. This workgroup will provide input into the implementation of this new process.

Meeting Schedule (Note:  Meetings are subject to change.)
Due to required security notification, participants attending the meetings are required to let the State contact know of your participation at least 5 days in advance of the meeting; but no further than 2-weeks in advance.

Meeting Agendas, Meeting Minutes, Handouts, and Resources

 

The Encounter Data Submission Guidance Webinar was held on 3/9/20 to review expectations for reporting encounter data for the delivery of Developmental Disability Services and to answer provider’s questions.  The webinar is 2 hours in length.  If there are additional questions after listening to the webinar, please email your questions to Jennifer.perkins@vermont.gov .  Additionally, the State will be holding periodic conference calls to answer questions as agencies begin to submit their encounter claims to MMIS.  A schedule of those calls will be sent out to agencies.  Please note:  The in person trainings on this topic that were scheduled for March 18 in Rutland and March 23 in Waterbury were cancelled to help reduce the risk of spread of COVID-19.

Encounter Data Guidance: This document provides instruction and information on submission of DDSD encounter data claims, encounter data service codes and provider requirements and responsibilities. It is intended to be used in together with the DDSD FAQ’s document also listed on this web page.  It can be expected that the guidance and process for reporting to the MMIS will require additional adjustments, guidance and process modifications as providers begin reporting. If an agency is seeing overall process issues that are resulting in denials, they may call Jennifer Perkins, DAIL at 802-442-0809 or Jennifer.perkins@vermont.gov with any questions.

Frequently Asked Questions (FAQ’s) Document: To support provider understanding of encounter data Submission expectations, DAIL DDSD has developed a DDSD Encounter Data Submission Guidance for Agency-Managed and Shared-Managed Services. This document is intended to address the specific questions DDSD has received to further clarify information regarding DDSD encounter data claims submissions. This document is a supplement to the DDSD Encounter Data Submission Guidance and should be used together with the DDSD Encounter Data Submission Guidance and all relevant provider resources to gain a full picture of DDSD encounter data requirements. The division will update this document with additional questions and answers as they are received.

 

 

 

 

 

 

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