Texas MCO transition: 3 important things we learned in Week 1

Ken BellSimpleCFS, Texas MedicaidLeave a Comment

Texas Medicaid MCO transition

The new STAR+PLUS Managed Care/MCO structure is now a fact of life in Texas. Here are 3 important things we learned during Week 1.

1) SimpleLTC customers are adapting to the new workflow… but still have a ways to go

Customers are quickly becoming familiar with the new requirements. Here are a few metrics from how customers utilized the SimpleCFS MCO functionality in Week 1:

  • 578 MCO notification forms were started and 494 were submitted, covering all 5 MCOs
  • 190 individual facilities and 33 total companies submitted forms
  • Most forms were completed in 4 minutes or less

While this is a good start, about 77% of our customer facilities have not yet submitted an MCO notification, so we expect these numbers to increase rapidly.

2) MCO functionality is working as planned… but we’re not done yet

We’ve adapted SimpleCFS to automate as much of the MCO/managed care process as possible, and are adding new functionality as it’s needed. Some potential updates we’re considering are:

  • MCO notification form history: You’ll be able to click on a row learn who did what, when (similar to how 3618/3619 form history works).
  • Improvements to MCO notification workflow, including tracking MCO receipts, i.e., what happens if a form doesn’t get received.
  • Additional managed care reports to clarify MCO data.

3) Several new questions have popped up

There will definitely be a learning curve, so we’ve created a new MCO FAQ support document to cover several new customer questions, such as:

  • “An MCO Service Coordinator told me I can’t submit a Service Coordination Notification (SCN) form through SimpleLTC and that it must instead be faxed directly to them. Is this true?”
  • “How does the new MCO structure affect our 3618s, 3619s and LTCMI workflow? We’ve heard MCOs will not be able to access 3618s or 3619s.”
  • “In what situations do we need to submit a Service Coordination Notification (SCN) form?”

Two more things to keep in mind

  • We’re here to help! Our Support Team is standing by to address your questions. You can reach them at 469.916.2803 or support@simpleltc.com.
  • We have lots of helpful resources on our MCO resource page and we’ll continue to update it with new information as it arises.

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