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I/DD Billing

While many billing companies are focused on Hospital billing, physician practices billing, surgical billing, and other specialties, few billing companies have given the necessary attention to health and human services billing including billing for Intellectual and Developmental Disability (I/DD) services and behavioral health.  

Millin recognized the need for a solution for billing experts to focus on the billing process for I/DD and behavioral health providers that serve people with disabilities.

Being that developmental disability services and behavioral health services are generally reimbursed by Medicaid or Managed Care Organizations (MCOs), there are many specific rules and regulations associated with this type of billing. Not only is it critical to get paid in full on all IDD and behavioral health claims but ensuring that all I/DD and behavioral health billing rules and regulations are being followed is just as important to avoid recoupment of payments and penalties upon audit. Most recoupments are not due to fraud but simply due to human error and lack of following certain regulatory requirements that could have been avoided with the right ability and systems in place. 

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I/DD Services

Thankfully, there are many services available to support individuals with developmental disabilities.

To name a few: 

  • Individualized Residential Alternatives (IRA’s) 
  • ICF 
  • Supported employment (SEMP) 
  • HCBS Waiver 
  • Self-Directed Services 
  • Person Centered Planning 
  • Day Habilitation 
  • Community Habilitation 
  • Prevocational Services 
  • Care Coordination 
  • Respite 
  • Family Support Services (FSS) 
  • Day Programs
switcherImage

I/DD Services

Thankfully, there are many services available to support individuals with developmental disabilities.

To name a few: 

  • Individualized Residential Alternatives (IRA’s) 
  • ICF 
  • Supported employment (SEMP) 
  • HCBS Waiver 
  • Self-Directed Services 
  • Person Centered Planning 
  • Day Habilitation 
  • Community Habilitation 
  • Prevocational Services 
  • Care Coordination 
  • Respite 
  • Family Support Services...
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I/DD Services

Thankfully, there are many services available to support individuals with developmental disabilities.

To name a few: 

  • Individualized Residential Alternatives (IRA’s) 
  • ICF 
  • Supported employment (SEMP) 
  • HCBS Waiver 
  • Self-Directed Services 
  • Person Centered Planning 
  • Day Habilitation 
  • Community Habilitation 
  • Prevocational Services 
  • Care Coordination 
  • Respite 
  • Family Support Services (FSS) 
  • Day Programs
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Some I/DD services are billed monthly, while others are billed daily, or by number of units. Units of time can also vary from one program to another. Some programs have 15-minute units while other programs have 1-hour units. 
 
In some cases, you can combine the minutes within a day to capture as many billable services as possible while in other instances you may not be able to do so. Then there are rules as to when you can round up the minutes and when you need to round them down. This can also vary by program.
  
These billing rules for intellectual and developmental disabilities services are just the starting point and without the proper I/DD billing expertise and proper I/DD billing software solution, agencies can easily get tripped up.
 
In addition, there are several States that are already contracted with Managed Care Organizations (MCOs) to be the payer for intellectual and developmental disabilities and behavioral health providers. This also means that not only do IDD and behavioral health providers need to keep track of the nuances for each program, but each payer may have their own billing rules as well. 
 
For these, and many other reasons, having an I/DD and behavioral health billing system like MillinPro is critical and Millin’s expertise is invaluable. The MillinPro billing system has a sophisticated rules-engine that is updated on an ongoing basis as rules and regulations change. Millin has business analysts on staff that continuously keep track of new and updated regulations to incorporate them into the MillinPro billing system. The rules-engine can keep track of rules by program, payer, and individuals served. This ensures claims are submitted correctly the first time around. This will not only increase your cash-flow but ultimately increase your overall collection rate and decrease time spent managing the developmental disabilities billing as well.  
 
In addition, MillinPro has a proprietary issue tracker that ensures you are able to keep track and follow up on all issues without having claims fall through the cracks. For those agencies that recognize the value of outsourcing the IDD billing processes so that they can better focus on the services they provide, Millin is here for them. We manage the I/DD billing process for small, medium, and large agencies. Some of our clients process less than one million dollars in claims annually while others process a few hundred million dollars, and everything in between.  

Electronic Health Record & Electronic Visit Verification Systems Integration

Most I/DD agencies are already using an electronic health record (EHR) system and/or an electronic visit verification (EVV) system. The following are some of the most common systems I/DD agencies use to connect with MillinPro but there are many others. And the MillinPro solution can integrate with all EHR and EVV systems. These are just a few examples below, plus many more.

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The MillinPro billing system can integrate in several ways depending on the EHR and EVV capabilities. 

For example, Therap has a Millin report in their suite of reports that an agency can request. Clients that use Therap as their I/DD EHR system will upload that report into MillinPro for billing purposes. This process takes about one minute and includes a reconciliation process within MillinPro confirming all the claims that were transferred from Therap. In addition, if there are any new individuals in the Therap system, those will automatically be setup in MillinPro. With each transfer of data from Therap, MillinPro will also confirm how many new individuals are being set up in the system. 

This process and reconciliation is also available with Netsmart, Welligent, Foothold, TaskmasterPro, MITC, and others. 

There are a few EHR and EVV systems that integrate with MillinPro via API. For example, Evero and Precisioncare have an API integration with MillinPro so with a click of a button in Evero or Precisioncare, the billing data is transferred into the MillinPro system. It’s that simple.  

The same process applies to Accumedic and a number of other systems. 

Most electronic health records and EVV systems IDD organizations use have a billing module, however it’s generally not up to par with the agency's needs, to collect on all eligible claims and have a process that’s most efficient and effective.  

That is why hundreds of agencies choose to use the MillinPro billing system.  

For an agency to improve their I/DD billing process, they do not need to switch out from their EHR or EVV system, which can be a considerable undertaking, disruption, and significant cost. All an IDD agency needs to do is integrate the MillinPro billing system with their EHR. Generally, this doesn’t affect more than a handful of people and those are the people that are thrilled to switch to MillinPro as it makes their work much easier and efficient. 

General Ledger System Integration

One of the many notable features in MillinPro is the ability to have a custom general ledger (GL) report based on the way your organization captures data in your general ledger system. The data in the GL report within MillinPro will be mapped with the cost centers in your GL system. Regardless of which general ledger system you use for your I/DD agency, you will be able to upload the GL report from Millin. Countless agencies that have this custom GL report have told us this saves them many hours of tedious work every month, not to mention chasing down human errors. Millin’s staff will work closely with you to create this report exactly the way you need it.

 

Reports 

We can certainly create other custom reports for you in addition to the GL report, but it is most likely that all reports your organization may need throughout the year are already available in our reporting module with endless filtering capabilities. All reports can be exported in excel.

 

No two States I/DD Billing are the same 

Millin understand that each State has its own unique billing process, payers, and compliance requirements for intellectual and developmental disabilities programs. Therefore, Millin configures the MillinPro billing system according to each State’s process and regulatory requirements. However, the MillinPro system has one source code for all clients that use the system. This gives us a huge advantage as it provides Millin with the ability to make changes very quickly when there are new rules and regulations or payer changes. We have heard many times I/DD providers complain that they are waiting on their vendor for a few months until they make the necessary changes. This can affect the cash-flow and reimbursement in a drastic way when not dealt with promptly. By using the MillinPro billing system, IDD providers mitigate this risk. 

 

So, you wonder how different can the billing process be from one State to another? Quite different. 

For example, in New York, Medicaid I/DD claims are processed through a system called eMedNY and there are extremely specific pieces of information that are required on the claims file (which is referred to as the “837” file) but there is another payer in downstate New York called PHP. PHP has an exclusive contract with a clearinghouse, so claims need to be submitted through that specific clearinghouse for PHP claims.  

In Texas however, all Medicaid I/DD billing needs to be submitted through the TMHP system. It can be quite cumbersome submitting claims through TMHP if you don’t have a billing system like MillinPro that integrates directly with TMHP. While the same file type (837) is used in Texas and most other States, the information required on this file is quite different from one State to another. If any piece of information that Texas requires, is not reported on the file or is reported in the incorrect loop and segment, the claim may be rejected or denied. An even worse scenario is when claims are missing information on the 837 file and make it through the system for payment, only to be recouped years later upon audit. 

There are several States that are already contracted with Managed Care Organizations (MCOs) and the claims need to be submitted to those MCOs via a clearinghouse. In such cases, you are likely to encounter that different MCOs will require different information on the claims that are being sent. This is one of the many reasons why having an IDD billing system like MillinPro is so critical. The MillinPro billing system has a rules engine incorporated in its system that can ensure all claims submitted are in accordance with each State and payer requirement and ensures only the correct information is transmitted onto the 837 billing file when submitting claims to Medicaid or the clearinghouse.  

Experts at I/DD Billing Management

Millin keeps its offerings simple. You can license the MillinPro billing system and manage the I/DD billing process internally at your organization or you can license the MillinPro billing system and outsource the billing process to the experts at Millin. Should you choose to outsource the I/DD billing process, you will have full real-time access to the...

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Experts at I/DD Billing Management

Millin keeps its offerings simple. You can license the MillinPro billing system and manage the I/DD billing process internally at your organization or you can license the MillinPro billing system and outsource the billing process to the experts at Millin. Should you choose to outsource the I/DD billing process, you will have full real-time access to the MillinPro system just as if you manage the billing process internally. In other words, we provide full transparency in the work we perform on your behalf. The following are some of the many reasons why agencies choose to outsource the billing process to Millin:

  • Billing for developmental disabilities has become too complicated for the staff to handle, and too little resources are available 
  • Too much money is being left on the table year after year that should have been collected
  • Too much billing staff turnover 
  • Hard to find the necessary billing experts to maximize revenue 
  • Millin keeps track of all the industry regulatory and payer changes that affect the IDD billing process 
  • Millin can quickly identify provider specific issues vs. global issues affecting all providers 
  • MillinPro for other health and human services  
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Experts at I/DD Billing Management

Millin keeps its offerings simple. You can license the MillinPro billing system and manage the I/DD billing process internally at your organization or you can license the MillinPro billing system and outsource the billing process to the experts at Millin. Should you choose to outsource the I/DD billing process, you will have full real-time access to the...

Read More

Experts at I/DD Billing Management

Millin keeps its offerings simple. You can license the MillinPro billing system and manage the I/DD billing process internally at your organization or you can license the MillinPro billing system and outsource the billing process to the experts at Millin. Should you choose to outsource the I/DD billing process, you will have full real-time access to the MillinPro system just as if you manage the billing process internally. In other words, we provide full transparency in the work we perform on your behalf. The following are some of the many reasons why agencies choose to outsource the billing process to Millin:

  • Billing for developmental disabilities has become too complicated for the staff to handle, and too little resources are available 
  • Too much money is being left on the table year after year that should have been collected
  • Too much billing staff turnover 
  • Hard to find the necessary billing experts to maximize revenue 
  • Millin keeps track of all the industry regulatory and payer changes that affect the IDD billing process 
  • Millin can quickly identify provider specific issues vs. global issues affecting all providers 
  • MillinPro for other health and human services  
Read Less

Millin provides the same cutting-edge MillinPro billing system and billing services for agencies that provide mental health treatment, substance use treatment, and foster care services. Some of Millin’s clients provide IDD and behavioral health services and use multiple different EHR systems. Those agencies can incorporate billing related data from multiple EHRs (Electronic Health Records) into one MillinPro billing system. 

Accessing MillinPro 

All you need to easily access MillinPro is internet connectivity. Millin uses Microsoft Azure to store all your data, redundancies, and backups. This also ensures that your data is secure and compliant with all the necessary Federal, State, and local regulations. Millin also uses Multi-Factor Authentication (MFA). In addition to each user having a unique user id and password to access the MillinPro software they also have a secondary verification method that is required to access data. 

Return on Investment (ROI) 

By now you probably have a good grasp as to why so many I/DD providers turn to Millin for their I/DD billing. In a perfect world you would want one system that does it all; EHR, EVV, Billing, Accounting, Payroll, HR. In reality, you are much better off working with vendors that specialize in one particular area but can integrate with other systems. That is why best-of-breed systems will provide you with so many more advantages and have become so popular with IDD providers that understand the need to be as efficient as possible.  

Agencies that use the MillinPro billing system tend to have an ROI north of 10x what they pay for the system when compared to the collection rate prior to using MillinPro and the number of hours spent on the billing process prior to using MillinPro, not to mention the added IDD billing compliance they now have in place. The value-add proposition of Millin’s I/DD billing services is equally impressive. By outsourcing the billing process, I/DD providers are able to better focus on growing the programs and provide the best possible quality of service for the individuals in need of services. 

Contact Millin for I/DD Billing
We are looking forward to having the opportunity to schedule a call or demo with you to discuss the I/DD billing at your agency and show you how Millin can be of assistance to you and your agency.
Frequently Asked Questions

Most EMR companies do not focus nearly as much on the billing module compared to the EMR system itself. The difference between using MillinPro vs. the billing module in your EMR system can be tremendous. You will spend significantly less time managing the billing process, have a higher collection rate, better reporting, and better cash flow when using MillinPro. This often results in increased revenue in the hundreds of thousands of dollars or even in the millions with some agencies. 

Very little. This is another big differentiator with some of the other vendors. Millin will set up the entire system with all the necessary information for your organization. This includes; provider information, locations, rates, services, clearinghouse integration, Medicaid system integration, the rules engine, consumer demographic information, etc. By having Millin’s experts configure the system for your agency, you do not need to worry about misconfigurations that can affect payments and cash flow.

The fee is based on the type and number of different programs provided by the agency, as well as the overall annual claim volume. The monthly fee includes access to the system including the reporting module, updates and upgrades, hosting, backups, redundancies, and security.

Rather than update the system quarterly or annually, Millin continuously updates the system as soon as new features are tested, when new programs/services are introduced, or when there are new rules and regulations that can be incorporated into MillinPro’s billing system’s rules engine. All the updates to your MillinPro system are done by Millin and do not interfere with your daily work within the MillinPro billing system.

Absolutely. We can even have this automated to occur daily, weekly, or any interval that works for your organization.

No. The fee is flat rate based on the workload it takes to get you paid on all your claims. Whether you collect $50 a service or $500 a service, the workload is often the same and there is no reason for you to pay a premium on high-value claims.

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With over 40 years of Health & Human Services billing experience and expertise, we can help increase efficiencies and reduce or even eliminate denials. Experience Revenue Cycle Management Software & Services from the Company You Trust. 

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