I/DD Billing

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. 

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.

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.  

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. 

Frequently Asked Questions