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Please check out the provided link for this assignment: Billing & Coding Reimbursement Rates_ Decision-Support-Tool.xlsx Download Billing & Coding Reimbursement Rates_ Decision-Support-Tool.xlsx Purpose The purpose of this assignment is assist managers in achieving financial sustainability. As many integrated behavioral health programs are still fee-for-service, understanding billing codes, reimbursement rates, and all possible avenues for reimbursement for integrated healthcare services in a primary care clinic is an essential component of this toolkit. This assignment explores one of the first steps needed in determining revenue and financial planning; reimbursement codes, provider types, and payment. Learning Objectives Identify components of fee-for-service reimbursement for strategic use in business planning and determining impact. Describe specific provider types needed for reimbursement of identified services. Summarize additional value-based cost savings that may be opportunities for the setting. Create a quick financial information sheet for use in clinics Assignment Instructions In this assignment, you will analyze reimbursement rates as a component of your business case for integrated behavioral health. In this assignment each of you will research the billing codes specific to the institution, payers, and provider license for either a) your current clinical practice (you work in a clinical setting) or b) a primary care clinic in your state/province or country area (for students who do not work in a clinic – simply focus on a primary care clinic. Identify what type of clinic (ACO, FQHC, independent, etc.). Approach this with the assumption that you are the manager/ program director. You will evaluate which reimbursement codes your clinic is eligible for, what types of clinicians are eligible for reimbursement, and what codes each provider type can use. Many of you do not have experience with reimbursement codes, and even for those experienced in reimbursement this type of evaluation is challenging. For those with more experience, there also may be additional opportunities for reimbursement to explore. This is often a work in progress, so for this assignment do your best to come up with reimbursement codes that you think can be used to add or enhance and add value and financial sustainability to the integrated behavioral health services in your clinic scenario. Review the CPT codes in the Corso et al., (2016) Chapter 7 and the Chapter 7 Appendices as well as the links to these resources in the Module 4 Course Content Assigned Readings. You should evaluate each of the specific codes listed below for your clinic scenario. Further, use all the web resources for financial billing to assist. Step 1- Written Assignment Please write a brief summary indicative of your research on reimbursement for services in support of integrated behavioral health in your clinic scenario aligned with the location (state, province, country). For your paper format, please use the sections listed below as your heading type and including the answers for each of the questions listed under each section. Reimbursement Which codes are eligible for reimbursement in your state/province/or country area? [Provide a direct link to the eligibility at the state, province, or country area and the definition of which providers are allowed to bill for service] How would you use them? [Describe briefly one -paragraph on how each code could be implemented clinically] Which codes are not eligible and why? [identify one paragraph on which codes are not eligible and the reasons why] Do all payers reimburse for these codes? [Identify the payers who allow for billing in your area through bullet points with the link to their information about approval] Which ones are you not able to determine based on available resources? Were the reimbursement rates available? [Provide a table with the code, insurance provider, rate allowance, and the website you found the rate] Value-Based Reimbursement Use this section to briefly discuss added value (and financial benefit) in team-based delivery (cost by value and resources). For example, a BHC saving PCPs time in their daily schedules enabling them to increase RVUs. Or, improving patient satisfaction and outcomes, both aligned with the quadruple aim. Provide one paragraph minimum of describing your management lens on the value of IC outside of direct billing. Identify 3 value based metrics you would recommend in primary care to demonstrate and monitor value (outside of direct billing). Ensure to write your metrics S.M.A.R.T.. Manager’s Experience Were there challenges in obtaining information on codes for reimbursement? If so, what were the most significant ones? What specific skills do you think managers should employ in obtaining information like this? As a manager, are there ways you might do this differently? How often should managers complete this type of task, knowing billing can change throughout the year and in the US is tied to state and federal legislation yearly. Format: Your paper should be written in APA style. Include a title page and references. The paper should be between 4-6 pages long, including title page and references. Tables, bullet points, and paragraphs

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