Billing Manual for Community Care Network Providers

3. Secondary Data - OMHSAS will develop data exchange agreements with otherstate agencies, as feasible; to obtain regularly scheduled data file extracts that willbe loaded into the POMS central database. Data exchanges with state agenciessuch as the Department of Corrections, State Police, and the Department ofEducation are under development.4. Consumer/Family Satisfaction Reports - There will be standardized measuresadministered by the BH-MCO. The BH-MCO will submit reports of findings to theDPW. A survey will be conducted annually.5. BH-MCO Consumer Registry File - BH-MCOs will maintain a computerizedregistry of their enrollees who have accessed behavioral health services. Theregistry is comprised of a minimum data set including clinical descriptions such aspriority population and critical dates during the episode of care such as date of firstservice request, registration date, and termination date. These data will be submittedby the BH-MCOs to the POMS central database.6. BH-MCO Quarterly Status File - BH-MCOs will maintain a computerized fileconcerning the status of priority populations. The file will be updated on a calendarquarter basis for each enrollee in the priority population. The quarterly status file iscomprised of a minimum data set including outcome measures such asvocational/educational status and independence of living arrangement. These datawill be submitted by the BH-MCOs to the POMS central database on a regularschedule.Please note: Providers contracted with the BH-MCO are required to submit POMS data quarterly for allnew members receiving behavioral health services during the quarter. Providers are expected to submitupdates to POMS data every six months for members in continuous care. Providers may submit POMSdata by completing individualized member specific POMS data collection paper surveys or by electronicfile submission using specifications developed by Community Care. For those submitting paper POMSdata, providers will be notified of members for whom POMS data is required each quarter through theconfidential mailing of individualized, member specific POMS Data Collection Survey forms. Instructionsfor completing the POMS Data Collection Survey are printed on the back of each individual form.7. Performance Indicator Reports - On a regular schedule, DPW will produce fromthe POMS central database a set of performance indicators that measure theperformance of each BH-MCO consistent with the outcome dimensions outlined inthe attached table of outcome measures. The performance indicator reports will beissued by DPW on a regular schedule to all relevant DPW monitoring staff, the BH-MCOs and other stakeholder groups.CONTINUOUS QUALITY IMPROVEMENT (CQI) PROCESSDPW encourages the BH-MCOs to implement a continuous quality improvement (CQI)process based upon Deming’s 14-point program adapted to the health care industry,and Joint Commission on Accreditation of Health Care Organization (JCAHO)guidelines. The overall process should include:Delineating the scope of the services to be monitored and improved.Identifying the important aspects of the services whose quality should be examinedand improved.Community Care Provider Manual | 1-888-251-CCBH | © 2012 All Rights Reserved | Page 212