TN Commercial Insurance - Phase 2 Kickoff by Mary Claire Leverett https://padlet.com/leverettm/7rwuf8lvpub42ha en-us 2025-03-25 15:26:25 UTC 2025-05-13 14:21:23 UTC hello@padlet.com https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446810421 Don't have a customer friendly electronic way at this time for clients to pay bill or co-pay easily

]]> 2025-05-12 16:30:32 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446810421 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446811093 Front desk staff don't always know what amount they are supposed to collect


]]> 2025-05-12 16:31:05 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446811093 Explore offering self pay options; payment plans https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446811922 2025-05-12 16:31:39 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446811922 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446812051 Copays and bill pay is a huge frustration for staff and clients alike.


]]> 2025-05-12 16:31:45 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446812051 No proper patient portal. https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446812937 2025-05-12 16:32:20 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446812937 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446812981 Provider delays in returning documents to credentialing team/TA team

]]> 2025-05-12 16:32:22 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446812981 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446813258 By the time the client gets their statement they typically owe large amounts of money and are overwhelmed.


]]> 2025-05-12 16:32:31 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446813258 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446813591 No good virtual options for copay collection at time of service.

]]> 2025-05-12 16:32:48 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446813591 Consider a financial advisor for patients - reviewing their options and billing policies, estimated costs, etc https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446813726 2025-05-12 16:32:52 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446813726 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446814565 Would their be someone credentialed to see patients under 18 years of age?

]]> 2025-05-12 16:33:28 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446814565 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446814960 90-120 day processing time on payer panel side

]]> 2025-05-12 16:33:39 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446814960 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446815009 The paperwork to complete is overwhelming, and lot of information is duplicated on the different forms


]]> 2025-05-12 16:33:41 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446815009 Commercial clients are limited to appt. times because of the number of staff that are paneled for certain commercial plans. https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446815875 2025-05-12 16:34:25 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446815875 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446815880 Limited PTO/sick days in 1st years of employment.

Continuing education is expensive and requires staff to take time off with limited PTO


]]> 2025-05-12 16:34:25 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446815880 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817005 We have way too many errors on billing due to thinking someone doesn't have commercial, so they are applying for Safety Net. Then we provide an intake and we have to write that service off because they really do have commercial.

]]> 2025-05-12 16:35:10 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817005 Billing System https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817165 We need a uniform naming/billing method in our system. For example, if you run Enlighten data for Commercial revenue, non-commercial revenue is included. There will be Payers listed who are labeled as Medicare Advantage. Cleaning up the labeling of Payers/revenue will give us a more accurate picture of our Commercial revenue and Payer Mix in general.

]]> 2025-05-12 16:35:17 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817165 Building talent pipelines https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817525 Interdepartmental alignment and communication on enterprise expansion of services current and future goals. Sourcing and recruiting for the future happens in real time. Workday systems updates are necessary for the recruiting platform to build our talent pipelines.

]]> 2025-05-12 16:35:34 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817525 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817578 need dedicated billing staff for commercial collections

]]> 2025-05-12 16:35:37 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817578 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817922 Internal credentialing only meeting once per week to approve candidates.

Much of the credentialing/onboarding paperwork is duplicated.


]]> 2025-05-12 16:35:51 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817922 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817985 would Commercial patients be able to get scheduled within 3 to 4 days

]]> 2025-05-12 16:35:53 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446817985 Credentialing https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446819032 Staff do not timely return completed documents for credentialing. I do not know if they understand the importance of getting those documents to our credentialing staff as soon as possible.

]]> 2025-05-12 16:36:44 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446819032 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820003 Need Training "PTO" system for CEs to keep up licensure to remain competitive

]]> 2025-05-12 16:37:20 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820003 Systems Recruiting https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820199 Maintenance and updates in Workday to improve our candidate onboarding experience and efficiency.


]]> 2025-05-12 16:37:28 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820199 Commercial insurance eligibility checks- automated https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820237 The current process for commercial insurance verification is completely manual. Verification of eligibility prior to every visit is extremely time-consuming. Medicaid is verified manually upon the first verification, but subsequent checks are run through Waystar 270/271 automated process, which identifies clients with termed insurance. Those "exceptions" are then worked and accounts resolved prior to appt. 270/271 process for Commercial insurance clients has been discussed, but I am not certain if there has been any movement on that. Currently, every time a commercial client is seen, there is a manual recheck.

]]> 2025-05-12 16:37:30 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820237 Write Offs https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820448 We seem to write off a tremendous amount of revenue. We need to drill down on the reasons.

]]> 2025-05-12 16:37:38 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820448 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820451 Frustrated clients not knowing who to direct their billing questions to, often reaching out to clinical staff who have no understanding/answers for them despite their best efforts.


]]> 2025-05-12 16:37:38 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820451 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820566 Not sending timely statements to clients


]]> 2025-05-12 16:37:43 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446820566 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446821615 would this include all Commercial Insurance

]]> 2025-05-12 16:38:36 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446821615 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446821809 Need to do a better job collecting payments and co-payments from clients.


]]> 2025-05-12 16:38:45 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446821809 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446823061 Plan for commercial clients that remain or need to be seen at in-person clinics

]]> 2025-05-12 16:39:47 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446823061 Understanding Reimbursement Rates https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446824147 Does our billing team know the negotiated rate for each Payer/service? Does that information get distributed by their manager? We need a process by which the billing team knows whether the amount of reimbursement is correct? Are they following up on incorrect amounts?


]]> 2025-05-12 16:40:32 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446824147 Building a system that allows for development & advancement https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446824163 Training and development of leadership across the enterprise to prioritize a culture of opportunity for current and new staff. Ensuring we do not pigeonhole talent and limit their growth.

]]> 2025-05-12 16:40:32 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446824163 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446825470 Hiring delayed due to credentialing process

]]> 2025-05-12 16:41:22 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446825470 https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446827327 currently have to eat the cost of some services due to therapist not being credentialing for up to 120 days after hire

]]> 2025-05-12 16:42:46 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446827327 Review/Renegotiate rates - consider new payers https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446829660 2025-05-12 16:44:33 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446829660 do we offer after hour/weekend sessions? https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446830569 2025-05-12 16:45:12 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446830569 Consider specialty therapists - Do we appropriately assign patients to therapist based on need? https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446832083 2025-05-12 16:46:20 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446832083 Do we have licensed therapists assigned and supervise (and bill commercial) unlicensed therapists? https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446832698 2025-05-12 16:46:51 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446832698 do we utilize CAQH? or have automated credentialing system that ongoing verifies license and OIG? https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446834680 2025-05-12 16:48:09 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446834680 Tracking Code Denials https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446835564 We should track which codes a Commercial Payer is denying and the reasons for denial. They could be denied in error. Or maybe a particular code is not included in our contract and could easily be added.

]]> 2025-05-12 16:48:49 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446835564 Do we have a collection group that we utilize after a specified time period? https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446836061 2025-05-12 16:49:10 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446836061 Do we appropriately code and bill to the highest level? Do we have coding auditors or follow up on denials with education? https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446838520 2025-05-12 16:50:57 UTC https://padlet.com/leverettm/7rwuf8lvpub42ha/wish/3446838520