Tuesday, September 09, 2008

Barriers to Mental Health Care: Value Options' slow responses put providers at financial risk

More Barriers to mental health care as associated w/ the VO and NC DHHS system which is constantly changing the paperwork and takes such a long time going over the blasted forms that they required you to submit that by the time they get done w/ their job one of the forms has changed and you have to return to GO.

Who can run a business when there are people and procedures over you like this?

A recent news article about Value Options (VO), who is the authorizing agent for Medicaid in NC (and who is feared and abhored in the rest of the country, apparently, according to some correspondence I have received re: Defarge VO oriented posts) has the following quote from a VO official:

"We're able to apply more rigor to the requests coming in," Woodell said, and the company is recommending more intensive mental health treatments or other social services more often." (here is the link: cut and paste it:


Contractor fights for screening job -
Raleigh (NC) News & Observer
Lynn Bonner

No, Mr. Woodell, this is not correct, at least from my perspective.

Your 'more rigor' is this: clerks combing over the authorization request for services for several weeks, and should a form be changed in some way, the request is sent back, leaving the provider wondering what is the problem as none of the clerks advised the provider of yet ANOTHER problem w/ the PAPERWORK that gets picked up by the second tier of reviewers at VO.

Moreover, the LME's are also guilty of these kinds of maneuvers.

I have one state funded client under Western Highlands Network LME in western NC.

I sent in all the paperwork last fall that was required as per the WHN LME website and as associated w/ conversations w/ WHN management.

Over 30 days later, they indicate to me that I have to send it in back again as one of the forms had changed.

argh. easier to just see the client for free, hoping he will not ask too much.

Just by ridding the providers and the process of VO will not make the authorization process work any more smoothly. Indeed, my experience over the past several years has been that the LME's----unbelievably----are WORSE than VO in terms of the amount of time and phone calling that it takes in order to drive an authorization through.


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