Saturday, April 07, 2012

Value Options Approved 44 Outpatient Therapy Sessions Thru Remainder of Year: What is the Purpose of the V.O. 'IN' Box??

The client of which I spoke in a just previous post, who I had been seeing for over 6 years, a matter which merited an initial refusal of Value Options (V.O.) to pay for continued visits-----was approved for 44 sessions thru the remainder of 2012.

Bear in mind that V.O. is the private company that is the spokesman for NC Medicaid outpatient therapy authorization-----or any Medicaid authorization. If you are not authorized by V.O., you will not get paid. NC Medicaid providers are provided with a secure link in order to communicate w/ V.O. We must submit all ORF2 forms (the form which allows a provider to be paid after the 8 sessions/ calendar year) via this link. Supposedly, V.O. reciprocates and communicates with US via this link. Ya think?

When I asked the Value Options woman who spoke to me about this matter----as I had received no paperwork (a route formerly utilized by V.O. to communicate w/ providers) after a couple of weeks about the matter---and neither was there any information in my "IN" box as associated with being a Value Options provider----said that as far as she knew, I should have received an OK in my "IN" box.

Whatever else is the reason for the "IN" box at the Provider URL for Value Options if not this?

Chalk up one more barrier to care for NC Medicaid patients: the provider is not even sent efficient notification as to whether s/he will continue to be authorized/ paid to see a client when the ORF2 Form is sent to Value Options (requesting authorization after 8 outpatient mental health care visits).

Nooooo: you have to call them time and time again. And they can't even tell you why the information is not in the "IN" box.


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