New Jersey Providers Generate Fee For Service Claims on Therap

Monday, August 22, 2016 Lifestyle News J E 4
Therap's electronic billing software processing FFS Medicaid claims for submission to the Department of Developmental Disabilities

TRENTON, N.J., Aug. 22, 2016 /PRNewswire/ -- Therap took part in New Jersey's Fee for Service pilot, implementing its developmental disability software across multiple providers in New Jersey. FFS is a service model that reimburses providers for services rendered.

Seventeen New Jersey providers are using Therap's electronic claims to process Fee for Service claims. During June of 2016 Therap users created 820 Service Authorization from NJ Prior Authorization Documents. Therap users also submitted 7,260 claims to the state amounting to $359,778. Most of that amount went towards  the new Fee for Service program, but a number of providers are submitting claims for DCFS services as well.

For the FFS implementation, Therap created a unique rounding factor for DCFS, produced a feature to manage multiple NPI number and took into consideration other factors that impacted the complex claiming process. Additionally, for FFS billing, a Prior Authorization copy function is available to accommodate the multiple Prior Authorizations, allowing for minimal data entry. To manage authorized service units, users may generate overlap reports or over and under utilization reports.

Ken Slavin, Northeast Business Development Director, states, "To some extent the FFS model being implemented in NJ has been a moving target with operational and programming challenges every step of the way. We could not have supported our clients during the pilot if we did not have highly skilled people on our billing teams to address challenges as they appear."

Therap's billing applications automatically exports claims in the ANSI X12 837 format. Therap's billing features integrate with the service outcome/goal tracking documentation features to provide excellent audit trails. Billing data can be generated using case notes, attendance data, manual entry, or service outcome/goal tracking documentation with a number of reports and in all steps of the claiming process such as Billable, Submitted, Paid, Rejected, or Denied.  Therap also provides codes that link service line items to an external accounting system and general ledger.

About Therap

Therap's HIPAA, ARRA and HITECH compliant Developmental Disabilities software applications are used in home and community-based services (HCBS), Intellectual & Developmental Disabilities and other LTSS provider settings. Therap provides person centered planning and assists with case management and eligibility assessments.

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SOURCE Therap Services



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