ValueOptions®

December 15, 2009

ValueOptions® - Recognized Public Sector Leader

• Currently manages more public sector behavioral health contracts than any other company.

• More than 4.5 million covered lives across 13 states.

• Many of these contracts have Member populations exceeding 400,000, and several exceed 1 million covered lives.

Overview of the ValueOptions® Contract• Approved by the Board of Public Works on June 3, 2009.

• Two year contract with 3 one-year renewal options.

• Includes a16.6% participation by minority businesses.

• Responsible for managing inpatient and outpatient mental health services for Maryland’s Public Mental Health System (PMHS) for approximately 99,000 Medicaid and Uninsured individuals.

• Responsible for facilitating the recoupment of all available Federal Fund Participation (FFP).

• Began on September 1, 2009.

Customer Service:How are we doing ?

Goal Sept Oct Nov

Total ACD calls N/A 11,854 14,465 12438

Call abandonment (percent) 3% 33.99% 2.25% 1.83%

Call abandonment (count) N/A 6,112 333 232

Wait time less than 3 minutes for referrals 90% 94.92% 99.23% 98.85%

Wait time less than 5 minutes for authorizations 90% 36.55% 94.67% 99.77%

Wait time less than 5 minutes for provider customer service 90% 53.95% 97.45% 98.95%

Claims Processing:How are we doing ?

  Goal Sept Oct Nov

Electronic claims paid within 14 days (percent) 100% 98.71% 89.62%  

Electronic claims paid within 14 days (count)   74665 141914  

Paper claims paid within 21 days (percent) 99% 99.80% 83.24%  

Paper claims paid within 21 days (count)   1991 2394  

Paper claims paid within 30 days (percent) 100% 100.00% 96.24%  

Paper claims paid within 30 days (count)   1995 2768  

Claims Payments:How are we doing ?

• Paper Claims - $41,707,228.83

• Electronic Funds Transfers (EFT) - $96,039,171.77

• Adjustments - ($243,828.60)

• Total Claims Payments* - $137,502,572.00

* as of 12/1/09

Claims Payments:Contract with ACSValueOptions® contracted with ACS, the prior claims processing

vendor, to pay claims for dates of service before September, 2009.

Month Source PAPER EFT ADJUSTMENT Amount

SEP ACS $14,197,671.66 $18,880,257.38 ($3,165.25) $33,074,763.79

SEP VO $2,019,031.66 $7,702,409.87 $0.00 $9,721,441.53

OCT ACS $3,874,387.39 $1,683,432.00 ($2,319.05) $5,555,500.34

OCT VO $8,635,775.41 $28,239,147.70 $0.00 $36,874,923.11

NOV ACS $2,534,479.05 $2,284,684.89 ($238,344.30) $4,580,819.64

NOV VO $8,741,537.37 $28,779,330.47 $0.00 $37,520,867.84

DEC VO $1,704,346.29 $8,469,909.46 $0.00 $10,174,255.75

TOTAL $41,707,228.83 $96,039,171.77 ($243,828.60) $137,502,572.00

Staffing Update

• Over 60 ValueOptions® staff, managers, directors and National Leadership participated in the start-up planning and implementation.

• Over 20 additional National staff have assisted with the daily operations during implementation.

• ValueOptions® currently has 84.75 of its 87.50 budgeted FTE’s hired.

Provider Trainings

ValueOptions® Maryland offered over 30 Provider Connect Trainings

via Webinars as well as face-to-face trainings in several regions statewide.

Topics included:

Inpatient/Higher Levels of Care

Residential Treatment Centers

Outcomes Management System (OMS)

Standard Outpatient

Psychiatric Rehab Program (PRP) & Residential Rehab Program (RRP)

Case Management

Core Service Agency Trainings

• Introduction to Service Connect / Care Connect• Member Files/Eligibility (What to find there) • Provider Files (What to find there) • Creating Reviews • Authorizing Reviews • Managing Your Work Queue • Hospital Diversion Process

Questions?