COUNTY CLEARED TO SUBMIT MEDI-CAL BILLS; STATE'S LETTER URGES CAUTION, SAYING THERE'S NO GUARANTEE ALL BACK CLAIMS WILL BE OK'D.Byline: Krystn Shrieve Staff Writer State officials have instructed Ventura County's Behavioral Health Behavioral health was first used in the 1980's to name the combination of the fields mental health and substance abuse. As an example, an organization serving both mental health and substance abuse clients might refer to its practice as behavioral health or Department to immediately resume submitting Medi-Cal claims - which now total $16 million - following a cursory cur·so·ry adj. Performed with haste and scant attention to detail: a cursory glance at the headlines. [Late Latin curs review of its billing practices. The state Department of Mental Health issued the directive Friday, giving the county the go-ahead to seek reimbursement Reimbursement Payment made to someone for out-of-pocket expenses has incurred. - a practice it had halted once a federal investigation of its billing practices unfolded in November. ``While we cannot guarantee approval of all the claims that have been held, we would encourage you to submit the claims with one advisory,'' reads the letter which was addressed to department director David Gudeman. ``You should exercise caution before submitting any specific claims which have already been identified as inappropriate.'' The county stopped submitting Medi-Cal claims in November, after the U.S. Health Care Financing Administration Health Care Financing Administration, n.pr department in the U.S. agency of Health and Human Services responsible for the oversight of the Medicaid and Medicare benefit programs, including guidelines, payment, and coverage policies. began looking into its Medicare billings. HCFA HCFA abbr. Health Care Financing Administration HCFA, n.pr See Health Care Financing Administration. officials told the county not to bill Medicare or Medicaid for services rendered during the nine-month period that the Behavioral Health Department had been merged with the Public Social Services social services Noun, pl welfare services provided by local authorities or a state agency for people with particular social needs social services npl → servicios mpl sociales Agency. County officials say the Behavioral Health Department is owed $16 million in reimbursements, which the state has said it cannot guarantee will be paid because the time for submissions has lagged. State officials said typically the county can be reimbursed for services provided only within the past six months - which means the county could recoup for services provided only since May of this year. Supervisor John Flynn said although the state has given its approval, local officials want to get a final nod from County Counsel James McBride James McBride may mean:
The reason for the added precaution, Flynn explained, is that the person who signs off on the bills - namely Health Care Agency Director Pierre Durand Pierre Durand is the name of several people:
McBride did not return telephone calls for comment. ``It's not the county who would be responsible, it would be the individual administrator,'' Flynn said. However, Flynn said he feels so confident in the state's letter that he would be willing to take the responsibility for starting up the billing process again. ``I'm very comfortable with the letter,'' Flynn said. ``It satisfies me. But if for some reason Mr. McBride finds a caveat or two within the letter that he doesn't feel comfortable with I will ask the board to appoint me temporary chair - just for an hour - and I will sign the claims.'' Nora Romero, spokeswoman for the state Department of Mental Health, said that in addition to last week's letter, the county was told in May that it could resume billing. |
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