May 22, 2024

Following are this week’s updates. If you have questions, please contact [email protected]. 

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The Big Picture

The EHR leadership team has prioritized implementing the new CPT coding standards forthcoming from the Department of Health Care Services and is keenly focused on restructuring the way rates are entered to help you meet those standards. 

This is an exciting opportunity to meaningfully improve the process your behalf ahead of the July 1 rate change. Because it is both a major change and our number one priority, many CalMHSA resources will be dedicated to this initiative for the next several weeks. We will, of course, ensure your teams are updated along the way as changes are deployed and milestones achieved. 

 

New Data Requirement for 2024-25 Billing and Rates 

To create rates and billing codes for the 2024-25 fiscal year, counties will need to integrate Datapalooza with three specific data elements for each program in SmartCare: 

• Program Services (Required) 
• Funding Source 
• Location  

All counties are required to complete the data element “Program Services” in order to create their rates and billing codes for the 2024-25 fiscal year.   

For some counties, not entering a funding source if they have a FFPSA program will result in that program not having the billing modifiers required for their claims. Additionally, if the location data is not set up, CalMHSA will be unable to complete additional validation on the program setup (counties will still receive all configured rates and billing codes). 

Counties can set up programs manually in SmartCare under the screen “CalMHSA Program Meta Tagging LP (Administration).” To import the Datapalooza data, a spreadsheet is available on the CalMHSA website. 

 

New Claims Denial Report Available 

Users can now access a new report that displays denied claims where the process date was between the start and end date parameter values entered by the end user; or, if left blank, all claim processing dates. The report will enforce CDAG security and includes minimal formatting so that it can be exported to Excel.    

 

From Request to Deployment: A Step-by-Step Guide to the EHR Change Process 

CalMHSA has developed a comprehensive review of the EHR planning and development process to help counties better understand how projects are analyzed, planned, developed and deployed. As we work to standardize clinical forms and practices and meet all state requirements — including new initiatives — on behalf of counties, the EHR team follows a rigorous and thoughtful process.  

While the length of time needed for each step in the process depends on complexity, resources available and other emerging issues that may take precedence, counties can be confident that each initiative undergoes standard protocols that include the following key steps.   

Initial Review and Planning 

Each project begins with a request; to assess the request’s impact, we begin with an initial review and planning process that may take time to ensure highest quality through these stages: 

• Analysis 
• Strategy 

• Planning 
• Development Request 

 

Development 

The development process starts the same way the analysis process starts – with a request. CalMHSA continually re-evaluates its current product roadmap and adjusts as needed, ultimately ensuring that each development process includes: 

• Requirements 
• Design 
• Scheduling Development 
• Development 
• QA Review 
• Deployment Requested  

 

Deployment  

All deployments go through Streamline. Development items are not released piecemeal; rather, completed development bundles are grouped together to be added to a build (a build is basically a set of development projects that will be released at the same time). Projects in deployment follow this path: 

• Packaging for Deployment 
• Scheduling Deployment for QA 
• User Acceptance Testing 
• Scheduling Deployment to Production 
• User Guide and Training 
• Implementation 

County users are encouraged to review the full analysis of the project process from review to deployment and contact us at [email protected] with any questions. 

 

This Week’s Production Updates 

New functionality in the EHR – and what you need to know about it – is available here. 

 

Upcoming Initiatives 

The EHR Product Team’s ambitious upcoming initiatives in this list, updated weekly as products and priorities evolve — and sortable by topics like medical, clinical billing and more. 

EHR Initiative Report 5-23-24