Currently there is only one resource that manually reviews and adjudicates the TDO claims submitted to the TDO fund. The current turnaround is significant and results in aging accounts receivable.  An electronic submission option is not currently available when submitting to the TDO Fund for payment. There are also claim specific requirements that some electronic health records are not able to accommodate so they need to be handwritten on the claim form submitted. Adding ECO reimbursement under the TDO program for non-Medicaid eligible individuals or secondary coverage through the TDO program will increase the volume of claims submitted to the TDO Fund. There will need to be an increase in resources to manage and adjudicate these claims timely. It is also reasonable that there is an electronic option that does not include direct data entry for the additional claim volume anticipated.

 Page 7 does not include an appropriate taxonomy for ECO services for non-facility setting.  We provide ECO activity in the hospital setting, not in our CSU or 23hr Crisis Receiving center so would need an appropriate taxonomy code to utilize for billing.

For non-Medicaid eligible individuals under an ECO in any setting, claims for prescreening assessments conducted through emergency services pursuant to section §37.2-800 et. seq. and section §16.1-335 et seq. of the Code of Virginia may be submitted to the TDO Program using the H2011 HCPCS code. Providers should use the 32 modifier to indicate that the prescreening was conducted under an ECO and the appropriate team modifier (see Appendix G to the Mental Health Services Manual for details). DBHDS Virginia Crisis Connect requirements apply but providers do not have to submit a registration form to the TDO Program.