Provider Readiness w/ BH Supplemental Data Survey

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* 1. What is the name of your organization?

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* 2. Who is the best contact at your organization to receive communications, materials, and technical assistance with Behavioral Health Supplemental Data?

Name & Title

Email Address

Phone Number

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* 3. Are you prepared to collect data on 1/1/2020 per HCA requirements in the BH Supplemental Transaction Data Guide?

Yes

Comments

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* 4. How do you anticipate collecting data on 1/1/2020 (EHR, Spreadsheet, Paper, Other)?

EHR

Spreadsheet

Paper

Other (please describe below)

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* 5. If you are not yet prepared to collect data on 1/1/2020 (i.e. need to make EMR configuration), what is your timeline for implementation?

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* 6. Do you have prior experience with this data set (collecting/submitting)? 

Yes

Comment

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* 7. Use the comment box below to ask any questions or voice concerns to the joint-MCO group. You may submit questions/concerns at any given time.

The joint-MCO group will be monitoring these survey results for new questions and will respond as quickly as possible to you individually or will provide answers at an upcoming Provider Support Webinar.

Thank you for completing this survey. Managed Care Organizations (MCOs) will be reaching out to providers to support readiness with this HCA requirement soon.