GAHSC SHINES Overview Colleen Mousinho Patrick Coogan

1
GAHSC SHINES OverviewColleen Mousinho Patrick
Coogan

• September 10, 2008

2
Agenda

• Georgia SHINES Facts
• Key Benefits
• Deployment Schedule
• How SHINES Affects Payment Processing
• Key Facts for Providers
• Questions and Answers

3
Georgia SHINES Facts

• Web based SACWIS system
• Primary data management system for the entire
  case lifecycle.
• Supports resource recruitment and maintenance
• Replaces several separate legacy systems
• IDS
• Risk Assessment"
• CPRS (for DFCS users)
• ADAM (from December 2008)
• Supplements information in other current systems
• SMILE
• KidStar

4
Deployment Schedule

• Pilot 59 users
• September 2007

• Phase 3 1256 users
• April 2008

• Phase 1 164 users
• December 2007

• Phase 4 1278 users
• June 2008

• Phase 2 1036 users
• February 2008

SHINES supports approximately 3,800 users
4
5
Key Benefits

• SHINES brings together in a single system all
  relevant information about a case
• Intake and Investigation
• Placement
• Eligibility
• Services authorized and provided
• Case Plan
• Available resources
• Consistency is enforced child can only be paid
  for their correct current eligibility, in their
  correct current placement, and for services the
  case manager has approved. There is no longer
  conflicting information leading to incorrect
  payments.

5
6
How SHINES Affects Payment Processing

• Georgia SHINES interfaces with SMILE for payment
  processing.
• Checks will continue to come from SMILE.
• Pre-bills will continue to be generated in SMILE.
• Accounting contacts are the same.
• Accounting workers are actually working in SHINES
  to update invoices and then send them through the
  interface SMILE primarily only prints the
  checks.
• SHINES maintains information on the contracted
  services, rates and RBWO programs for all
  providers.

7
SHINES Payment of Care Page
RBWO Program
7
8
How SHINES Affects Payment Processing (Cont.)

• Because SHINES brings together in a single
  location information for clients, resources,
  services, and placement, invoices are generated
  based off of the information in SHINES
• Invoices for placement services are based
  directly on the placement and payment information
  entered in SHINES, not any other system.
• Invoices for delivered services are based
  directly on the service authorizations entered in
  SHINES.
• Up to date information must be in SHINES to be
  paid.
• Providers may only be paid for services for which
  SHINES contracts have been entered.

8
9
Key Facts for Providers

• Communication is key since payments are based
  on SHINES data, it is critical that you keep case
  managers and DFCS provider relations up to date
  with relevant information
• New CPA foster homes
• Placement moves
• Waivers and RBWO program changes must be in
  SHINES to be paid
• If providing delivered services, confirm any
  service you provide against the service
  authorization. You must first contact the case
  manager for additional authorization if you wish
  to provide additional services.

9
10
Questions and Answers