Valeska Reynolds

My core work in this Behavioral Health department includes outpatient therapy insurance authorization procurement and management as well as development of a process for submission of case management claims in accordance with rules pertaining to MO HealthNet spendowns. This has an impact on reimbursement which increases efficient use use of funding and increases ability to provide services within the community. I also train new community support case managers in MO HealthNet applications and spend down information, advocate for clients regarding their applications, and provide related resources. One of my favorite projects has been review of current/creation of authorization process flow in an ambulatory clinic that resulted in a decrease in claim denials and a reorganization of job tasks to appropriate personnel. A current project relates to review of processes and staff training regarding mandatory reporting items in clinical documentation.