How soon can Mental Health bill carriers?

by Mindy Aguon

Guam - The Guam Legislature may have passed the Department of Mental Health's fee schedule, but it will be a while before the agency can actually begin collecting the millions in revenue they expect to generate each year. Acting director Rey Vega confirms with KUAM News that they are seeking legal advice on whether they will be able to bill local insurance carriers when the fees are implemented.

There is some question about whether the bill that was passed into law requires the department to wait until they first receive certification from Medicare and Medicaid before they can bill any of their patients. While they wait for that guidance though, Vega says the department is in the process of developing the charge vouchers and they need to establish provider payer agreements with local insurance companies.

The department has never billed for its services, which has resulted in a reliance on the General Fund. Once implemented, Mental Health expects to generate between $9 million and $12 million a year.

The department will also not be able to bill individuals under Medicaid and Medicare for at least another eight months because it must first be certified as a facility provider. The certification will require that the Tamuning facility and the entire department undergo a full survey. 

Vega says his staffers are working with their technical consultant to prepare them for that survey, which is a lengthy process.