Qualified providers and quality providers are not always synonymous. Managed Care Organizations (MCOs) may be given direction to utilize qualified providers, but guidance on what qualified really means may not be part of the conversation. For some Financial Managment Services (FMS) providers, quality is a no brainer. For others, the learning curve according to payer expectations, can be challenging for all parties involved including the participant.
Mollie Murphy moderated a panel at the 2019 HCBS Conference, Finding Quality in “Qualified” FMS Providers, to discuss the quality journey between a MCO and FMS Provider. The panel included the Kansas Dept of Aging & Disability, two Centene affiliates, and FMS provider Palco to talk through tools, oversight and support, and on-going communication which promote good quality and performance.