Billing and Information Technology: A Toolkit for Behavioral Health Agencies - Transition Plan Template Guide

Sep 11, 2026

Billing and information technology transition guidance for behavioral health providers moving from a Behavioral Health Organization (BHO) billing environment to an integrated payment environment. The toolkit explains how to use a transition plan template to document current state and future state across six operational areas: information systems, IT support, billing operations, staffing, BHO sunset data handling, and contingency planning. It includes prompts for evaluating EHR, encounter data generation, HIPAA-standard transactions, support coverage, billing policies, reconciliation, and plan-B readiness with defined responsible owners and timeframes.

LanguageEnglish

CategoryPresentations

FormatPDF

Pages4

Reading Time2 min

AccessFree to download

Guide to the Transition Plan Template

Transition plan overview and template instructions

Six transition areas and guiding questions

Information systems

IT support

Billing operations

Staffing

BHO sunset

Contingency plan

Transition Plan Template (blank and example)

Billing and Information Technology: A Toolkit for Behavioral Health AgenciesIn Guide to the Transition Plan Template This template serves as a simple at-a-glance transition planning tool. Once completed, it can be used internally to guide the transition work or feed a more detailed project plan. Instructions on how to complete the template are contained in the following table. | Area | Current State | Future State | Transition Steps | Responsible | Timeframe | | --- | --- | --- | --- | --- | --- | | Each of the six areas is listed and sub-divided into components needed to bill in an MCO environment. | Briefly describe the current state for each of the components listed. | Briefly describe the desired end state for each of the components listed. | List the major steps required to go from the current state to the future state. | List the area or individual responsible for each of those steps. | List the desired begin and end dates for each of the steps listed. | Transition Plan Template In order to successfully transition from billing in the Behavioral Health Organization (BHO) environment to billing in the environment, the provider organization needs to consider changes in six areas, listed in the table below. The transition plan should describe the strategies to achieve the desired future state in each area. For each of these areas, consider the current state (what you are doing currently) and what you need to be doing in the integrated payment environment. The questions in the table below can direct your thinking about these areas in preparation for completing your information technology (IT) transition plan. | Area | Questions for Consideration | | --- | --- | | 1. Information Systems | • Do you need to change or modify your Electronic Health Record (EHR?)
• Will your EHR generate encounter data?
• Can you bill multiple organizations for your services?
• Can you generate encounters for non-Medicaid services provided to Medicaid clients?
• Do you need to change or modify your billing and financial system?
• Are you able to generate and accept HIPAA-standard transactions for encounter and eligibility data? | | 2. IT Support | • Do you have adequate support available for the desktop PCs, laptops, mobile devices, local network, and internet connectivity?
• Do you have support available when issues/questions about your EHR occur? | 1 Billing and Information Technology: A Toolkit for Behavioral Health AgenciesIn Guide to the Transition Plan Template (continued) | Area | Questions for Consideration | | --- | --- | | 3. Billing Operations | • Are there policies and procedures in place to bill the MCOs?
• Are you currently billing third-party insurances for Medicaid client services? (TPL)
• Are you billing other insurance companies for the non-Medicaid services?
• Are you able to bill Medicare for any of the services you provide?
• Are there procedures in place to check that all services are being sent as encounters?
• Are there procedures in place to review errors returned on encounter submissions and correct them? | | 4. Staffing | • Will you need additional technical staff to support the billing process?
• Will you need additional data analysts to support the billing process?
• Will you need additional help to generate reports to monitor the encounter process?
• Will you need additional help to reconcile and record MCO payments? | | 5. BHO Sunset | • Do you need to obtain any of the encounter or native data that were sent to the BHO?
• When will you submit your last regular submission of encounter data to the BHO?
• How will you check your records to ensure that all encounter data have been sent to the BHO?
• How will you support the clean-up of errors in encounter or native data that occur in the last two submissions to the BHO?
• How long will you need to support the BHO data?
• Do you need look-up access to the BHO records post-transition? | | 6. Conting

FAQs

What does the transition plan template help behavioral health agencies document?

It captures current state, desired future state, major transition steps, responsible parties, and timeframes so the agency can guide billing and IT work through the transition to an integrated payment environment.

Which six areas must be addressed in the transition plan?

Information Systems, IT Support, Billing Operations, Staffing, BHO Sunset, and Contingency Plan are the six areas used to structure the transition planning.

What key topics are covered under Information Systems?

The prompts include whether the EHR must change, whether it generates encounter data, whether billing can support multiple organizations, whether HIPAA-standard transactions for encounter and eligibility data can be generated and accepted, and whether the billing and financial system needs modification.

Sep 11, 2026

Uploaded by Lucas Vance