Community
15th Night is becoming a “Billing Hub”
July 10, 2024
We are excited to share details about a new project to support our community-based youth service partners with Oregon Health Plan (OHP) Medicaid funding. 15th Night is developing a third-party “billing hub” and will provide administrative support to process non-clinical Medicaid billing for partner agencies with Traditional Health Worker services. We believe this innovative approach is an important piece to the puzzle that will help us achieve our mission to eliminate youth homelessness. The billing hub’s goal: To offset the cost of staff who are providing one-on-one resource navigation and group support to youth on the Oregon Health Plan (OHP). Our message to partners: Sustainability is possible!
What are “Traditional Health Workers”? The word Traditional Health Worker (THW) is an umbrella term for a variety of non-clinical providers, including Community Health Worker, Peer Support Specialist, and Birth Doula. These types of supports have a long history of existing in communities through the world, and in 2011 Oregon passed legislation that allowed these provider types to bill OHP. By definition, THWs are people with lived experience who are a part of the community they serve to offer trauma-informed support to underserved populations. Access to THWs is one of the ways the Oregon Health Authority is trying to eliminate health disparities by 2030.
For 15th Night partners who don’t already have Community Health Workers or Peer Support Specialists, we will review job descriptions and the lived experience of direct service staff and create a comprehensive report outlining training requirements needed for billing, and subsequently support staff after training in obtaining state certification and health plan credentialing. 15th Night will also negotiate and hold the contract with local Coordinated Care Organizations (CCOs) and will require a signed MOU (memorandum of understanding) with participating partners. To ensure longevity of the billing hub, 15th Night will charge a small administrative fee, passing the majority of billing revenue to partner agencies.
The why is simple: to ensure youth have services provided by trauma-informed trained staff that are culturally and/or linguistically congruent, access to local resources and health care for their physical and mental well-being, and that youth programs are financially sustainable.
The billing hub may seem technical and complicated – and that’s because it is. The good news is that we have hired an expert in the field to support this work! Iris Bicksler started as 15th Night’s new Hub Director back in May, and previously worked as the Senior Traditional Health Worker Liaison at PacificSource Health Plan for almost five years. As a Community Health Worker, Peer Support Specialist and Birth Doula herself, she comes with a wide variety of experience in both direct service and system level advocacy.
We are thrilled Iris has joined our team and we look forward to providing the 15th Night community with updates on this project as it moves forward.