CASE STUDY:
Pinnacle Services
Pinnacle Services Enhances HCBS Delivery and Billing Efficiency with PlanStreet Care Management
Organization Overview
Pinnacle Services provides Home and Community Based Services (HCBS) to seniors and individuals with disabilities across Minnesota. Their mission is to connect individuals and families to the services and community resources they need to live independently and thrive.
As their programs expanded, Pinnacle required a system that could:
- Streamline eligibility verification
- Manage service authorizations
- Accurately track billable units
- Automate claims submission to Minnesota DHS
- Ensure financial reconciliation and GL synchronization
Pinnacle selected PlanStreet Care Management to support end-to-end service delivery and billing operations.
The Challenge
Before implementing PlanStreet, Pinnacle faced several operational complexities:
- Manual eligibility checks and service authorization tracking
- Time-consuming billing processes to Minnesota DHS via MNITS
- Risk of errors in unit tracking and claim submission
- Administrative burden of reconciling Remittance Advice (RA) with claims
- Difficulty synchronizing payments with financial systems and GL accounts
These inefficiencies reduced staff productivity and increased compliance risk.
The Solution: PlanStreet Care Management + MNITS Integration
PlanStreet implemented a fully integrated care management and billing workflow tailored to Pinnacle’s HCBS operations.
- Automated Eligibility Verification: PlanStreet verifies participant eligibility directly within the system, ensuring services are delivered only to eligible individuals and reducing claim denials.
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Service Authorization Import:
PlanStreet imports service authorizations into the platform, enabling:
- Clear visibility of approved services
- Real-time tracking of remaining authorized units
- Accurate alignment between delivered services and approved funding
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Billable Unit Tracking for CHWs:
Community Health Workers (CHWs) use PlanStreet to:
- Document services in real time
- Track billable units against authorizations
- Ensure compliance with Minnesota DHS guidelines
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Automated Claims Submission to MNITS:
PlanStreet seamlessly connects to MNITS (Minnesota Medicaid Information Technology System), allowing:
- Automatic claim generation
- Direct electronic submission
- Reduced manual data entry
- Faster reimbursement cycles
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RA Reactivation & Financial Reconciliation:
PlanStreet automatically:
- Reactivates Remittance Advice (RA)
- Links payments to relevant claims
- Maps payments to appropriate GL accounts
Results
By leveraging PlanStreet Care Management, Pinnacle Services achieved:
- Reduced billing errors and claim denials
- Faster claims submission and reimbursement turnaround
- Improved visibility into service authorizations and utilization
- Streamlined workflows for CHWs and billing teams
- Stronger compliance with Minnesota DHS requirements
Impact on Clients & Families
Most importantly, automation and operational efficiency allow Pinnacle staff to focus on what matters most:
- Supporting seniors in maintaining independence
- Connecting individuals with disabilities to vital community resources
- Helping families navigate complex care systems
With administrative burdens reduced, Pinnacle can dedicate more time to delivering high-quality, person-centered care.