hp enterprise services hometown health presentation august 4, 2010 partnering for success!
TRANSCRIPT
HP Enterprise Services
HomeTown Health Presentation
August 4, 2010
Partnering for Success!
2 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Provider Beta Testing
August 16 – August 20 TuckerAugust 30 – September 3 Cordele
Provider Implementation Workshops
August 5 – October 141,636 Participants Registered Institutional
BETA Testing and Workshops
3 / Georgia MMIS Presentation August 2010 HP Enterprise Services
ACS Last Claims Cycle – October 22, 2010 Last day to submit electronic claims for processing -
October 21, 2010 Last day paper claims are received for processing -
October 15, 2010 Last day to receive calls – October 29, 2010
HP Enterprise Services First Claims Cycle – October 29, 2010 First day to submit electronic claims, except web portal, for
processing – October 22, 2010 First day to submit web portal claims for processing –November 1,
2010 First day paper claims are received for processing - October 18, 2010 First day to receive calls – November 1, 2010
Tentative Timeframes
4 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Questions asked at July 2010 Webinar
Who is the head of the MMIS Implementation project at the Georgia Technology Authority (GTA)?
Tom Fruman
Will the 835 format be changing?Yes, refer to the Readiness Website for the most current
companion guides. Changes are highlighted in yellow.
5 / Georgia MMIS Presentation August 2010 HP Enterprise Services
EDI Helpdesk
EDI Services Phone Number Available after September 1, 2010770-325-9590 or toll free 1 877-261-8785
EDI Email Address: [email protected]
Provider Assistance
6 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Transition Information
Will the process for submitting Part B crossovers change, currently providers submit the claims to DCH.
Yes, the claims will be sent directly to HP for processing. New edits have been created to suspend the claims for review.
2502: MEMBER COVERED BY MEDICARE B - No attachment
2503: MEMBER COVERED BY MEDICARE B – With attachment
7 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Billing Manuals will be available via the web portal. The current billing information contained in the DCH Part I Policy and Procedures Manual will be removed.
Transition Information
8 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Transition InformationWill the Rendering Provider Activity
Report be available in the new MMIS?While the ACS Rendering Provider Activity Report will no longer be
available, HP designed the Payee remittance advice to report by rendering provider. In addition, an extract of the file is sent to the rendering provider.
9 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Transition ItemsPrior Authorization/Precertification
Inquiries sent to GMCFThe DMA 520A form was created for providers to submit any
PA/Precertification questions directly to GMCF.
10 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Transition Item_Attachment CodeAttachment Codes
Crosswalk Old Attachment Code
HIPAA Attachment Code Comments
040512
AS Admission Summary History & Physical or progress notes
04 B3 Physician Order
21 B4 Referral Form Hospice Referral form, Revocation Form, Election Form, Hospice Discharge Form, Hospice Transfer Form, Hospice
01051214 21
CT Certification DMA-964, DMA-400 (DFCS issued letter), Temporary Medicaid Certification Form, Supplemental Security Income Letter, DMA-304, Death Certificate
04 DA Dental Models
04 05 12
DS Discharge Summary
06 09 11
EB Explanation of Benefits EOMB, TPL, Remittance Advice
04 NN Nursing Notes
11 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Transition Item_Attachment CodeAttachment Codes
Crosswalk Old Attachment Code
HIPAA Attachment Code Comments
04 05 12
OB Operative Notes
04 05 12 21
OZ Support Data for Claim This can be any miscellaneous documentation needed to support processing a claim
04 RB Radiology Films
04 RR Radiology Reports
04 RT Report of Test and Analysis
If you are unable to find the appropriate attachment code for documentation being submitted as an attachment, please use “OZ”.
12 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Provider Readiness Web Portal
Web Portal Address
http://providerinfo.mmis.georgia.gov/providerprereadiness/home.aspx
CBTs for web portal training
Workshop Dates/Locations
Workshop presentations
13 / Georgia MMIS Presentation August 2010 HP Enterprise Services
Any questions?