hp enterprise services hometown health presentation july 7, 2010 partnering for success!
TRANSCRIPT
HP Enterprise Services
HomeTown Health Presentation
July 7, 2010
Partnering for Success!
2 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Go Live Date
Dear Association,
The Georgia Department of Community Health (DCH) and HP Enterprise Services, formerly EDS, are collaboratively designing a new Medicaid Management Information System (MMIS) to begin processing Medicaid Fee-for-Service (FFS) claims for the state of Georgia.
DCH and HP have mutually agreed to change the go-live date to accommodate additional time for system testing. The new go-live date for the MMIS is November 1, 2010.
In the coming weeks, expect to receive invitations from HP to attend transition workshops on the new MMIS application. Registration for the workshops will be e-mailed, mailed and available on the HP readiness Web site: http://providerinfo.mmis.georgia.gov/providerprereadiness/home.aspx.
If you require immediate assistance or have general comments or questions about the transition, feel free to contact us via the ‘Contact Us’ link on the Web site or send an e-mail to [email protected]. HP will respond directly to all inquiries. We look forward to working along side you in the coming months as we continue our transition from the current fiscal agent to HP.
3 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Project PhasesProject Phases
System Development Life Cycle
√ Startup√ Design
√ Development√ System Testing
√ User Acceptance TestingImplementation
4 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Provider Beta TestingAugust 2010
In preparation for the transition, DCH is asking selected providers to participate in a Provider Beta testing session designed to solicit provider input and feedback on the new system.
These sessions will allow selected beta providers to preview the new Georgia Health Partnership Web Portal and will allow testing of critical portal activities.
The DCH mailed the BETA testing letter and checklist to a sampling of providers representing various categories of service late May, 2010 and the deadline to return the checklist was July 1, 2010 in order to prepare the required data.
BETA Testing
5 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Provider Implementation Workshops
30 provider workshops specific to providers who submit claims on the UB04.
Institutional workshops will be conducted in15 cities throughout the state
Invitations sent in July Register via Readiness Web Portal link
6 / Georgia MMIS Presentation July 2010 HP Enterprise Services
HIPAA TransactionsACS
HIPAA TransactionsHP Enterprises Services
HIPAA Transactions
997 Acknowledgement 824 Acknowledgement
837 D/P/I Claims 837 D/P/I Claims
835 Remittance Advice 835 Remittance Advice
270 Eligibility Request 270 Eligibility Request
271 Eligibility Response 271 Eligibility Response
N/A 276 Claim Status Request
N/A 277 Claim Status Response
N/A 277U Suspended Claims or Invalid NPI
7 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Transition Items
HP Enterprise Services will mail new Member ID Cards in advance of go live
HP Enterprise Services will mail Web Portal PIN letters to providers two months prior to go live
Each individual working for a provider must have their own password to access the web portal
Suspended Claims Conversion
8 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Transition Items
Web Portal available as soon as conversion from ACS has been completed.
HP Enterprise Services anticipates the web portal being available for claim submission on day one.
Other methods of claim submission will be available to the provider community between when the ACS website for claim submission is turned off and when the HP website will be available.
Providers using their own software, clearinghouses, vendors, etc. will see no disruption in service.
9 / Georgia MMIS Presentation July 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
10 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Frequently Asked Questions
Currently in the ACS web portal providers can go in and simply change the month of service and submit a new claim.
Converted claims will be available through the Web Portal. If the claim is paid, the copy claim button will be available to copy, modify and submit a new claim.
11 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Frequently Asked Questions
Will the portal include the same functionality as the existing Web Portal?
In addition to offering providers the functionality that exists on the current Web Portal, additional enhancements have been added, including the ability to attach documents to claims and automated password resets.
Attachment file types accepted are TIF, TIFF, JPG, JPEG and PDF. The maximum size of the attachment file must be less than 20 mb.
12 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Frequently Asked QuestionsWhen will the providers know if we are
keeping the same provider numbers?
Provider numbers will not be changing. An active, enrolled provider should continue submitting claims with the provider ID they are using today.
Will providers have to fill out any new paperwork?
Current providers will not be asked to complete any paperwork. The existing information is being converted from the current MMIS; this includes electronic funds transfer information.
13 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Frequently Asked Questions
Will Member IDs change?
The current member IDs will not change and will remain the same length. Currently existing member IDs begin with 111. New member enrollments after November 1, 2010 will begin with 222.
14 / Georgia MMIS Presentation July 2010 HP Enterprise Services
Frequently Asked Questions
Will the crossover process from Medicare to HP Enterprise Services be ready to go electronic on November 1, 2010?CMS awarded a contract to Group Health Incorporated (GHI) to perform consolidation duties for all intermediaries.
HP Enterprise Services has successfully received crossover claims from GHI. As a result of the thorough testing, we are prepared to process crossover claims electronically beginning November 1, 2010.
15 / Georgia MMIS Presentation July 2010 HP Enterprise Services
5010 Project
When will HP implement HIPAA 5010 Standards? HP will conduct provider workshops on 5010
standards between November, 2010 and December, 2010.
January, 2011, HP will accept both the new 5010 format and the current format for all claims, Institutional, Professional, Dental and crossovers, as well as HIPAA transactions for eligibility and claims. HP will continue accepting either format between January 1, 2011 and December 31, 2011.
Substantial changes in the content of the data that providers submit with electronic claims.
Numerous changes in response to provider electronic inquiries transactions that will be modified or created for 5010.
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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
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Any questions?