hp enterprise services hometown health presentation november 3, 2010 partnering for success!

HP Enterprise Services

HomeTown Health Presentation

November 3, 2010

Partnering for Success!

2 / Georgia MMIS Presentation November 2010 HP Enterprise Services

• Certain providers exempt from POA including:– At this time, the following hospitals are EXEMPT from the POA

Indicator and HAC:1. Critical Access Hospitals (CAHs)2. Long-term Care Hospitals (LTCHs)3. Cancer Hospitals4. Children's Inpatient Facilities5. Rural Health Clinics6. Federally Qualified Health Centers7. Religious Non-Medical Health Care Institutions8. Inpatient Psychiatric Hospitals9.Inpatient Rehabilitation Facilities10. Veterans Administration/Depart of Defense Hospitals

Changes


Changes

• LTC and Swingbed Facilities must being including the prior authorization:

The HP System was built to require Prior Authorization for Nursing Facility Residents as a mechanism for compliance with federal Pre-Admission Screening and Resident Review guidelines. The prior authorization is directly linked to submission of the PASRR Level I Screen. Because the capacity to submit prior authorization requests was not available prior to the HP transition on November 1, this function will not be activated until January 1, 2011 in order to allow nursing facility providers time to learn about the requirement and submit PA requests.


Changes

• Claims must be submitted red dropout ink

• Claims must have all digits on provider ID; do not drop leading zeros

• IVRS Check Amount– Must use Payee to verify not Rendering


Web Portal Information

• Batch Billing Process: Link– The Trade Files >> Upload menu item is restricted to Trading Partner

users only. Therefore, if they wish to submit HIPAA batch files, they will need to be setup with a Trading Partner account from EDI services, which were the letters sent on the green paper.

• Downloading/click won't download/any pubic– HP has tested this and are able to download publications from the

public web portal. Issues downloading publications could be browser related. On all of the publication pages, above the publication panels, there is a section called “File Download Issues”. If they click the help link in that section, it will instruct them how to set their browser to allow publications to be downloaded if their browser is preventing this from occurring.

• Where on the web portal do I find RA information?– Secure portal/Reports/Financial/select Remittance Advices from

dropdown box


Web Portal Response to Questions• How do you link several providers under a

single login? If you are working with more than one provider, do you have to have a separate login for each provider?

– Please refer to section 3.2 in the Web Portal User Account Management Guide found at www.mmis.georgia.gov >> Provider Information >> Provider Manuals on the procedures taken to link multiple accounts under a single user ID/password.

– Yes, each provider PIN account must be registered separately with a unique username.


Web Portal Response to Questions• We can’t access Remittance Advice or

check status of weekly payment check.

– ACS RA’s are available under the payee/provider account that was setup to receive web RAs within the GHP site. Users may access this information through their payee account on the new secure Web Portal under Reports >> Financial Reports with the report type of RA’s before 11/1/2010.


Web Portal Response to Questions• Do you have any sites that are able to

retrieve RA on the new HP web portal or able to view EFT’s? If so how are they accessing them? – Any RA created out of interChange is available

to the rendering and payee provider web accounts under Reports >> Financial Reports >> Report Type = Remittance Advice. This past weekend was the first financial run for interchange.

– Users may access this information through their payee account on the new secure Web Portal under Reports >> Financial Reports with the report type of RA’s.


Web Portal Response to Questions• Payee Accounts:

– Payee accounts do not have access to Eligibility. This access is granted to rendering provider accounts only. Please make sure you register the rendering provider accounts for web access.


Web Portal Response to Questions• How can I remove a user? – the “remove” button on web-site does

not seem to work. – To remove some or all delegated roles from a billing agent user, please

refer to section 3.3 within the Web Portal User Account Management Guide found at www.mmis.georgia.gov >> Provider Information >> Provider Manuals.

• Can I or someone change a username? - I set up the hospital with my name as a username thinking that I was setting up my account. Did not realize I was setting up the hospital, otherwise I would’ve done something more generic. – Once a username has been registered against a specific provider

account, it cannot be changed.

• How do I inactivate an old provider # ? – I received letters for old Provider numbers we no longer bill for. – Please provide a list of those IDs and provide that information to EDI

Services. Those accounts will be locked to prevent account registration. You may also send a written request to Provider Enrollment to terminate those provider accounts for the future.


Web Portal Response to Questions• PIN letter for payee # instead of provider # - I

received several PIN letters for some of our payee numbers instead of my provider numbers. Should

I just disregard?

– No payee’s and rendering accounts will be needed for RA purposes if you wish to download/access RAs sent to

the payee account.


Web Portal PIN Letters

• Web Portal User Account Management Guide

• Provider Change of Information Form available on readiness website.

• If you have not received the PN letter, send an email to [email protected]. Include the following information:

– Individual providers: Provider name and ID, location address, date of birth and SSN

– Facility providers: Provider name and ID, and tax ID

• Indicate on subject line PIN REQUEST

• Reminder: Provider IDs that were enrolled or became active in the Georgia Medicaid/Peach Care for Kids Program after July 31, 2010, must wait to receive their new MMIS Web Portal PIN in the mail after conversion has occurred or after (go-live) on November 1, 2010.


Web Portals

Readiness Web Portal Address

http://providerinfo.mmis.georgia.gov/providerprereadiness/home.aspx

MMIS Web Portalwww.mmis.georgia.gov


Post Office Boxes

ACSCurrent

POST OFFICE BOXES

HP Enterprise ServicesFuture

POST OFFICE BOXES

Member Correspondence PO Box 3000

Member & Provider CorrespondencePO Box 105200Tucker, GA 30085

Provider Enrollment PO Box 4000

Provider Enrollment & EDI ServicesPO Box 105201Tucker, GA 30085

Claims PO Box 5000

CMS 1500 Claims PO Box 105202Tucker, GA 30085

Crossover ClaimsPO Box 105203Tucker, GA 30085

ADA 2006 Dental Claims PO Box 105205Tucker, GA 30085

Adjustments & Voids PO Box 105206Tucker, GA 30085


Post Office Boxes continued

ACSCurrent

POST OFFICE BOXES

HP Enterprise ServicesFuture

POST OFFICE BOXES

Special Projects PO Box 6000 No Corresponding PO Box

Nurse Aid Registrations & PAs PO Box 7000

No Corresponding PO Box

Returned Mail PO Box 9000No Corresponding PO Box

Finance PO Box 888386

TPL/ Finance/ Buy-in PO Box 105207Tucker, GA 30085

Retro Claims/Certified Mail PO Box 888347

Special Handling Documents PO Box 105208Tucker, GA 30085

Non-Claim (miscellaneous) DocumentsPO Box 105209Tucker, GA 30085


GMCF PO Boxes (new)

Review/Mail Type PO Box 105753Atlanta, GA 30348

Nurse Aide Program PO Box 105329Atlanta, GA 30348

Prior Authorization PO Box 105330Atlanta, GA 30348

Medical Claims Review, SURS, CISWaiver: Katie Beckett; GAPP; ICWP

PO Box 105406Atlanta, GA 30348


Medicare Part B Inpatient Only Claims• Medicare EOB attached and should

not be handled like regular claims therefore PO Box to send these claims is Special Handling Documents

• PO Box 105208Tucker, GA 30085


Any questions?