Aetna Better Health of New York Information Center

At HHAeXchange, we believe that healthcare should be simple, effective, and transparent. Our mission is to provide better outcomes for patients who represent some of the most vulnerable and fragile members of our society. Since 2008, we have been at the forefront of delivering industry-leading homecare management solutions by helping payers and providers achieve operational efficiency, increased compliance, and improved patient outcomes. Today, HHAeXchange is the premiere homecare management software solution for the Medicaid LTSS population. We act as the single source of truth in connecting payers, providers, and patients through our intuitive web-based platform, enabling unparalleled communication, transparency, and visibility.

HHAeXchange & Aetna Better Health of NY Partnership

Aetna Better Health of New York (ABHNY) has partnered with HHAeXchange to leverage our platform to implement Electronic Visit Verification (EVV) for Personal Care Services. Through the HHAeXchange platform you will be able to receive new home health aide cases, manage authorizations, confirm visits, and communicate certain types of issues in real-time.

In addition, the HHAeXchange platform offers a robust agency management solution that can help streamline and automate time-consuming agency functions including placement, scheduling, compliance, and billing of services.

What does the HHAeXchange Portal provide to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to Aetna Better Health of New York for:

    • Electronic case broadcasting, authorizations, confirming visits using EVV
    • Real-time two-way messaging with ABHNY
    • Free EVV solution for time & attendance and duty tracking
    • Electronic billing along with pre-billing review

Your Agency’s Options & Onboarding Phase

Agencies currently using another 3rd Party EVV Solution (Existing EDI Providers): Authorization data will become available in the HHAeXchange Portal, rather than coming by fax. Schedule and visit data will be imported from your 3rd party system into HHAeXchange. Please work with your EVV Vendor to determine requirements to set up this interface and refer to the EDI Process tab for more details. Providers will be going live with the linked Aetna NY contract in Phase 1.

Agencies not currently using HHAeXchange (New Providers – EVV option of EDI or Free HHAX): You will receive an HHAeXchange Portal in order to receive authorizations and submit claims/invoice data. Please complete the Provider Portal Questionnaire Survey to ensure our team can create your unique credentials for access. Providers will have the choice to either use the free HHAeXchange EVV tools or select to integrate with their own third party EVV system. Providers will be going live with the linked Aetna NY contract in Phase 1.

Agencies currently using HHAeXchange (Existing Enterprise Providers): You will be able to continue using HHAeXchange, utilizing the system’s enhanced Linked Contract functionality. Providers will be implemented with the linked Aetna NY contract in Phases 2 & 3. Providers will receive a detailed welcome letter in advance, letting them know which phase they fall under along with the go-live date expectations.

Important dates

  • Phase 1 (New Providers / Existing EDI)
    • Go-Live Dates for Phase 1: Monday April 26th, 2021
  • Phase 2 (Existing ENT providers)
    • Enhanced Linked Training Sessions: April 19, 2021 – April 22, 2021
    • Go-Live Date: Enterprise Providers: Monday May 17, 2021
  • Phase 3 (Existing ENT providers)
    • Enhanced Linked Training Sessions: May 10, 2021 – May 13, 2021
    • Go-Live Date: Enterprise Providers: Monday June 7, 2021

Phase 1 (New Providers / Existing EDI) An Information Session was held for all providers to provide them with key dates and details about the implementation, including key workflow changes, system benefits, and next steps. Please refer to the links below to access videos and presentations from the Provider Info Sessions, held via webinar in March 2021. If you have not done so already, complete the HHAeXchange Provider Portal Questionnaire . This questionnaire will provide necessary information for HHAeXchange to configure your portal and allow you to select whether you want to use free HHAeXchange EVV tools or use your existing EVV system.

Phase 2 & 3 (Existing ENT providers) (Phase 2 & 3 Existing Enterprise Providers): An Information Session was held for all providers to provide them with key dates and details about the implementation, including key workflow changes, system benefits, and next steps. Please refer to the links below to access videos and presentations from the Provider Info Sessions, held via webinar in April 2021.

*To access any of the training recordings viewed during a live webinar, please login to your LMS account to access those recordings.

Provider System User Training

Provider System User Training will be provided via the HHAeXchange Learning Management System (LMS). Providers will have to log on the Learning Management System to complete their training to understand the use of the HHAeXchange Provider Portal along with its functionalities. This training is required to ensure you have a clear understanding of the functionalities available to you in the HHAeXchange Provider Portal. The courses include a variety of videos, documents, and tests to help ensure you have a clear understanding of the different aspects of the Provider Portal to use for your EVV benefits.

Receive LMS Credentials from the HHAeXchange Onboarding Team and follow instructions to complete the courses and videos on a self-paced format to complete:

    • An email will be sent to the contact that completed the Aetna NY Provider portal questionnaire
    • One Username will be sent for your Agency to use. Username can be distributed amongst all members of your agency to complete the assigned courses.
    • Login to the LMS website using the provided credentials in the email
    • Work on completing the courses by reviewing the information provided
    • Any updates made to the password should be distributed amongst all members who have access to the account
    • For any questions or concerns, please reach out to Support@hhaexchange.com

ENT Training Webinar – Enhanced Linked Contract Experience The purpose of this training is to cover several enhancements that allow for more flexibility and ease of use with linked payers. These enhancements include the Universal Patient Record linked contract functionality and improvements to the patient management experience. Please keep in mind this training is for those providers who use our most enhanced Enterprise system. ABHNY ENT Provider Training:  | Slides | Recording | UPR Guide |

EDI INFO SESSIONS For providers using 3rd party EVV system outside HHAX, please attend an EDI information session that will provide you with the next steps in your integration. Please register here for EDI Specific information sessionIn the meantime, please reach out to EDISupport@hhaexchange.com with the subject line “AetnaNY Integration” to discuss your next steps or visit the “EDI PROCESS” tab.

Importing Caregivers into HHAeXchange

(Note: This is not required for agencies using an EDI Import file to integrate with their 3rd Party Agency Management System) To assist organizations with a large census of Caregivers, HHAeXchange has created a Caregiver Bulk Import tool to expedite the entry process. Please CLICK HERE to access the Caregiver Bulk Import Process Guide, which provides instructions for how to:

  • Access and Save the Caregiver Import Template
  • Prepare the Caregiver import File for your Agency
  • Send the file to HHAeXchange (EDISupport@hhaexchange.com) for File Processing

EDI Overview (Integrating with a 3rd Party Agency Management System)

Thank you for your participation in working with HHAeXchange on the Electronic Data Interchange (EDI) project for your agency. Below you will find information about the general requirements and steps necessary to successfully integrate your Agency Management System with HHAeXchange. HHAeXchange coordinates directly with Aetna Better Health of NY to ensure members and, if desired, authorizations are passed directly into the HHAeXchange system. Once this data is in the HHAeXchange system, a unique member key is created which HHAeXchange will pass to your Agency Management System to ensure seamless processing of member information between the systems. HHAeXchange will also give you a unique Provider Agency ID to include in all files used in the EDI processes. In order to integrate between your Agency Management System and HHAeXchange, you will need to create the EDI files corresponding to the HHAeXchange specifications found in the following documentation (links below):

Here is a look at some of the benefits you will get from the HHAeXchange Portal:

Ease of billing

  • Quickly enter confirmed visits in a user-friendly interface.
  • Increase billing acceptance rates with real-time pre-claim edit checks.

Efficient communication

  • Reduce payer communication time with real-time, two-way messaging.
  • Increase census by accepting new cases via the broadcasting module.
  • Access real-time authorization and notification of changes to the care plan (increase or decrease of units, change of service code, etc.).

Free tools

  • Free scheduling module to manage schedules online in real-time.
  • Free EVV solution to electronically track time and attendance.
  • Free interface with your agency management system.

HHAeXchange is the premiere Homecare Management Software company for the Medicaid non-skilled LTSS population. We are the leaders in connecting payers and homecare agency providers to enable more collaboration, communication, and workflow efficiencies.

Ease of billing

  • Quickly enter confirmed visits in a user-friendly interface
  • Increase billing acceptance rates with real-time pre-claim edit-checks

Efficient communication

  • Reduce payer communication time with real-time, two-way messaging
  • Increase census by accepting new cases via the broadcasting module
  • Access real-time authorization and notification of changes to the care plan (increase or decrease of units, change of service code, etc.)

Free tools

  • Free scheduling module to manage schedules online in real-time
  • Free EVV solution to electronically track time and attendance
  • Free interface with your agency management system

Through the HHAeXchange Portal, ABHNY is offering free telephony for clock-in and clock-out functionality, including capturing completed plan of care duties. Each agency who has indicated they would like to use HHAeXchange’s free EVV system will be set up with a toll-free 800 number to provide to their caregivers.

Great! If you’ve indicated that you’d like to use HHAeXchange’s free EVV system, the contact person listed on your survey will receive more information in the coming weeks on how to set up your agency’s 800 numbers, upload caregivers into the HHAeXchange Portal and begin processing EVV and claims.

It is simple to connect your existing EVV system to ABHNY through the HHAeXchange Portal. Ensure that you’ve completed the survey, and the HHAeXchange Integrations Team will coordinate with you to create an interface to process your existing EVV visits and claims. For additional information, please review the “EDI Process” tab or contact EDISupport@hhaexchange.com.

They will be sending new placements, authorizations, and all communication through the HHAeXchange Portal. ABHNY may send additional information as they deem necessary.

All claims will be created through the HHAeXchange Portal and sent electronically via an 837 eBilling file. Agencies will then receive an 835 eRemittance file back into the HHAeXchange Portal.

Yes. The HHAeXchange Portal provides a Prebilling Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and the ABHNY contract.

Yes. You will need a Portal to connect to ABHNY for placements, authorizations, communication, and billing.

Yes. You’ll be able to schedule your caregivers through the HHAeXchange Portal either by creating schedules based on the authorization provided by ABHNY, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.

The person within your organization that filled out the survey will receive more information to identify super users and for training planning. The user who completed the survey will receive the Learning Management System (LMS) credentials for self-paced videos and webinar details with a live Q/A chat option to interact and review this information with the HHAeXchange training team.

Processes for importing and exporting data from the HHAeXchange Portal can be found on the “EDI Process” tab. You can also contact EDISupport@hhaexchange.com for further details and concerns.

Provider Services in Scope: Please see below all the provider services in scope for this implementation.

Service Code

Description

S5130:U1:NY

S5130:U1:LI

S5130:U2:NY

S5130:U2:LI

S5130:U3:NY

S5130:U3:LI

T1019:U1:NY

T1019:U1:LI

T1019:U2:NY

T1019:U2:LI

T1019:U3:NY

T1019:U3:LI

T1019:U4:NY

T1019:U4:LI

T1019:U5:NY

T1019:U5:LI

T1020:NY

T1020:LI

T1020:U2:NY

T1020:U2:LI

T1020:U5:NY

T1020:U5:LI

T1019:U6:NY

T1019:U6:LI

T1019:U7:NY

T1019:U7:LI

T1019:U8:NY

T1019:U8:LI

T1019:U9:NY

T1019:U9:LI

T1020:U6:NY

T1020:U6:LI

T1020:U7:NY

T1020:U7:LI

T1020:U8:NY

T1020:U8:LI

T1020:U9:NY

T1020:U9:LI

S5125:NY

S5125:LI

S5125:U2:NY

S5125:U2:LI

S5126:NY

S5126:LI

S5126:U2:NY

S5126:U2:LI

S9122:LI

S9122:NY

S9122:U1:NY

S9122:U1:LI

PCS LEVEL I – 15 MINUTES

PCS LEVEL I – 15 MINUTES

PCS LEVEL I TWO CLIENT

PCS LEVEL I TWO CLIENT

PCS LEVEL I MULTIPLE CLIENT

PCS LEVEL I MULTIPLE CLIENT

PCS LEVEL II BASIC – 15 MINUTES

PCS LEVEL II BASIC – 15 MINUTES

PCS LEVEL II BASIC TWO CLIENT

PCS LEVEL II BASIC TWO CLIENT

PCS LEVEL II MULTIPLE CLIENT

PCS LEVEL II MULTIPLE CLIENT

PCS LEVEL II HARD TO SERVE

PCS LEVEL II HARD TO SERVE

PCS LEVEL II TWO CLIENT HARD TO SERVE

PCS LEVEL II TWO CLIENT HARD TO SERVE

PCS LEVEL II LIVE-IN

PCS LEVEL II LIVE-IN

PCS LEVEL II LIVE-IN TWO CLIENT

PCS LEVEL II LIVE-IN TWO CLIENT

PCS LEVEL II LIVE IN TWO CLIENT HARD TO SERVE

PCS LEVEL II LIVE IN TWO CLIENT HARD TO SERVE

CDPA BASIC – 15 MINUTES

CDPA BASIC – 15 MINUTES

CDPA TWO CONSUMER

CDPA TWO CONSUMER

CDPA ENHANCED

CDPA ENHANCED

CDPA TWO CONSUMER ENHANCED

CDPA TWO CONSUMER ENHANCED

CDPA LIVE IN

CDPA LIVE IN

CDPA LIVE IN TWO CONSUMER

CDPA LIVE IN TWO CONSUMER

CDPA LIVE IN ENHANCED

CDPA LIVE IN ENHANCED

CDPA LIVE IN TWO CONSUMER ENHANCED

CDPA LIVE IN TWO CONSUMER ENHANCED

HHA – 15 MINS

HHA – 15 MINS

HHA TWO CLIENT

HHA TWO CLIENT

HHA LIVE IN

HHA LIVE IN

HHA – LIVE IN TWO CLIENT

HHA – LIVE IN TWO CLIENT

HHA

HHA

ADVANCED HOME HEALTH AIDE

ADVANCED HOME HEALTH AIDE

For questions and issues, email HHAeXchange at Support@hhaexchange.com.