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HHAeXchange & Fidelis Care Partnership

Fidelis Care has partnered with HHAeXchange to leverage our platform to implement Electronic Visit Verification (EVV) for Personal Care Services, as part of the approach for the 21st Century Cures Act.

Through the HHAeXchange platform you will be able to receive new members and authorizations from Fidelis Care, as well as schedule and confirm visits for those members.

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.

About Fidelis Care

Fidelis Care is proud to provide affordable, quality health insurance plans to over 2.3 million New Yorkers of all ages and stages of life. More than 20 community offices throughout New York State allow Fidelis to serve members at the local level. For more information, follow Fidelis Care on Twitter.

What does the HHAeXchange Portal provide to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to Fidelis Care for:

  • Electronic case placement, authorizations, plan of care management and entering confirmed visits
  • Free EVV solution for time & attendance and duty tracking
  • Electronic billing along with pre-billing review

Your Agency’s Options:

Agencies currently using HHAeXchange: You will be able to continue using HHAeXchange, utilizing the system’s Linked Contract functionality. Please review your implementation milestones and timeline by clicking on the welcome packet link below:

Enterprise Providers: Full Platform- Welcome Packet

Enterprise Providers: Free EVV Tools- Welcome Packet

Agencies currently using another 3rd Party EVV Solution: 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. Please review your implementation milestones and timeline by clicking on the welcome packet link below:

Existing EDI Providers- Welcome Packet

Agencies not currently using HHAeXchange: You will receive an HHAeXchange Portal in order to receive authorizations and submit claims/invoice data. Please review your implementation milestones and timeline by clicking on the welcome packet link below:

New Providers: Please select the Welcome Packet based on your provider survey EVV selection. If you did not submit the provider portal questionnaire please click here to complete.

New Provider Free EVV- Welcome Packet

New Provider EDI- Welcome Packet 

Important Dates

Provider Information Sessions- Please review Info Session tab for more details 

System User Training Sessions – Please refer to “Training” tab for more details

Enhanced Linked Training Sessions – Please refer to “Training” tab for more details

Go-Live dates for all Providers: December 20, 2021

Claim Denial Date: February 14, 2022

Contact Fidelis Care

Phone Number – 1-888-343-3547

Mailing Address – Member Services Department, Fidelis Care, 25-01 Jackson Avenue, Long Island City, NY 11101

Location and Hours – Find a community office near you.

The Cures Act Mandate requires all visits for personal care services to be timestamped via an electronic verification method utilizing EVV tools to record the member, caregiver, location of the service, date of the service and the type of service performed. To ensure EVV data is being accurately captured, Fidelis Care will be implementing HHAeXchange. An Information Session was held for all providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. 

**Please note that we received word from Fidelis Care that they will now be utilizing the payer communications module within HHAeXchange. This is a change from what was communicated initially to providers in our information sessions.**

**Please note HHAeXchange and Fidelis Care have decided to extend the date for member and authorization data to be loaded into HHAeXchange to December 13, 2021. As a result, the go live date will now be Monday December 20, 2021.**

New Providers: Please note that any new provider who does not currently have an HHAeXchange Portal will need to complete the HHAeXchange Provider Portal Questionnaire. This questionnaire will gather necessary information for HHAeXchange to configure your provider portal and allow you to select whether you want to use free HHAeXchange EVV tools or use your existing EVV system.

To assist new providers in successfully completing this questionnaire, Fidelis Care and HHAeXchange held a joint meeting to explain the information being gathered and guide providers through completing the Survey. Please review the recording of this webinar and slide deck attached below:

**Please note HHAeXchange and Fidelis Care have decided to extend the date for member and authorization data to be loaded into HHAeXchange to December 13, 2021. As a result, the go live date will now be Monday December 20, 2021.**

Ease of billing

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

Member & Authorization Management

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

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.

Upcoming Training Webinars

Please Click Here for Additional Training Webinars

Recorded Webinars

EDI Provider Training This training was held on April 24, 2023 and covered training and instruction on 3rd party EVV integration processes.

Recording | Slides

Linked Provider Portal Training This training was held on April 24, 2023 and covered training and instruction on linked payer workflows.

Recording | Slides

Please visit the Provider Portal Resource Page in the HHAeXchange System Support Center to view additional previously recorded webinars

New Providers: 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.

Use the Learning Management System (LMS)

New Providers & Existing EVV Providers:

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 Fidelis Care 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, all providers can use our Client Support Portal to find answers to questions and create support requests.

Existing Enterprise Providers: Enhanced Linked Contract Experience

Fidelis Care has partnered with HHAeXchange to implement the Professional Platform and Linked Contract Functionality by 12/13/2021. 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.

Fidelis Care ENT Provider Training: Slides Recording | UPR Guide

**Please note HHAeXchange and Fidelis Care have decided to extend the date for member and authorization data to be loaded into HHAeXchange to December 13, 2021. As a result, the go live date will now be Monday December 20, 2021.**

New & Existing EDI Providers

For providers using 3rd party EVV system outside of HHAeXchange, please attend one EDI provider onboarding webinar session and one Post Integration Training. The Onboarding Webinar provides an understanding of the HHAeXchange Provider Portal and the EDI integration process. The Post Integration Training Session assists our Providers with post go-live review of EDI processes in the HHAeXchange System.

EDI Onboarding Webinar

  • Our EDI Onboarding Webinars were concluded in November 2021. You can review the EDI Onboarding Webinar material anytime by logging into your LMS account.

EDI Post Integration Training Webinar

  • Our EDI Post Integration Training Webinars were concluded in December 2021. You can review the EDI Onboarding Webinar material anytime by logging into your LMS account.

If you need assistance with the next steps for integration, please visit the EDI process tab for further instructions.

**Please note HHAeXchange and Fidelis Care have decided to extend the date for member and authorization data to be loaded into HHAeXchange to December 13, 2021. As a result, the go live date will now be Monday December 20, 2021.**

EDI Provider Resources

EDI Provider Rebilling Job Aid: This job aid provides guidance to the various rebilling scenarios for EDI Providers. This aid can also be found on the provider portal resources page in the HHAeXchange support center.

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
  • Please follow these instructions in order for the EDI team to receive your file. Go to hhaexchange.com/supportrequest, from the support portal page please click on 3rd party integration support and submit a caregiver import request.

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 Fidelis Care 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 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):

Training Opportunities for EDI Providers

EDI Onboarding Webinar

  • Our EDI Onboarding Webinars concluded on Nov 17th, 2021. You can review the EDI Onboarding Webinar material anytime by logging into your LMS account.

EDI Post Integration Training Webinar

  • Our EDI Post Integration Training Webinars were concluded in December 2021. You can review the EDI Onboarding Webinar material anytime by logging into your LMS account.

To contact our EDI team please submit a 3rd party integration support request and include the name of Fidelis Care.

**Please note HHAeXchange and Fidelis Care have decided to extend the date for member and authorization data to be loaded into HHAeXchange to December 13, 2021. As a result, the go-live date will now be Monday, December 20, 2021.**

How will the free HHAeXchange EVV system work?

Through the HHAeXchange Portal, Fidelis Care 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.

What is HHAeXchange?

HHAeXchange is the premier 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.

What are the benefits of 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.

Member & Authorization Management

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

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.

What if we would like to use HHAeXchange’s free EVV System?

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.

What if we have an EVV System that we would like to keep?

It is simple to connect your existing EVV system to Fidelis Care 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.

What information will Fidelis Care send to my agency through the HHAeXchange Portal?

Fidelis Care will be sending new placements, including members and authorizations, through the HHAeXchange Portal. Fidelis Care will also send communications via the Message Center. Fidelis Care may send additional information as they deem necessary.

How will the HHAeXchange Portal bill to Fidelis Care?

All claims will be created through the HHAeXchange Portal and sent electronically via an 837 eBilling file. Once the claim is received by Fidelis, a standard adjudication process will follow.

Can I check my claims before submitting them to Fidelis Care?

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

Will I need a Portal for Fidelis Care?

Yes. You will need a Portal to connect to Fidelis Care for placements, authorizations, and billing.

Can I schedule my caregiver through the HHAeXchange Portal?

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

What are my options as a provider for using HHAeXchange with Fidelis?

There are three options for using the HHAeXchange portal to ensure EVV compliance with Fidelis:

  1. Providers with an HHAX Enterprise Portal will continue to use your existing portal for EVV on the Enhanced Linked Contract functionality with Fidelis.
  2. Providers with a Third-Party EVV (EDI) Portal will continue to use your existing EVV portal and integrate with the HHAX portal to import confirmed and billed visits.
  3. Providers with an HHAX Free EVV Portal will use your HHAX portal for EVV and billing to Fidelis.

How will I be trained on the HHAeXchange Portal?

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.

Can I Import and Export data into the HHAeXchange Portal?

Processes for importing and exporting data from the HHAeXchange Portal can be found on the “EDI Process” tab

What do I do if my claims submitted through HHAeXchange have not reached Fidelis?

First, confirm that your invoices were successfully exported from HHAeXchange (the visits have passed the Prebilling and Billing Review validation checks and the invoice is in a Billed status). Second, check the claim status of the visit from the HHAX portal (Billing > Invoice Search > By Visit). If an ‘accepted’ response has not been received, then use our Client Support Portal for investigation of the claim status.

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

Service Code                            Description

S5130:U1 PCS Level I – 15 Minutes
S5130:U2 PCS Level I Two Client
S5130:U3 PCS Level I Multiple Client
T1019:U1 PCS Level II Basic – 15 Minutes
T1019:U2 PCS Level II Basic Two Client
T1019:U3 PCS Level II Multiple Client
T1019:U4 PCS Level II Hard to Serve
T1019:U5 PCS Level II Two Client Hard to Serve
T1020 PCS Level II Live In
T1020:U2 PCS Level II Live in Two Client
T1020:U5 PCS Level II Live in Two Client Hard to Serve
T1019:U6 CDPA Basic – 15 Minutes
T1019:U8 CDPA Enhanced
T1019:U7 CDPA Two Consumer
T1019:U9 CDPA Two Consumer Enhanced
T1020:U6 CDPA Live in
T1020:U8 CDPA Live in Enhanced
T1020:U7 CDPA Live in Two Consumer
T1020:U9 CDPA Live in Two Consumer Enhanced
S5125 HHA – 15 minutes
S9122 HHA
S5125:U2 HHA Two Client
S5126 HHA – Live in
S5126:U2 HHA Live in Two Client
S9122:U1 Advanced Home Health Aide

Fidelis Direct Contact Information:

Contact your Fidelis Care Provider Relations Specialist

Provider Call Center: 1-888-FIDELIS (1-888-343-3547)

HHAeXchange:

All providers can use our Client Support Portal to find answers to questions and create support requests.