Healthfirst 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 premier homecare management software solution for the Medicaid Long Term Services & Supports (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 & Healthfirst Partnership

Healthfirst has partnered with HHAeXchange to leverage our homecare management Provider Platform to implement Electronic Visit Verification (EVV) for Personal Care Services (PCS) and Home Health Care Services (HHCS), as part of the approach for the 21st Century Cures Act.

Through the HHAeXchange platform, you will be provided with new member demographic data and authorizations from Healthfirst, with the ability to schedule, confirm, and bill 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.

 

What does the HHAeXchange Portal provide to homecare agencies?

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

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

 

Your Agency’s Options & Onboarding Phase

Phase 1:

Enterprise Free Agencies currently using HHAeXchange’ s EVV tools: You had a free HHAeXchange portal created through completing an enrollment questionnaire for a previous implementation. You will be able to continue using HHAeXchange, utilizing the system’s linked contract functionality. Providers will be implemented with the linked Healthfirst contract in Phase 1. Providers should have received a detailed welcome letter in advance, letting them know which phase they fall under along with the go-live date expectations.

Enterprise Free Agencies currently using another 3rd Party EVV Solution (Existing EDI Providers): You had a free HHAeXchange portal created through completing an enrollment questionnaire for a previous implementation. You will be able to continue using HHAeXchange, utilizing the system’s Healthfirst Linked Contract functionality. Schedule and visit data will be imported from your 3rd party system into HHAeXchange to be billed to Healthfirst. 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 Healthfirst contract in Phase 1.

  • Please click here to view your HHAeXchange & Healthfirst EDI Provider Welcome Packet for Enterprise Free Providers Integrating a 3rd Party EVV solution.

Agencies not currently using HHAeXchange: You will receive a free HHAeXchange Portal as part of this Implementation. Please complete the Provider Portal Enrollment Form 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 existing third party EVV system. Providers will be going live with the linked Healthfirst contract in Phase 1.

  • You will receive a welcome packet upon making an EVV selection and completing a the Provider Enrollment Form. 
 
Phases 2 & 3:

Enterprise Agencies currently using HHAeXchange – You currently pay for the HHAeXchange Full Enterprise platform. With Healthfirst, you will be able to continue using HHAeXchange, utilizing the system’s enhanced Linked Contract functionality. Providers will be implemented with the linked Healthfirst contract in Phases 2 and 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 Milestone Dates for Providers: 

Phase 1 (New/Existing Enterprise Free Providers):

  • Phase 1 Portal Review Webinars: June 1, 2022 & June 7, 2022
  • Phase 1 Info Sessions: Jun 6, 2022 – Jun 16, 2022
  • Phase 1 EDI Webinars: Jun 14, 2022, Jun 23, 2022 & Jun 29, 2022
  • Phase 1 System User Trainings: Jun 27, 2022 – Jul 1, 2022
  • Phase 1 Go Live: Aug 15, 2022

 

Phase 2 (Enterprise Providers):

  • Phase 2 Info Sessions: Jul 26, 2022 – Jul 29, 2022
  • Phase 2 UPR/Linking: Aug 22, 2022 – Aug 31, 2022
  • Phase 2 Go Live: Oct 17, 2022

 

Phase 3 (Enterprise Providers):

  • Phase 3 Info Sessions: Aug 29, 2022 – Sep 2, 2022
  • Phase 3 UPR/Linking: Oct 3, 2022 – Oct 7, 2022
  • Phase 3 Go Live: Nov 14, 2022

 

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, Healthfirst will be implementing HHAeXchange.

 

Phase 1 (New Providers/Existing Enterprise Free/Existing EDI Providers):

The Information Sessions were held for all phase 1 in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The info sessions concluded on June 16, 2022. The recording and slide deck can be found below: 

*Please note that the information session recording refers to a claim denial date of Jan 9, 2023. Healthfirst has since moved the claim denial date forward to Jan 1 2023. 

New Providers

Complete the Healthfirst Provider Portal Enrollment Form . 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. A webinar was held to explain how to complete the Enrollment Form and you can view a recording of this webinar here. 

 

Phase 2 (Existing ENT Providers):

The Information Sessions were held for all phase 2 in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The info sessions concluded on July 29, 2022. The recording and slide deck can be found below: 

 

Phase 3 (Existing ENT Providers):

The Information Sessions were held for all phase 3 in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The info sessions concluded on July 29, 2022. The recording and slide deck can be found below: 

TRAINING TAB

 

Phase 3: Enterprise Providers

These training sessions provide detailed information on how to use the enhanced linked functionality in the HHAeXchange system. Attendance is only required for ONE (1) session as all
provide the same information. The pre-recorded training sessions allow for a Q/A chat option to answer all questions. Click here to Register

 

Phase 2: Enterprise Providers

The Enterprise Provider Training was held for all in scope phase 2 providers and covered the enhanced linked contract functionality in the HHAeXchange system. The webinar sessions concluded on Aug 31, 2022. The recording and slide deck can be found below: 

 

Phase 1: New Providers & Existing Enterprise Free Providers

Learning Management System (LMS)

Jun 22, 2022 – Receive LMS Credentials from the HHAeXchange Onboarding Team and follow instructions to complete the courses and videos on a self-paced format.

  • An email will be sent to the contact that completed the Healthfirst Provider Portal Enrollment Form or the individual who is designated on the HHAeXchange contact form.
  • 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 viewing the videos and materials included. The course will only be completed once the knowledge quiz is taken for each module.
  • Your training for this implementation will only be considered complete once you have passed all the course contained within the Healthfirst training module. 
  • For any questions or concerns, please reach out to Support@hhaexchange.com

System User Training Webinar Week

Complete system user training by attending a series of webinars. The Webinars will provide the opportunity to view the same materials as the LMS courses. In addition, HHAeXchange staff will be available during the webinars to answer your questions live via a Q/A chat feature. 

System User Training has concluded as of July 1, 2022. Please refer to your LMS to access any of the videos shown

 

 

EDI PROCESS

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.

As part of the EDI project, you can continue to use your existing EVV system for scheduling/visit confirmation.  However, you will need to set up an integration to send the confirmed and billed visit data to HHAeXchange to be passed to Healthfirst.

HHAeXchange coordinates directly with Healthfirst to ensure members and 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.

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):

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

Training Opportunities for EDI Providers

EDI Onboarding Webinar 

  • Our EDI Onboarding Webinars have concluded. You can review the EDI Onboarding Webinar material by logging into your LMS account (starting June 22)

EDI Post Integration Training Webinar

  • Our EDI Post Integration Training Webinars have concluded. You can review the EDI Post Integration Training Webinar by logging into your LMS Account (starting June 22).

Please reach out to EDISupport@hhaexchange.com with the subject line “Healthfirst NY Integration” to discuss your next steps or visit the “EDI PROCESS” tab.

BENEFITS

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.
  • Quickly access authorization changes (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, if required.

 

HHAeXchange is the premier Homecare Management Software company for the Medicaid non-skilled Long Term Services & Solutions (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.

Member & Authorization Management

  • Increase census by accepting new cases via Healthfirst 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.

Through the HHAeXchange Portal, Healthfirst is offering free telephony for clock-in and clock-out functionality. 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 Healthfirst 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.

Healthfirst members and authorizations, including new placements, will be provided through the HHAeXchange Portal. Relevant communications will also be sent through the portal.

All claims will be created through the HHAeXchange Portal and sent electronically via an 837 eBilling file.

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

Yes. You will to log into Healthfirst’s Provider Portal to access placements, authorizations, communications, 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 Healthfirst, 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. Please refer to the Training tab on this site for more details. 

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. 

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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
S5130:TV PCS LEVEL I WEEKEND/HOLIDAY
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
T1019:TV PCS LEVEL II WEEKEND/HOLIDAY
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
T1020:TV PCS LEVEL II LIVE-IN WEEKEND/HOLIDAY
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
T1001 HCPCS Code for Nursing assessment/evaluation
T1030 NURSING CARE IN HOME (RN) PER DIEM (13 HOURS)
T1031 NURSING CARE IN HOME (LPN) – PER DIEM (13 HOURS)
S9129 OCCUPATIONAL THERAPY – PER VISIT
S9131 PHYSICAL THERAPY – PER VISIT
S9128 SPEECH THERAPY – PER VISIT
S9470 NUTRITIONAL COUNSELING – PER VISITS
S9127 MEDICAL SOCIAL SERVICES – PER VISIT

 

Healthfirst Direct Contact Information:

For Healthfirst related questions or help, please contact your Healthfirst Account Manager, or the Provider Call Center at 1-888-801-1660. 

 

HHAeXchange:

For questions and support please Contact Us using one of the following options below: 

Providers with an existing HHAeXchange portal please use the HHAeXchange Live Chat within your Support Center to receive assistance from a Live Agent. The Live Chat option is recommended for quicker response times. 

All providers can contact us by phone 1-855-400-4429 or email at Support@hhaexchange.com.