HHAeXchange is designed to support agencies and caregivers in delivering better outcomes. We are excited to work with Florida providers to remain compliant with state and federal Electronic Visit Verification (EVV) laws, and ensure a simplified, user-friendly, and seamless experience.
Under Section 12006(a) of the 21st Century Cures Act, states are required to implement EVV for all Medicaid personal care services and home health care services that require an in-home visit by a provider. The EVV system must verify the type of service performed, along with the date, time, and location of the service, as well as the individual receiving and the individual providing the service.
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 are the key benefits of the HHAeXchange Portal to homecare agencies?
To view information on the AHCA Home Health Provider (FFS) solution – select the tab on the left or click here.
To view information on the Florida Managed Care Organizations (MCOs) solution – select the tab on the left or click here.
Option 1, Payer-sponsored HHAeXchange EVV: Our agency wants to use HHAeXchange’s Payer-sponsored EVV system.
Option 2, Use our Current EVV System: Our agency has an existing EVV system that we’d like to keep. It’s simple to connect your existing EVV system to AHCA Home Health FFS or MCOs through the HHAeXchange Portal. HHAeXchange will coordinate with you to create an interface to process your existing EVV visits and claims.
AHCA has contracted with HHAeXchange to implement an Electronic Visit Verification (EVV) system. This system will be used to validate in-home visits for Medicaid recipients and will fully comply with federal regulation. EVV ensures beneficiaries are receiving services as planned and authorized, improves the accountability of caregiver services, and increases claim accuracy for service provided.
The first step in effectively working with AHCA is to fill out the FL HHAeXchange Provider Portal Agency Registration for your organization. Your answers will allow HHAeXchange to configure your agency’s portal. Please note that you only need to fill out the questionnaire once, regardless of how many Florida payers you are contracted with. In addition, if you already have a HHAeXchange provider portal, you do not need to complete the FL HHAeXchange Provider Portal Agency Registration. Your portal will be linked with your contracted payers.
Home Health (HH) Fee-For-Service (FFS) providers participating with the Florida Agency for Health Care Administration (AHCA) officially started using HHAExchange software for Electronic Visit Verification on Tuesday, October 1, 2024.
What happens during a state of emergency?
During a state of emergency AHCA will allow agencies to add new FFS members to HHAeXchange through our provider driven placement process if the member does not have an active provider placement. Providers can deliver care and bill without an authorization for dates of services that fall within the state of emergency.
What is a state of emergency?
A state of emergency is a time period specified by AHCA and requires specific service codes for service delivery and billing. Provider driven placement functionality will be made available during a state of emergency and will only apply to your agency’s FFS members.
What do providers need to do?
Providers need to learn how to add members in HHAeXchange. Review the brief training videos linked below.
Which service codes should providers use?
Providers should use service codes that include with an extension of -SOE for members they are providing services to without an authorization. A complete list of service codes is attached. The list includes service codes with and without the -SOE extension.
Adding a physician’s NPI number to each patient profile is required to support federal Medicaid guidelines. This important step helps ensure the Florida Agency for Health Care Administration (AHCA) complies with Medicaid audit requirements.
What does this mean to providers? Providers using electronic data interchange (EDI), the state-sponsored HHAeXchange system or the HHAeXchange enterprise system must manually add physician information, including their NPI, to each member’s profile in the system.
It’s easy to do. Follow the simple instructions below.
We’ve also put together helpful resources in our Knowledge Base to guide you through the process.
Helpful Resources:
By completing this step, you’ll ensure compliance and keep your billing on track.
HHAeXchange Status (statuspage.io)
For HHAeXchange AHCA Support: providers can submit a ticket via the Client Support Portal at https://www.hhaexchange.com/supportrequest or call 1-646-821-8646 (MCO support not available at this number).
Starting December 1, 2018, Humana and Sunshine Health, Children’s Medical Services, Molina Healthcare and as of April 3rd 2023, Florida Community Care (the “MCOs”) require providers to use HHAeXchange to submit confirmed visits and bill directly to each MCO through the free HHAeXchange Portal.
The first step in effectively working with the MCOs is to fill out the FL HHAeXchange Provider Portal Agency Registration for your organization. The answers from your questionnaire will allow HHAeXchange to configure your agency’s portal. Please note that you only need to fill out the questionnaire once, regardless of how many MCOs you are contracted with or if you are contracted with AHCA. In addition, if you already have a HHAeXchange provider portal, you do not need to complete the FL HHAeXchange Provider Portal Agency Registration. Your portal will be linked with your contracted payers.
Information Sessions were held for all in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The recording and slide deck can be found below:
Florida Community Care Recording | Slides
Provider Information Sessions (English) HHAeXchange Provider Information Session (60 min) VIDEO | SLIDES
MCO Provider Information Presentations:
Provider Information Sessions (Spanish) HHAeXchange Provider Information Session (45 min) VIDEO | SLIDES
Use the Learning Management System (LMS):
For any questions or concerns, all providers can visit the Support Center or use our Client Support Portal to find answers to questions and create support requests.
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 to take to successfully integrate your Agency Management System with HHAeXchange.
HHAeXchange coordinates directly with AHCA Home Health FFS and the Managed Care Organizations (MCOs) 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):
EDI Provider Rebilling Job Aid: This job aid provides guidance to the various rebilling scenarios for EDI Providers. This aid can also be found in the provider portal resources page in the HHAeXchange support center.
(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.
The Caregiver Bulk Import Process Guide provides instructions for how to:
CLICK HERE to access the HHAeXchange Provider System FAQ Document (check back often for updates to this document).
What is HHAeXchange?
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.
What are the benefits of the HHAeXchange Portal?
What if we’d like to use HHAeXchange’s Payer-sponsored EVV System?
Great! If you’d like to use HHAeXchange’s Payer-sponsored EVV system ensure that you’ve completed the FL HHAeXchange Provider Portal Agency Registration . The contact person listed in your response will be contacted by HHAeXchange to set up your agency for EVV.
What if we have an EVV System that we’d like to keep?
It’s simple to connect your existing EVV system to AHCA or the MCOs through the HHAeXchange Portal. Ensure that you’ve completed the FL HHAeXchange Provider Portal Agency Registration , and the HHAeXchange Integrations Team will coordinate with you to create an interface to process your existing EVV visits and claims. EDI Process Guides can be found in the EDI Process tab, above.
What information will AHCA or the MCOs send to my agency through the HHAeXchange Portal?
The AHCA or the MCOs will send placements, authorizations, plan of care, and all communication through the HHAeXchange Portal. MCOs may send additional information as they deem necessary.
How will my agency bill to AHCA or the MCOs?
All claims will be created through the HHAeXchange Portal and sent electronically via an 837 e-Billing file. Agencies will then receive an 835 eRemittance file back into the HHAeXchange Portal.
Can I check my claims before submitting them to AHCA or each MCO?
Yes. The HHAeXchange Portal provides a Pre-billing Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and Payer contract.
Will I need a separate Portal for AHCA or each MCO?
No. You’ll only need one Portal to connect to ACHA, Humana, Staywell, and Sunshine Health for placements, authorizations, communication, and billing.
Can I schedule my caregivers 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 the payer, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.
How will I be trained on the HHAeXchange Portal?
Please see the User Training tab, above.
Can I Import and Export data into the HHAeXchange Portal?
Please see the EDI Process tab, above.