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Humana Virginia Information Center

Provider Portal Questionnaire
  • Humana Virginia Go-Live
    March 3, 2025

Overview

HHAeXchange is designed to support agencies and caregivers in delivering better outcomes. We are excited to work with Providers in Virginia contracted with Humana 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?

  • Payer-sponsored Electronic Visit Verification (EVV) tools
  • Open Model EDI Integration with 3rd Party EVV Vendors
  • Real-time, two-way messaging with each Payer
  • Receive recipient demographics, authorizations, and plan of care electronically
  • Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle

 

Your Agency’s Options

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 Humana Virginia through the HHAeXchange Portal. HHAeXchange will coordinate with you to create an interface to process your existing EVV visits and claims.

Learn About HHAeXchange

Humana Virgina 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 Humana is to fill out the Provider Onboarding Questionnaire 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 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.

Information

Training Schedule

Training Sessions Date Links to Training
Info Session January 2025 Registration Available Soon
Info Session January 2025 Registration Available Soon
EDI Onboarding Coming in 2025 Registration Available Soon
Milestone 1: Portal Set up Coming in 2025 Registration Available Soon
Milestone 2: Payer Contract Coming in 2025 Registration Available Soon
Milestone 3: Payer Data & Scheduling Coming in 2025 Registration Available Soon
Milestone 4: EVV Management Coming in 2025 Registration Available Soon
Milestone 5: Billing Coming in 2025 Registration Available Soon
EDI Milestone 5 – Post Integration Training: Billing Coming in 2025 Registration Available Soon
Open Hours #1 Coming in 2025 Registration Available Soon
Open Hours #2 Coming in 2025 Registration Available Soon
Open Hours #3 Coming in 2025 Registration Available Soon
Open Hours #4 Coming in 2025 Registration Available Soon

 

System Status and Updates

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).

EDI Overview

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 Humana Virginia 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 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 in 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.

The Caregiver Bulk Import Process Guide provides instructions for how to:

  • Access and Save the Caregiver Import Template
  • Prepare the Caregiver import File for your Agency
  • In order for the EDI team to receive your file, go to hhaexchange.com/supportrequest
  • From the Support Portal page, click on 3rd party integration support and submit a caregiver import request.

FAQ

For additional questions about the HHAeXchange software we invite you visit our Knowledge Base

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?

  • Payer-sponsored Electronic Visit Verification (EVV) tools
  • Open Model EDI Integration with 3rd Party EVV Vendors
  • Real-time, two-way messaging with each MCO
  • Intelligent case broadcasting for new referrals / cases
  • Receive recipient demographics, authorizations, and plan of care electronically in real-time
  • Pre-bill scrubbing to ensure clean claims and accelerate revenue cycle

 

How will the payer-sponsored HHAeXchange EVV system work?

Through the HHAeXchange portal, Humana Virginia is offering clock-in and clock-out functionality via mobile app or telephony.

A caregiver can download the free HHAeXchange Mobile App (available for both iPhone and Android users) to clock-in and clock-out, review patient information, and visit information. Agencies can also use HHAeXchange’s free telephony system with a toll-free 800 number to provide to their caregivers.

What if we would like to use HHAeXchange’s payer-sponsored EVV System?

When completing the Provider Onboarding form, select the check box for “I would like to use the payer-sponsored HHAeXchange EVV solution.”

Can I use my own EVV system?

It is simple to connect your existing EVV system to the HHAeXchange portal. Please see the EDI Process page for additional information and whom to contact.

What information will Humana Virginia send to my agency through the HHAeXchange Portal?

Humana Virginia will send member and authorization data through the HHAeXchange portal.

How will the HHAeXchange Portal bill to Humana Virginia?

Claims will be created through the HHAeXchange Portal for verified visits and sent electronically via an 837 e-Billing file to the fiscal agent for adjudication.

Can I check my claims before submitting them to Humana Virginia?

Yes. The HHAeXchange Portal provides a Prebilling Claims module designed to ensure that your claims are compliant with Humana Virginia EVV requirements.

Will I need a Portal for Humana Virginia?

You can link to multiple payers/contracts within one portal.

Can I schedule my caregiver through the HHAeXchange Portal?

Yes. You will be able to schedule your caregivers through the HHAeXchange Portal.

How will I be trained on the HHAeXchange Portal?

Please visit the Training tab.

Can I Import and Export data into the HHAeXchange Portal?

Processes for importing data into the HHAeXchange Portal can be found on the EDI Process tab.

Contact

  • Humana Virginia: For questions that are not related to EVV (e.g., EDI support, claims submissions, provider enrollment) please contact the Agency by calling x-xxx-xxx-xxxx or visit Provider Services on the (insert website)
  • HHAeXchange: All providers can contact us by submitting a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest