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New Jersey DMAHS-Personal Care Services

Provider Portal Questionnaire

Bringing the 21st Century Cures Act across New Jersey

*Please note, if you are looking for Information regarding Phase 2 and Home Health within New Jersey, please visit the New Jersey Home Health Information Center Page

New Jersey DMAHS has partnered with HHAeXchange as their EVV Aggregation solution to ensure the provider community complies with the Cures Act Mandate requirements. The HHAeXchange solution will focus on collecting and reporting EVV compliant data for all personal care services for the New Jersey Family Care program. As part of the New Jersey Family Care EVV program initiative, we will need to gather more information from your provider agency.

The first step will be to fill out the New Jersey Family Care program Provider Portal Survey found below.

Provider Portal Questionnaire

Selecting an EVV solution that fits your provider agency

This questionnaire is designed to capture information about your provider agency necessary for New Jersey DMAHS and New Jersey Managed Care Organizations (MCOs), as part of the effort to implement methods of collecting and reporting EVV compliant data for all personal care services.

We understand that each MCO has offered their own solution to participating providers and you may already have an enterprise EVV solution in place  to help you be compliant. In connection with all New Jersey MCOs and the New Jersey Family Care program, this survey will allow us to understand your choice for EVV data collection and provide the best viable option for your agency. Below you will find more information on each method of EVV data collection.

Your provider agency plays a vital role in the success of our EVV program.  As part of your participation with New Jersey Family Care, you have multiple options provided to you to ensure EVV compliance:

  • Option 1 – Use your existing EVV system or a system you intend to implement by January 1 to collect and report to each plan and/or to DMAHS
  • Option 2 – Use Free EVV tools provided by each Health Plan (HHAeXchange for WellCare, Aetna, UHC* and Fee-for-Service members; CareBridge for Horizon and Amerigroup members) *pending finalization of SOW and risk assessment
  • Option 3 – Use the Free EVV tools provided by DMAHS (HHAeXchange) to collect and report visit data for all members regardless of Health Plan or Fee-for-Service.

Important Updates

Provider Information Sessions below:

  • Go-Live date for all Providers: December 14th, 2020
  • EVV Mandate for Personal Care Services: January 1, 2021

Important Rate Change Information on behalf of NJ DMAHS: Effective January 1, 2022 as per the State of NJ Dept of Human Services Newsletter, rates paid to Personal Care Assistant (PCA) Provider agencies will increase by $1.00, from an hourly rate of $22.00 to $23.00. Please ensure you update the rates in the HHAX Provider Portal to reflect the rate change as of January 1, 2022.

To enter the new rates:

  • Go to Admin> Contract Setup > Search Contract
  • Search and select the desired Payer Contract Name
  • Select the Billing Rates tab
  • Click the Edit link, update the To Date for the current rate to 12/31/2021, and click Save
  • Click the New Rate button, and add the new PCA Discipline Rate for each Service Code impacted (entering a From Date of 1/1/2022)
    • *Please NoteDo not select the “Update Rate” button!

The appropriate rate will be applied to the service performed based on the date of service.

For any additional questions please contact HHAX Client Support by submitting a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest

HHAeXchange Overview (applicable to ALL 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 October 2020.

Please Note: The provider go-live has been extended to December 14th, 2020 for all providers. Please disregard the old dates mentioned in the pre-recorded webinar and review the updated dates in the Welcome Packets on the “Overview” page. HHAeXchange EDI Session (applicable only to EDI providers with their own third party EVV system) For Providers that want to integrate with HHeXchange, an EDI Information Session was held to provide more information about key next steps in regards to your EDI Integration.  Please refer to the links below to access videos and presentations from the EDI Info Sessions, held via webinar in October 2020.

Please Note: The provider go-live has been extended to December 14th, 2020 for all providers. Please disregard the old dates mentioned in the pre-recorded webinar and review the updated dates in the Welcome Packets on the “Overview” page.

If you chose Option 3 on the survey – (I want to use the free HHAeXchange EVV solution for all New Jersey Payers), below are some of the benefits you will see by utilizing our solution:

EVV

  • Member Managament for NJ FFS & 5 MCOs
  • Clock-In / Clock-Out Exception Dashboard
  • Submission / Aggregation of EVV Data to NJ FFS & 5 MCOs
  • Mobile Application in Multiple Languages
  • Telephony Lines in English and Spanish

Scheduling

  • Master Week Scheduling
  • Case & Scheduling Coordination
  • Plan of Care Management for NJ FFS, Aetna, United, and Wellcare

Communication

  • Real-Time Two-Way Messaging with NJ FFS, Aetna, United, and Wellcare

Billing

  • Prebilling Claims Scrubbing
  • eBilling (837) / eRemittance (835) for NJ FFS, Aetna, United, and Wellcare

Compliance

  • Automatic Authorization Receipt from NJ FFS, Aetna, United, and Wellcare
  • Manual Authorization Input for Amerigroup and Horizon
  • Plan of Care Adherence
  • Visit Confirmation Compliance
  • Visit reporting to Horizon and Amerigroup

Upcoming Webinars

Please Click Here for Additional Training Webinars.

Recorded Webinars

A Day in the Life of an EDI-Integrated Provider (60 min): VIDEO

Navigating EVV (31 min): VIDEO | SLIDES

NJ CareBridge Integration (26 min): VIDEO | SLIDES

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

HHAeXchange User Training Video:

Ready to get started with training? HHAeXchange offers self-paced training, providing agencies with access to videos produced by our Subject Matter Experts. These videos help you and your staff understand how to use the HHAeXchange Provider Portal and its functionalities.

This training is required to ensure you have a clear understanding of the features available in the HHAeXchange Provider Portal.

Access Minnesota-specific training videos here: | Access the videos

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. NJ DMAHS ENT Provider Training:  | Slides | Recording | UPR Guide |

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. 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. Note, this process applies specifically for providers that chose option 1, found on the “Overview” tab above. Below you will find information about the general requirements and steps to take to successfully integrate your 3rd Agency Management System with HHAeXchange. To integrate between your 3rd Party Agency Management System and HHAX, providers will be required to comply with both the business requirements and technical specifications listed below. Upon review of the documents below, please initiate contact with HHAX to begin the integration process Initial steps EDI providers should follow:

Click here to review the detailed FAQ document in regard to the NJ DMAHS Implementation which will provide you with more insight on the program, patient placement, billing, EVV, Communications, as well as EDI and other functionalities.

What is HHAeXchange?

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.

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

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

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

Through the HHAeXchange Portal, New Jersey DMAHS is offering free telephony for clock-in and clock-out functionality, including capturing completed plan of care duties. Each agency who has indicated they’d like to use HHAeXchange’s free EVV system will be set up with a toll-free 800 number to provide to their caregivers. A caregiver will also be given the option to download the free HHAeXchange Mobile App available for both iPhone and Android users that can be used to clock-in and clock-out, review patient information and visit information.

How will the free HHAeXchange EVV System work?

Through the HHAeXchange Portal, New Jersey DMAHS is offering free telephony for clock-in and clock-out functionality, including capturing completed plan of care duties. Each agency who has indicated they’d like to use HHAeXchange’s free EVV system will be set up with a toll-free 800 number to provide to their caregivers. A caregiver will also be given the option to download the free HHAeXchange Mobile App available for both iPhone and Android users that can be used to clock-in and clock-out, review patient information and visit information.

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

It is simple to connect your existing EVV system with your payer(s), through the HHAeXchange Portal. Ensure that you’ve completed the survey, and review the EDI welcome packet. Upon reviewing the welcome packet, please submit a ticket to the HHAX EDI support email at: [email protected] with the subject ‘NJ EVV’. The HHAeXchange Integrations Team will coordinate with you to create an interface to process for your existing EVV visits. If my payer(s) plans to utilize or is currently utilizing the HHAeXchange portal, what information will my payer(s) send to my agency through the HHAeXchange Portal? Your payer(s) will be sending new placements, authorizations, and all communications through the HHAeXchange Portal. Additional information may be sent as deemed necessary by the payer.

How will the HHAeXchange Portal bill payer(s)?

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.

Can I check my claims before submitting them to the payer through 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 payer contract.

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?

The person within your organization that filled out the survey will receive more information to identify super users and for training planning.

Can I import and export data into the HHAeXchange Portal?

Processes for importing and exporting data from the HHAeXchange Portal can be found on this page under the “EDI PROCESS” tab.

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

  • Personal Care Assistance_15M (T1019)
  • Personal Care Assistance Group (T1019_HQ)
  • Personal Care Assistance_PD (T1020)
  • Personal Care Assistance (Self Directed) Individual (T1019_SE)
  • Personal Care Assistance (Self Directed) Individual – Agency (T1019_SE_UI)
  • Personal Care Service per 15 min, rural/outside providers’ customary service area (T1019_TN)
  • Personal Care Assistance Group (Self Directed) Group (S5125_SE_HQ)
  • Personal Care Assistance (Self Directed) Group – Agency (S5125_SE_U3)
  • DDD Individual Supports (H2016HI)
  • DDD Individual Supports (H2016HI22)
  • DDD Individual Supports (H2016HIU8)
  • DDD In Home Respite (T1005HI)
  • DDD In Home Respite (T1005HIU8)
  • DDD Community Based Supports (H2021HI)
  • DDD Community Based Supports (H2021HI22)
  • DDD Community Based Supports (H2021HI52)
  • MLTSS Home Based Supportive Care (S5130)
  • MLTSS Home Based Supportive Care – Self Directed (S5130_HQ)
  • MLTSS In Home Respite (T1005)
  • All providers can use our Client Support Portal to find answers to questions and create support requests. Please submit a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest