Backdrop 5 1

North Carolina Tailored Plans Provider Information Center

Provider Portal Questionnaire

Simple Claims Billing and EVV Implementation

Alliance Health, Trillium Health Resources, Vaya Health, and Partners – have partnered with HHAeXchange to provide a free Electronic Visit Verification (EVV) and billing tool for member placement, scheduling, authorization management, communication, and direct billing for Home Health Aide services.

What does the HHAeXchange Portal provide to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to your contracted Tailored Plans for:

  • Electronic case broadcasting, authorizations, plan of care management and entering confirmed visits
  • Real-time two-way messaging with the Tailored Plans
  • Free EVV solution for time & attendance and duty tracking
  • Electronic billing

Your Agency’s Billing Options

Option 1: Our agency wants to use HHAeXchange’s provider portal network which is provided at no cost. Great! If you’ve indicated that you’d like to use HHAeXchange’s EVV the contact person listed on your survey will receive more information in the coming weeks, upload caregivers into the HHAeXchange Portal and begin processing EVV and claims.

Option 2: Our agency has an existing EVV system that we’d like to keep. It’s simple to connect your existing EVV system to your contract Tailored Plans 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.

Important dates

  • Billing Mandate Go-Live: Providers servicing Personal Care Services are required to bill out of HHAeXchange beginning July 1, 2024
  • Home Health Services Go-Live: July 1, 2024

Please refer to the recent NC EVV Survey Bulletin looking to gather more information on 2024 services

Simple Claims Billing and EVV Implementation

Alliance Health, Trillium Health Resources, Vaya Health, and Partners – have partnered with HHAeXchange to provide a free Electronic Visit Verification (EVV) and billing tool for member placement, scheduling, authorization management, communication, and direct billing for Home Health Aide services.

Your Agency’s Billing Options

Option 1: Our agency wants to use HHAeXchange’s provider portal network which is provided at no cost. Great! If you’ve indicated that you’d like to use HHAeXchange’s EVV the contact person listed on your survey will receive more information in the coming weeks, upload caregivers into the HHAeXchange Portal and begin processing EVV and claims.

Option 2: Our agency has an existing EVV system that we’d like to keep. It’s simple to connect your existing EVV system to your contract LME(s) 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.

Information Sessions

Upon completion of the Provider Portal Survey, please review the record information session video and slide deck found below. These sessions provide a high-level introduction to the HHAeXchange System (including system demos)

PRE-GO LIVE WEBINAR RECORDINGS

In addition, if you missed the provider Pre-Go Live webinar, please review the recorded video and slide deck found below. The webinar will include a recap of all the completed steps and details needed to ensure EVV compliance by go-live, along with answering questions submitted through the questionnaire.

Training

*To access any of the training recordings viewed during a live webinar, please login to your LMS account to access those recordings.

Pre-Go Live Training Webinars

Pre-go live webinars allow providers to review the details needed to ensure EVV compliance come go-live. The webinar will provide a recap on all the completed steps including an overview of the billing process in the HHAeXchange system.

  • Please Click Here to view the Pre-Go live Training Webinar held June 2021.

EDI Provider Integration Training Webinars

This webinar will provide high-level detailed information of the EDI Process along with the core next steps on how to work in the HHAeXchange system for integrated providers.

  • Please Click Here to view the EDI Provider: Post Integration Webinar held June 2021

Additional Training Webinars

Please Click Here for Additional Training Webinars.

Recorded Webinars

Provider-Managed Billing Dx Codes (14 min): VIDEO | SLIDES

North Carolina System Functionality Refresher Training (1:03 min): VIDEO | SLIDES

North Carolina Medicaid Direct FFS Overview (41 min): VIDEO | SLIDES

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

Services in Scope

Please see below all the provider services in scope for this implementation.

Service Code Description
H2022 U4 Transitional Living Skills
H2022 U4 CR Transitional Living Adolescents and Adults
H2022 U4 GT CR Transitional Living Adolescents and Adults
S5125 Personal Care
T1015 In Home Intensive
T1019 U4 Individual Support
T1019 U4 CR Individual Support
T1019 U4 DJ Individual Supports
T1019 U4 EP Individual Supports – EPSDT
T1019 U4 GT CR Individual Support
T2013 Life Skills Training – Individual and Group
T2013 TFU4 Community Living and Supports
T2013 GT CR In-Home Skill Building – Individual
T2013 HQ In-Home Skill Building – Group
T2013 HQ GT CR In-Home Skill Building – Group
T2013 HQ U4 In-Home Skill Building – Group
T2013 TF Community Living and Supports
T2013 TF CR Community Living and Supports – catastrophe/disaster
T2013 TF EQ Community Living and Supports – Empl of Rec
T2013 TF FL Community Living and Supports – Individual
T2013 TF GT CR Community Living and Supports
T2013 TF HQ Community Living and Supports – Group
T2013 TF HQ FL Community Living and Supports – Group
T2013 TF HQ CR XU Community Living and Supports – Group
T2013 TF HQ EO Community Living and Supports Group/Empl of Rec
T2013 TF HQ GT CR Community Living and Supports – Group
T2013 TF HQ U4 Community Living and Supports – Group
T2013 TF HQ U4 Life Skills Training – Individual
T2013 TF HQ U5 Community Living and Supports
T2013 TF U4 In Home Skill Building
T2013 TF U5 Life Skills Training – Individual
T2013 U4 In-Home Skill Building
T2013 U4 CR In-Home Skill Building – Individual
T2013 U4 GT CR In-Home Skill Building – Individual
T2013 U4 TF Community Living and Supports – B3 DI
T2013 U4 TF HQ Community Living and Supports – Group B3 DI
T2013 UF In-Home Skill Building
T2033 U1 Supported Living Periodic
T2033 U1 CR XU Supported Living Periodic
T2033 U1 FL Supported Living Periodic
T2033 U1 U4 Supported Living Periodic

 

Ease of billing

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

Efficient communication

  • Reduce payer communication time with realtime, 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.

Download the HHAeXchange Portal Benefits

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. 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 your contracted MCO 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 the HHAeXchange, you will need to create the EDI files corresponding to the HHAeXchange specifications found in the following documentation (links below):

Please open each link and save each guide for your records.

EDI Provider Integration Training Webinars for Personal Care Services

This webinar will provide high-level detailed information of the EDI Process along with the core next steps on how to work in the HHAeXchange system for integrated providers.

  • Please Click Here to view the EDI Provider: Post Integration Webinar

EDI Provider Job Aids

Click here to review the detailed FAQ document in regard to the North Carolina Tailored Plans 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

How will the free HHAeXchange EVV System work?

Through the HHAeXchange Portal, your MCO 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 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 your contracted MCO 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 my contracted MCO send to my agency through the HHAeXchange Portal?

They will be sending new placements, authorizations, and all communication through the HHAeXchange Portal. Your MCO may send additional information as they deem necessary.

How will the HHAeXchange Portal bill to the contracted MCO?

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 each contracted MCO?

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

Will I need a separate Portal for each contracted MCO?

No. You will only need one Portal to connect to all MCO(s) 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 contracted MCO, 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. The user who completed the survey will receive the Learning Management System (LMS) credentials for self-paced videos and also webinar details with 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.

Provider Services in Scope:

Please see below all the provider services in scope for this implementation.

Service Code Description
H2022 U4 Transitional Living Skills
H2022 U4 CR Transitional Living Adolescents and Adults
H2022 U4 GT CR Transitional Living Adolescents and Adults
S5125 Personal Care
T1015 In Home Intensive
T1019 U4 Individual Support
T1019 U4 CR Individual Support
T1019 U4 DJ Individual Supports
T1019 U4 EP Individual Supports – EPSDT
T1019 U4 GT CR Individual Support
T2013 Life Skills Training – Individual and Group
T2013 TFU4 Community Living and Supports
T2013 GT CR In-Home Skill Building – Individual
T2013 HQ In-Home Skill Building – Group
T2013 HQ GT CR In-Home Skill Building – Group
T2013 HQ U4 In-Home Skill Building – Group
T2013 TF Community Living and Supports
T2013 TF CR Community Living and Supports – catastrophe/disaster
T2013 TF EQ Community Living and Supports – Empl of Rec
T2013 TF FL Community Living and Supports – Individual
T2013 TF GT CR Community Living and Supports
T2013 TF HQ Community Living and Supports – Group
T2013 TF HQ FL Community Living and Supports – Group
T2013 TF HQ CR XU Community Living and Supports – Group
T2013 TF HQ EO Community Living and Supports Group/Empl of Rec
T2013 TF HQ GT CR Community Living and Supports – Group
T2013 TF HQ U4 Community Living and Supports – Group
T2013 TF HQ U4 Life Skills Training – Individual
T2013 TF HQ U5 Community Living and Supports
T2013 TF U4 In Home Skill Building
T2013 TF U5 Life Skills Training – Individual
T2013 U4 In-Home Skill Building
T2013 U4 CR In-Home Skill Building – Individual
T2013 U4 GT CR In-Home Skill Building – Individual
T2013 U4 TF Community Living and Supports – B3 DI
T2013 U4 TF HQ Community Living and Supports – Group B3 DI
T2013 UF In-Home Skill Building
T2033 U1 Supported Living Periodic
T2033 U1 CR XU Supported Living Periodic
T2033 U1 FL Supported Living Periodic
T2033 U1 U4 Supported Living Periodic

 

For questions and issues please contact us by submitting a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest