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Oklahoma Information Center

Provider Onboarding Form
  • MCO Provider Go Live
    November 4, 2024

Electronic Visit Verification Solution for Oklahoma Managed Care Organizations (MCOs)

Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma have partnered with HHAeXchange to implement an Electronic Visit Verification (EVV) system to validate in-home visits for Medicaid recipients. This will bring payers and agencies into compliance with federal regulation, ensure beneficiaries are receiving services as planned and authorized, improve the accountability of caregiver services; and ensure payment accuracy for services provided. HHAeXchange features tools for scheduling, authorization management, and communication with the Oklahoma MCOs.

Take the First Step: Complete the Provider Onboarding Form

All agencies are required to complete the Provider Onboarding form as it captures information necessary to notify us of your EVV selection and configure your portal.

Select an EVV option that fits your Agency

As part of your participation with Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma you have the following options to ensure EVV compliance:

  • Option 1 – You may choose to use the Payer-Sponsored HHAeXchange solution at no cost.
  • Option 2 – You may choose to use another EVV Solution that integrates with HHAeXchange.

Regardless of the EVV solution selected, all impacted providers are required to complete the HHAeXchange Provider Onboarding Form.

After submitting the Provider Onboarding Form:

Please click HERE for more information about what to expect going forward.

Service Codes in Scope

The table below provides information about the service codes and modifier combinations for in-scope services for the November 1, 2024, go live. Placements for some service codes are payer managed while others are managed by the provider. 

  • Payer Managed Placement – The payer sends a member to an agency via HHAeXchange.
  • Provider Managed Placement – The agency sends the member to the payer in HHAeXchange.
Service Code (HCPCS Code) Description Placement Workflow
T1000 Private duty nursing Payer Managed
T1000:TU PDN Overtime Payer Managed
T1001 Nursing Assessment Evaluation Payer Managed
T1019 Personal care services Payer Managed
551 Skilled Nurse Visit Provider Managed
571 Home Health Aide/Visit Provider Managed
G0299 DIRECT SKILLED NURSING SERVICES OF A REGISTERED NURSE (RN) IN THE HOME HEALTH OR HOSPICE SETTING Payer Managed

Master HHAeXchange at Your Own Pace

Starting a new software can be exciting and challenging. Our goal is to make the transition to the HHAeXchange system for Electronic Visit Verification (EVV) as smooth as possible for your agency.

We developed self-paced training modules to help you master key concepts and tools at your own pace.  Training milestones begin with setting up your portal and run all the way through the steps needed to successfully bill in HHAeXchange. You can revisit these materials whenever you need to ensure you are fully prepared.

You will also have the opportunity to get your questions answered at one of the Oklahoma Open Hours Sessions. Subject matter experts will address questions in real time. You can join a session, ask your questions, stay for the entire time or come and go as you please. Sessions will be held in November and December. Keep an eye out for upcoming dates.

We need to know about your agency in order to provide the correct training plan. Be sure to submit the Oklahoma Provider Portal Registration Form so we can create your portal and get you started with training.

 

Providers Using the State Sponsored Software

Click the links below to access your self-paced training modules

 

Providers Using Electronic Data Interchange

Information is coming soon! Keep an eye on your email and this web page for training milestones.

 

All Providers

Open Hours offer a great opportunity to get your questions answered by subject matter experts in real time. All providers are welcome. You can join an open hours session, ask your question, receive an answer, and leave the webinar so you can continue on with your day. Registration is required.

Four dates are available:

  • Monday, November 11 – 1PM to 2PM EST
  • Tuesday, November 19 – 1PM to 2PM EST
  • Tuesday, December 3 – 1PM to 2PM EST
  • Thursday, December 17 – 9AM to 10AM EST

Click Here to Register.

 

Electronic Data Interchange (EDI) Overview (Integrating with a 3rd Party Agency Management System)

This overview is geared towards providers who will be using their own EVV solution and not the payer sponsored EVV solution. If you have your own EVV vendor, in HHAeXchange’s system the vendor will be referred to as an EDI vendor. The information below lists the general requirements and steps to successfully integrate a 3rd Party Agency Management System with HHAeXchange. Electronic Data Interchange (EDI) Providers will be required to comply with both the HHAeXchange Technical Specifications and Business Requirements listed below. After reviewing the specifications and requirements resources, please initiate contact HHAeXchange to begin the integration process.

  1. It is critical to complete the Third Party EVV Attestation Form to begin the process: Attestation Form
  2. Please click here for the Technical Specification document: EDI Technical Specifications 
  3. Please click here for the Business Requirements document: Business Requirements
  4. Please click here for the Authorization Specification: Web Service API Guide 
  5. Submit a ticket to HHAX EDI via the Client Support Portal: https://www.hhaexchange.com/supportrequest

Importing Caregivers into HHAeXchange

(Note: This action is not required for agency providers 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.CLICK HEREto 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 
  • Follow instructions in order for the EDI team to receive your file. Go to hhaexchange.com/supportrequest. From the support portal page please click on Provider EDI Integrations and submit a caregiver import request. 

Frequently Asked Questions

What is HHAeXchange?

HHAeXchange is the premiere Homecare Management Software company for the Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma population.  The HHAeXchange solution will connect payers and homecare providers to enable more collaboration, communication, and workflow efficiencies.

How will the payer-sponsored HHAeXchange EVV system work?

Through the HHAeXchange portal, Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma 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 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 Aetna Better Health of Oklahoma, Oklahoma Complete Health and Humana Healthy Horizons in Oklahoma send to my agency through the HHAeXchange Portal?

Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma will send member and authorizations through the HHAeXchange portal.

How will the HHAeXchange Portal bill to Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma?

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 Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma?

Yes. The HHAeXchange Portal provides a Prebilling Claims module designed to ensure that your claims are compliant with Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma EVV requirements.

Will I need a Portal for Aetna Better Health of Oklahoma, Oklahoma Complete Health, and Humana Healthy Horizons in Oklahoma?

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.

For plan specific information, please contact:

Additional Contact Info