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Pennsylvania EPSDT Information Center

Provider Portal Questionnaire

HHAeXchange & EPSDT Partnership

AmeriHealth Caritas Pennsylvania, Keystone First, University of Pittsburgh Medical Center (UPMC) and United HealthCare of PA – have partnered with HHAeXchange to provide a free Electronic Visit Verification (EVV) and billing tool for member placement, scheduling, authorization management, communication, and EVV compliance for their EPSDT member population.

All providers must be fully integrated by November 1st, 2020. Therefore, to help ensure your provider agency is compliant before the deadline, below are multiple options to help facilitate a path toward EVV compliance:

  • Agencies currently using HHAeXchange: You will be able to continue using HHAeXchange, utilizing the system’s Linked Contract functionality.
    • NOTE: You do not have to complete the survey as you already have the HHAeXchange Portal.
  • Agencies currently without an EVV Solution: You will be set up to use Free EVV tools from HHAeXchange for Homecare services. Please complete the survey with the details so we can create your portal.
  • Agencies currently using another 3rd Party EVV Solution: You will use your existing EVV system and import visit data into HHAeXchange using Electronic Data Interchange (EDI). Please complete the survey with the details so we can create your portal.

What does the HHAeXchange Portal provide to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to EPSDT for:

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

If you currently do not have a HHAeXchange Portal, please complete the Provider Portal Survey with your details and someone from the HHAeXchange team will reach out with your next steps.

Important dates

  • Provider information Session: starting October 2020 – please refer to tab labeled “Info Sessions” for registration
  • System User Training: Starting mid- October – please refer to the tab labeled “Training”
  • Targeting November 1st, 2020 for all providers to be fully integrated for compliance

Upon completion of the Provider Portal Survey, please refer to the links below to access videos and presentation from the provider info session Webinar, held via webinar in October 2020.

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.

Upcoming Webinars

  • Wednesday, March 27th @noon EST: Communication and Notes
    • Audience: ALL Homecare Provider Agencies
    • Description: This webinar will cover Member Notes and communication with the MCOs, with a focus on creating MCO Communications, and reviewing, replying, and closing Communications and Notes in the HHAeXchange Homecare Portal.

Training Material & Webinars

PROVIDER SYSTEM USER TRAINING

PLEASE CLICK ON THIS LINK TO REGISTER AND VIEW A RECORDING OF THE PENNSYLVANIA EPSDT PROVIDER HOMECARE USER SYSTEM TRAINING WEBINAR, ORIGINALLY DELIVERED IN OCTOBER 2019. THIS WILL PROVIDE YOU MORE INFORMATION ON THE FUNCTIONALITIES AVAILABLE TO YOU IN HHAEXCHANGE PORTAL AND HOW TO UTILIZE THEM WITH YOUR CURRENT WORKFLOWS.

Webinar | Download Presentation Only

Training Webinars

PA Portal Upgrade Training – Recording | Slides

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):

Homecare

To request new user access, users with the ADMIN role can add new users to the HHAeXchange system. Please refer to the Creating New Users Job Aid.

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 – [email protected] – will coordinate with you to create an interface to process your existing EVV visits and claims.

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.

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 tab.

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