North Carolina Home Health Provider Information Center

At HHAeXchange, we believe that healthcare should be simple, effective, and transparent. Our mission is to provide better outcomes for patients who represent some of the most vulnerable and fragile members of our society. Since 2008, we have been at the forefront of delivering industry-leading homecare management solutions by helping payers and providers achieve operational efficiency, increased compliance, and improved patient outcomes.

Today, 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.

EVV and Claims Billing for North Carolina’s State Medicaid Prepaid Health Plan (PHP) and Tailored Plans

Alliance Health, AmeriHealth Caritas of North Carolina, CardinalHealth, Carolina Complete Health, EastPointe, Partners, SandHills, Trillium Health Resources, UnitedHealthcare Community Plan of North Carolina, Vaya Health, and WellCare of North Carolina have partnered with HHAeXchange to provide software that allows providers to have a single login for all plans to access authorizations, communicate, and meet Electronic Visit and Verification (EVV) requirements of the 21st Century Cures Act. 

As a result, all the plans have partnered with HHAeXchange to provide you with a free EVV system and billing tool for member placement, scheduling, authorization management, communication, and EVV compliance. 

To get started, the first step will be to complete the HHAeXchange Provider Enrollment Form listed below, which will provide you access to your HHA Provider Portal.

Click here to complete the HHAeXchange Provider Enrollment Form

If you’re searching for information on Personal Care Services (PCS), which were implemented in November 1, 2021, go to https://hhaexchange.com/nc/.  

What are the key benefits of the HHAeXchange Portal to homecare agencies?

The HHAeXchange Portal provides a direct connection from the agency to the PHP/Tailored Plan for:

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

Your Agency’s EVV Options

Agencies utilizing Free HHAX tools HHAeXchange (New Providers  HHAX): Your agency wants to use HHAeXchange’s free EVV tools along with the portal, provided by the PHPs and Tailored Plans. If you’ve indicated that you’d like to use HHAeXchange’s free EVV tools! You will receive an HHAeXchange Portal in order to receive authorizations and submit claims/invoice data. Please complete the Provider Portal Questionnaire Survey to ensure our team can create your unique credentials for access. Providers will have the choice to either use the free HHAeXchange EVV tools or select to integrate with their own third party EVV system.

Agencies utilizing their own 3rd Party EVV Solution (Existing and New EDI Providers): Your agency has decided to continue the use of your existing EVV system along with the HHAeXchange portal. It’s simple to connect your existing EVV system to the PHPs through the HHAeXchange Portal. Authorization data will become available in the HHAeXchange Portal, rather than coming by fax. Schedule and visit data will be imported from your 3rd party system into HHAeXchange. Please work with your EVV Vendor to determine requirements to set up this interface and ensure that you’ve completed the questionnaire. Refer to the EDI Process tab for more details or reach out to the HHAeXchange EDI Integrations Team – edisupport@hhaexchange.com.

What Services are a part of the Program?

Home Health Services

Important Dates

EVV Mandate: January 1, 2023

NORTH CAROLINA MEDICAID HOME HEALTH INFORMATION SESSIONS

Information Sessions will be held for all providers to provide them with the key dates and details about this implementation, including key workflow changes, system benefits, and next steps. Please refer to the links below to access videos and presentations from Provider Info Sessions, held via webinar in September 2022.

Provider System User Training

We would like to extend an invitation to attend our live system user training. These trainings will give you an opportunity to ask questions and receive a live demonstration of the HHAeXchange system! Trainings will be held on Tuesday and Thursday for two weeks. 

 

 

 

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
  • Send the file to HHAeXchange (EDISupport@hhaexchange.com) for File Processing

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):

*Note: Please open each link and save each guide for your records along with sharing it to your third party EVV vendor.

 
 

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.

  • FREE Electronic Visit Verification (EVV) tools
  • Open Model EDI Integration with 3rd Party EVV Vendors
  • Real-time, two-way messaging with each PHP and tailored plans
  • 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

Great! If you’d like to use HHAeXchange’s Free EVV system ensure that you’ve completed the HHAeXchange Portal Configuration Questionnaire. The contact person listed in your response will be contacted by HHAeXchange to set up your agency for EVV.

It’s simple to connect your existing EVV system to the PHPs and 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. EDI Process Guides can be found in the EDI Process tab, above.

The PHPs and tailored plans will send placements, authorizations, plan of care, and all communication through the HHAeXchange Portal. PHPs and tailored plans may send additional information as they deem necessary.

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.

Yes. The HHAeXchange Portal provides a Pre-billing Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and PHP or tailored plans contract.

No. You’ll only need one Portal to connect to Wellcare, Carolina Complete, United Healthcare, and Amerihealth, Partners, Trillium Health Resources, EastPointe, SandHills, Vaya Health, CardinalHealth. and Alliance Health for placements, authorizations, communication and billing.
 

Yes. You’ll be able to schedule your caregivers through the HHAeXchange Portal either by creating schedules based on the authorization provided by the PHP or tailored palns, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.

Please see the User Training tab, above.

Please see the EDI Process tab, above.

Here’s a look at some of the benefits you’ll get from the HHAeXchange Portal:
 

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.

The state released the following bulletin: Home Health Services Electronic Visit Verification Implementation,

NC Medicaid has an established EVV webpage with more information. Home Health providers are encouraged to monitor this webpage frequently for HHS EVV announcements, bulletins, FAQs, stakeholder meetings and other communications.

Our site will be updated with a list of all CPT codes that are in scope for Home Health, once finalized.

For questions and issues, email HHAeXchange at NCSupport@hhaexchange.com.

For questions or issues over the phone, please call at: 866-242-2465.

 

Providers with an existing HHAeXchange portal please use the HHAeXchange Live Chat within your Support Center to receive assistance from a Live Agent. The live chat option is recommended for quicker response times.

Need Help? Contact Our Support Team