North Carolina 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)

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

North Carolina Medicaid has advised the PHPs that they will be filing for a Good Faith Effort exemption with CMS that will allow the state additional time to prepare for the implementation of EVV. As a result of this guidance from the state, the implementation with HHAeXchange is being delayed from the original roll out date of February 1, 2020 to a date that is still to be determined.

Additional information will be shared with providers as guidance is received from the state.

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 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 Billing Options

Option 1, Free HHAeXchange EVV: Our agency wants to use HHAeXchange’s free EVV system, provided by the PHPs. Great! If you’ve indicated that you’d like to use HHAeXchange’s free EVV system, the contact person listed on your questionnaire 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.

Option 2, Use my Current EVV System: Our agency has an existing EVV system that we’d like to keep. It’s simple to connect your existing EVV system to the PHPs through the HHAeXchange Portal. Ensure that you’ve completed the questionnaire, and the HHAeXchange EDI Integrations Team – edisupport@hhaexchange.com – will coordinate with you to create an interface to process your existing EVV visits and claims.

What Services are a part of the Program?

Personal Care

Important Links

NC Medicaid Transformation Update

NORTH CAROLINA MEDICAID PREPAID HEALTH PLAN INFORMATION SESSIONS

North Carolina Medicaid is filing for a Good Faith Effort exemption with CMS that will allow the State additional time to prepare for the implementation of EVV. As a result, the upcoming Info Sessions listed below will be rescheduled for a later date.

  • Raleigh – Tuesday, November 12th, 2019
  • Wilmington – Wednesday, November 13th, 2019
  • Charlotte – Tuesday, November 19th, 2019
  • Asheville – Wednesday, November20th, 2019
  • Webinar Only – Thursday, November 21st, 2019
  • Webinar Only – Monday, November 25th, 2019

 

In partnership with HHAeXchange, Carolina Complete Health, AmeriHealth Caritas of North Carolina, UnitedHealthcare Community Plan of North Carolina, and WellCare of North Carolina (the PHPs), will communicate new dates for the implementation and the Info Sessions once guidance is provided by NC Medicaid.

Please be on the lookout for additional communications from the PHPs. Information will also be published to the HHAeXchange Info Center. We encourage you to check the HHAeXchange Info Center regularly for updates on EVV in NC and the revised rollout.

*CLICK HERE to access materials and recordings from HHAeXchange Webinars and Training Sessions (Password is required).  

UPCOMING WEBINARS

  • Wednesday, July 31 @ noon EST: Preparing to Bill – Prebilling and Billing Review
    • Audience: Homecare Provider Agencies using HHAeXchange EVV or HHAeXchange Manual Visit Entry (Visit Quick Entry)
    • Description: This webinar will help EVV and Manual Visit Entry agencies prepare for their first billing. The session will cover identifying and addressing visit-related exceptions which could prevent a visit from being billed, using the HHAeXchange Prebilling Review and Billing Review functionality.

 

  • Thursday, August 1 @ noon EST: Don’t Leave $$$  on the Table – Addressing Billing Review “On Hold” Reasons
    • Audience: ALL Homecare Provider Agencies (EVV, Manual Entry, and EDI)
    • Description:  The Billing Review functionality in HHAeXchange highlights invoiced visits that are “On Hold” and cannot be billed, resulting in unrealized revenue (which is $$$ “left on the table” for your agency).  Understanding how to address these issues is the key to timely billing.  This webinar will focus on the 2 most common “On Hold” Reasons keeping your claims from being billed in HHAeXchange and preventing claims from being sent to the MCOs for adjudication:
      • Pending Billing of Additional Shifts on Same Day
      • Visits on Same Day/Service Code must be billed on Same Invoice
 
USER TRAINING WEBINARS
Homecare User System Training Webinar:
Please click on the link below to register and view a recording of the Pennsylvania CHC Homecare User System Training Webinar, last delivered in February 2019. Register Here Download Presentation Only

 
PA SCE (Service Coordination Entity) User System Training Webinar:
Please click on the link below to register and view a recording of the Pennsylvania CHC SCE User System Training Webinar, last delivered in February 2019. Register Here Download Presentation Only  

Non-Homecare User System Training Webinar:

Please click on the link below to register and view a recording of the Pennsylvania CHC Non-Homecare User System Training Webinar, last delivered in February 2019. Register Here Download Presentation Only

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)

3rd Party EVV Implementation Guide Coming Soon.

 
 

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
  • 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 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 will send placements, authorizations, plan of care, and all communication through the HHAeXchange Portal. PHPs 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 contract.

No. You’ll only need one Portal to connect to Wellcare, United Healthcare, and Amerihealth 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 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.

Download the HHAeXchange Portal Benefits

 

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