Backdrop 5 1

Pennsylvania Community HealthChoices Info Center

Provider Portal Questionnaire

Simple Claims Billing and EVV Implementation for Pennsylvania Community HealthChoices

Community HealthChoices (CHC) Phase 3 begins in Pennsylvania on January 1, 2020, and the state’s three Managed Care Organizations (MCOs) – Amerihealth, PA Health & Wellness and UPMC – have selected HHAeXchange, a web-based software solution, to collect confirmed homecare visits, create claims to MCOs and provide workflow efficiency tools.

What does the HHAeXchange Portal provide to homecare agencies?

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

  • Electronic case broadcasting, authorizations, plan of care management and entering confirmed visits
  • Real-time two-way messaging with each MCO
  • 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 free EVV system, provided by the MCOs. 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.

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 the MCOs 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.

Important dates

January 1, 2018: CHC begins in Zone 1 (Southwest Pennsylvania) January 1, 2019: CHC begins in Zone 2 (Southeast Pennsylvania) January 1, 2020: CHC begins in Zone 3 (Remaining areas of Pennsylvania)

EPSDT Population in Pennsylvania

For information specific to the EPSDT population, please visit the market specific Provider Information Center page at: https://hhaexchange.com/pa-epsdt/.

PA CHC ZONE 3 PROVIDER INFORMATION SESSIONS

Upon completion of the Homecare Provider Questionnaire please refer to the links below to access videos and presentations from the Provider Info Sessions, held in Pennsylvania in October 2019.

These sessions provided a high-level introduction to the HHAeXchange System (including system demos).

Provider Info Sessions:

Homecare Session (105 min) VIDEO | SLIDES SCE Session (80 min) VIDEO | SLIDES

Non-Homecare Sessions:

  • Thursday, 11/7 – Webinar, 9:00 am
  • Monday, 11/11 – Webinar, 2:00 pm

To sign up for one of the Non-Homecare webinars, please complete the non-homecare provider questionnaire.

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

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.

 

PA Portal Upgrade Training – Recording | Slides

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

Note – To access the EVV Support Center Resource Page:

  • Log into the HHAeXchange System
  • Select the Support Center link in the upper right-hand corner

This page contains a concentrated list of instructional references including Process Guides, Job Aids, and supporting videos to navigate the EVV functionality in HHAeXchange.

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 the Managed Care Organizations (MCOs) 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

Non-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.

CLICK HERE to access the HHAeXchange Provider System FAQ Document (check back often for updates to this document).

CLICK HERE for the PA CHC MCO-approved Billing Codes for Homecare and Service Coordinators.

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, the MCOs are offering free telephony for clock-in and clock-out functionality, including capturing completed plan of care duties. Each agency who has indicated they’d 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’d 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’d like to keep?

It’s simple to connect your existing EVV system to the MCOs 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 the MCOs send to my agency through the HHAeXchange Portal?

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

How will the HHAeXchange Portal bill to the MCOs?

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 MCO?

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

Will I need a separate Portal for each MCO?

No. You’ll only need one Portal to connect to all three MCOs 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 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 portal questionnaire will receive a link after completion to register two identified super users for training will occur at multiple locations throughout the T-Zone Region of Pennsylvania. Please see https://hhaexchange.com/pachc-training/ for more details and to register.

Can I Import and Export data into the HHAeXchange Portal?

Processes for importing and exporting data from the HHAeXchange Portal can be found here: https://hhaexchange.com/pachc-ediprocess/.

I still have questions about Community HealthChoices and what it means for my agency, where should I go?

The Pennsylvania Department of Human Services has created a Provider Resources section for frequently asked questions here: http://www.healthchoices.pa.gov/providers/about/community/providerfaqs/index.htm.

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.