Simple Claims Billing and EVV Implementation for Pennsylvania Community HealthChoices
Community HealthChoices (CHC) Phase 2 begins in Pennsylvania on January 1, 2019, and the state’s three Managed Care Organizations (MCOs) – Keystone First, 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.
The first step in preparing for CHC and effectively working with the MCOs is to fill out the appropriate survey for your organization:
- Homecare Entities: CLICK HERE to complete the PA CHC Visit Entry Option and MCO Billing Provider Survey
- Non-Homecare Entities: CLICK HERE to complete the PA CHC Non-Homecare Provider Survey
- Service Coordination Entities (SCEs): CLICK HERE to complete the PA CHC Visit Entry Options and MCO Billing Survey for Service Coordination Entities
The answers to your survey will allow us to set your agency up for success when it comes to processing your confirmed Homecare and Non-Homecare visits, and preparing your claims for the MCOs.
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 – PAintegration@hhaexchange.com – will coordinate with you to create an interface to process your existing EVV visits and claims.
Option 3: Our Agency isn’t ready for EVV just yet. No problem, we have a solution for you, too. If you choose this option, you’ll manually enter your visit data into the HHAeXchange Portal. Remember that the 21st Century CURES Act mandates that all homecare agencies use EVV. Pennsylvania will be requiring compliance by the summer of 2019. Therefore, this is will only be a temporary option to process your claims.
January 1, 2018: CHC begins in Zone 1 (Southwest Pennsylvania)
January 1, 2019: CHC begins in Zone 2 (Southeast Pennsylvania)
July 1, 2019: Pennsylvania requires CURES act compliance
January 1, 2020: CHC begins in Zone 3 (Remaining areas of Pennsylvania)
Download the Community HealthChoices Billing and EVV Options Overview