Pennsylvania Community HealthChoices Provider Information Center

HHAeXchange is the premiere Homecare Management Software company for the Medicaid LTSS population. We are the leaders in connecting payers and homecare agency providers to enable more collaboration, communication, and workflow efficiencies. Through the use of the HHAeXchange Portal, our goal is to make working with Pennsylvania’s Managed Care Organizations easy and efficient.

Simple Claims Billing and EVV Implementation for Pennsylvania Community HealthChoices

Community HealthChoices (CHC) begins in Pennsylvania on January 1, 2018, and the state’s three Managed Care Organizations (MCOs) – AmeriHealth Caritas, PA Health & Wellness and UPMC for You – 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 by January 1, 2019, so this is will only be a temporary option to process your claims.

Important dates

January 1, 2018: CHC begins in Zone 1 (Southwest Pennsylvania)

Download the Community HealthChoices Billing and EVV Options Overview

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

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

 
 

Webinar Training Options

Please continue to check back, as training webinars will continue to be added to the schedule.

CLICK HERE to download and complete the PA Rebilling Request Form
(please send completed forms to PASupport@hhaexchange.com)

UPLOADING CAREGIVERS INTO HHAEXCHANGE

To assist your organization with the Caregiver data load, we have made a tool available to expedite the process.  Please CLICK HERE to access the Caregiver Import Process Guide, which provides instructions for how to:

  • Create the Caregiver File for Import into HHAeXchange
  • Perform the Caregiver Import, using the HHAeXchange EDI Self Service Tool
  • Track the status of the Caregiver File Import
 

OVERVIEW

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):

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.

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.

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

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.

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.

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. If you’re not ready to integrate your existing EVV system prior to January 1, 2018, you can temporarily manually enter your visit date into the HHAeXchange Portal

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 by January 1, 2019, so this is will only be a temporary option to process your claims.

The MCOs will be sending new placements, authorizations and all communication through the HHAeXchange Portal. MCOs 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 Prebilling Claims Scrubbing module designed to ensure that your claims are compliant with the authorization and MCO contract.

No. You’ll only need one Portal to connect to all three MCOs 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 MCO, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.

The person within your organization that filled out the survey will receive a link after completion to register two identified super users for training will occur at multiple locations throughout the Southwest Region of Pennsylvania. Please see https://hhaexchange.com/pachc-training/ for more details and to register.

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

If you’re unable to create an interface between your 3rd party EVV system and the HHAeXchange Portal prior to January 1, 2018, you can temporarily manually enter visits to process your claims.

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

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