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RiverSpring Health Plans Information Center

Provider Portal Questionnaire

HHAeXchange & RiverSpring Partnership

RiverSpring has partnered with HHAeXchange to leverage our platform to implement Electronic Visit Verification (EVV) for Personal Care Services, as part of the approach for the 21st Century Cures Act.

Through the HHAeXchange platform you will be able to receive new members and authorizations from RiverSpring, as well as schedule and confirm visits for those members.

In addition, the HHAeXchange platform offers a robust agency management solution that can help streamline and automate time-consuming agency functions including placement, scheduling, compliance, and billing of services.

What does the HHAeXchange Portal provide to homecare agencies?

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

  • Electronic case placement, authorizations, plan of care management and entering confirmed visits
  • Free EVV solution for time & attendance and duty tracking
  • Electronic billing along with pre-billing review

Your Agency’s Options & Onboarding Plan:

Enterprise Free Agencies currently using HHAeXchange’ s EVV tools: You had a free HHAeXchange portal created through completing an enrollment questionnaire for a previous implementation. You will be able to continue using HHAeXchange, utilizing the system’s linked contract functionality. Providers will receive a detailed welcome letter in advance, letting them know which phase they fall under along with the go-live date expectations. Please find your Welcome Packet attached below for important next steps and implementation milestone dates.

RiverSpring Phase 1 Existing Free EVV Provider Welcome Packet

RiverSpring Phase 2 Existing Free EVV Provider Welcome Packet

Enterprise Free Agencies currently using another 3rd Party EVV Solution (Existing EDI Providers): You had a free HHAeXchange portal created through completing an enrollment questionnaire for a previous implementation. You will be able to continue using HHAeXchange, utilizing the system’s Linked Contract functionality. Schedule and visit data will be imported from your 3rd party system into HHAeXchange to be billed to RiverSpring. Please work with your EVV Vendor to determine requirements to set up this interface and refer to the EDI Process tab for more details. Please find your Welcome Packet attached below for important next steps and implementation milestone dates.

RiverSpring Phase 1 Existing EDI Provider Welcome Packet

RiverSpring Phase 2 New EVV Provider Welcome Packet

Agencies not currently using HHAeXchange: You will receive an HHAeXchange Portal to receive authorizations and submit invoices. 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 existing third party EVV system. Please find your Welcome Packet attached below for important next steps and implementation milestone dates.

Providers choosing to use an HHAX Portal – RiverSpring Phase 1 New EVV Provider Welcome Packet

Providers with an existing third party EVV system choosing to integrate with HHAX – RiverSpring Phase 1 EDI Provider Welcome Packet

Enterprise Agencies currently using HHAeXchange – You currently pay for the HHAeXchange Full Enterprise platform. With RiverSpring, you will be able to continue using HHAeXchange, utilizing the system’s enhanced Linked Contract functionality. Providers will receive a detailed welcome letter in advance, letting them know which phase they fall under along with the go-live date expectations. Please find your Welcome Packet attached below for important next steps and implementation milestone dates.

RiverSpring Phase 1 Enterprise EVV Provider Welcome Packet

RiverSpring Phase 2 Enterprise EVV Provider Welcome Packet

Important Milestone Dates for Providers in Phase 1

Information Sessions: May 2, 2022, May 4, 2022, May 5, 2022, May 11, 2022 & May 13, 2022

System User Training Sessions: May 23, 2022 – May 27, 2022

Go-Live Date for Providers: August 22, 2022

Important Milestone Dates for Providers in Phase 2

Information Sessions: November 1, 2022, November 3, 2022 & November 4, 2022

System User Training Sessions: November 15, 2022 to November 18,2022

Go-Live Date for Providers: December 12, 2022

The Cures Act Mandate requires all visits for personal care services to be timestamped via an electronic verification method utilizing EVV tools to record the member, caregiver, location of the service, date of the service and the type of service performed. To ensure EVV data is being accurately captured, RiverSpring will be implementing HHAeXchange.

Phase 1 Providers:

The Information Sessions were held for all in scope Phase 1 providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The info sessions for Phase 1 concluded on May 13, 2022. The recording and slide deck can be found below:

Recording | Slides

Phase 2 Providers:

Information Sessions were held for all in scope providers in Phase 2 to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The info sessions for Phase 2 concluded on November 4, 2022. The recording and slide deck can be found below:

Recording | Slides

New Providers: Please note that any new provider who does not currently have an HHAeXchange Portal will need to complete the HHAeXchange Provider Portal Questionnaire. This questionnaire will gather necessary information for HHAeXchange to configure your provider portal and allow you to select whether you want to use free HHAeXchange EVV tools or use your existing EVV system.

To assist new providers in successfully completing this questionnaire, RiverSpring and HHAeXchange held a joint meeting to explain the information being gathered and guide providers through completing the Survey. To access the recording and slide deck please visit the “Trainings” tab.

Existing EDI and Free ENT Providers: Please review and complete the survey below to identify the person who will receive all HHAeXchange related communications regarding the RiverSpring implementation. The survey can be found here.

Existing Full Enterprise Providers: Please review the Phase 1 Welcome Letters sent from RiverSpring on Wednesday, April 20, 2022 for important information regarding the RiverSpring Implementation.

The RiverSpring Welcome Letters for Phase 2 were sent out on Tuesday, October 11.

Ease of billing

  • Quickly enter confirmed visits in a user-friendly interface.
  • Increase billing acceptance rates with real-time pre-claim edit checks.

Member & Authorization Management

  • Increase census by accepting new cases via RiverSpring Member Placement.
  • Access real-time authorization and notification of changes to the care plan (increase or decrease of units, change of service code, etc.).
  • Reduce payer communication time with real-time, two-way messaging.

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.

Phase 1 Recorded Webinars

RiverSpring Provider Portal Enrollment Form Review Webinar: April, 29, 2022

Recording | Slides

RiverSpring Phase 1 Provider Information Session Webinar: May 2, 2022, May 4, 2022, May 5, 2022, May 11, 2022 and May 13, 2022

Recording | Slides

RiverSpring HHAeXchange Phase 1 System and Enhanced Linked Patient Experience (UPR): May 31, 2022, June 2, 2022 and June 3, 2022.

Recording | Slides

New Providers: System User Training

Phase 1

System User Training for Phase 1 has concluded as of May 27, 2022. Please refer to your LMS to access any of the videos shown.

Phase 2

Provider System User Training will be provided via the HHAeXchange Learning Management System (LMS). Providers will have to log on the Learning Management System to complete their training to understand the use of the HHAeXchange Provider Portal along with its functionalities. This training is required to ensure you have a clear understanding of the functionalities available to you in the HHAeXchange Provider Portal. The courses include a variety of videos, documents, and tests to help ensure you have a clear understanding of the different aspects of the Provider Portal to use for your EVV benefits.

Please refer to your LMS to access any of the videos included in this training.

New Providers & Existing EVV Providers:

Receive LMS Credentials from the HHAeXchange Onboarding Team and follow instructions to complete the courses and videos on a self-paced format to complete:

  • An email will be sent to the contact that completed the RiverSpring Provider portal questionnaire
  • One Username will be sent for your Agency to use. Username can be distributed amongst all members of your agency to complete the assigned courses.
  • Login to the LMS website using the provided credentials in the email
  • Work on completing the courses by reviewing the information provided
  • Any updates made to the password should be distributed amongst all members who have access to the account
  • For questions or concerns please contact us by submitting a ticket via the Client Support Portal: https://www.hhaexchange.com/supportrequest

Existing Enterprise Providers: Enhanced Linked Contract Experience

Phase 1

The Phase 1 Enhanced Linked Webinar has concluded as of June 3, 2022. Please refer above for the recording and slide deck of this presentation.

Phase 2

RiverSpring has partnered with HHAeXchange to implement the Professional Platform and Linked Contract Functionality by December 12, 2022. The purpose of this training is to cover several enhancements that allow for more flexibility and ease of use with linked payers. These enhancements include the Universal Patient Record linked contract functionality and improvements to the patient management experience.

The Phase 2 Enhanced Linked Webinars concluded Friday, November 18, 2022. Please see the links below for recording and slide deck for this presentation.

Recording | Slides

New & Existing EDI Providers

For providers using 3rd party EVV system outside of HHAeXchange, please attend one EDI provider onboarding webinar session and one Post Integration Training. The Onboarding Webinar provides an understanding of the HHAeXchange Provider Portal and the EDI integration process. The Post Integration Training Session assists our Providers with post go-live review of EDI processes in the HHAeXchange System.

The Phase 1 EDI Onboarding Webinars have concluded as of May 19, 2022.

Please reference your LMS for your EDI onboarding.

EDI Post Integration Training Webinars:

The Phase 1 EDI Post Integration Webinars have concluded as of June 30, 2022.

Please reference your LMS for your EDI onboarding.

If you need assistance with the next steps for integration, please visit the EDI process tab for further instruction.

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 necessary to successfully integrate your Agency Management System with HHAeXchange. HHAeXchange coordinates directly with RiverSpring 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 HHAeXchange, you will need to create the EDI files corresponding to the HHAeXchange specifications found in the following documentation (links below):

Training Opportunities for EDI Providers

The Phase 1 EDI Onboarding Webinars have concluded as of May 19, 2022.

The Phase 1 EDI Post Integration Webinars have concluded as of June 30, 2022.

Please reference your LMS for your EDI onboarding.

Please contact the HHAX EDI team via the Client Support Portal:

Portal: https://www.hhaexchange.com/supportrequest

Pre Go Live and Go Live Communications – All Providers

RiverSpring HHA EVV Go Live Communication – sent on August 22, 2022

RiverSpring EDI/Free EVV Go Live Communication – sent on August 22, 2022

RiverSpring HHA EVV Pre Go Live Communication – sent on August 3, 2022 and August 15, 2022

RiverSpring EDI/Free EVV Pre Go Live Communication – sent on August 3, 2022 and August 15, 2022

Implementation Updates – All Providers

RiverSpring Diagnosis Code Update Communication – sent on September 2, 2022

RiverSpring Go Live Update Communication – sent on July 25, 2022

RiverSpring Member and Authorization Data Loaded Communication – sent on July 12, 2022

RiverSpring Go Live Delay Communication – sent on July 8, 2022

LMS Go Live – New and Existing Free EVV and EDI Providers

LMS Go-Live Communication – sent on Wednesday, May 18, 2022 **each agencies contact person received a personalized email containing their unique username & password to login into their Learning Management System (LMS)

Reminders/Next Steps – All Providers

Full Enterprise Next Steps – sent on Tuesday, May 17, 2022

Free EVV Next Steps – sent on Tuesday, May 17, 2022

EDI Next Steps –  sent on Tuesday, May 17, 2022

Provider Information Session Registration Reminder – sent on Friday, April 29, 2022

Provider Portal Enrollment Form Webinar Registration Reminder – sent on Tuesday, April 26, 2022

Welcome Packets – All Providers

Full Enterprise Provider Welcome Packet – sent on Friday, May 6, 2022

Free EVV Provider Welcome Packet – sent on Friday, May 6, 2022

EDI Provider Welcome Packet – sent on Friday, May 6, 2022

Welcome Letters – All Providers

Existing EDI Providers Welcome Letter – sent on Friday, April 22, 2022

Existing Full Enterprise Providers Welcome Letter – sent on Friday, April 22, 2022

No Portal Providers Welcome Letter – sent on Friday, April 22, 2022

Existing Free EVV Providers Welcome Letter – sent on Friday, April 22, 2022

How will the free HHAeXchange EVV system work?

Through the HHAeXchange Portal, RiverSpring is offering free telephony for clock-in and clock-out functionality, including capturing completed plan of care duties. Each agency who has indicated they would like to use HHAeXchange’s free EVV system will be set up with a toll-free 800 number to provide to their caregivers.

What is HHAeXchange?

HHAeXchange is the premier 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.

Member & Authorization Management

  • Increase census by accepting new cases via RiverSpring Member Placement.
  • Access real-time authorization and notification of changes to the care plan (increase or decrease of units, change of service code, etc.).
  • Reduce payer communication time with real-time, two-way messaging.

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.

What if we would 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 would like to keep?

It is simple to connect your existing EVV system to RiverSpring 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. For additional information, please review the “EDI Process” tab.

What information will RiverSpring send to my agency through the HHAeXchange Portal?

RiverSpring will be sending new placements, including members and authorizations, through the HHAeXchange Portal. RiverSpring will also send communications via the Message Center. RiverSpring may send additional information as they deem necessary.

How will the HHAeXchange Portal bill to RiverSpring?

All Providers will complete the prebilling process to clean up any exceptions within the HHAeXchange Portal. Providers will then download the 837 file and submit to their Billing Clearinghouse.

Can I check my claims before submitting them to RiverSpring?

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

Will I need a Portal for RiverSpring?

Yes. You will need a Portal to connect to RiverSpring for placements, authorizations, and billing.

Can I schedule my caregiver 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 RiverSpring, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.

What are my options as a provider for using HHAeXchange with RiverSpring?

There are three options for using the HHAeXchange portal to ensure EVV compliance with RiverSpring:

  1. Providers with an HHAX Enterprise Portal will continue to use your existing portal for EVV on the Enhanced Linked Contract functionality with RiverSpring
  2. Providers with a Third-Party EVV (EDI) Portal will continue to use your existing EVV portal and integrate with the HHAX portal to import confirmed and billed visits
  3. Providers with an HHAX Free EVV Portal will use your HHAX portal for EVV and billing to RiverSpring

How will I be trained on the HHAeXchange Portal?

The person within your organization that filled out the survey will receive more information to identify super users and for training planning. The user who completed the survey will receive the Learning Management System (LMS) credentials for self-paced videos and webinar details with a live Q/A chat option to interact and review this information with the HHAeXchange training team.

Can I Import and Export data into the HHAeXchange Portal?

Processes for importing and exporting data from the HHAeXchange Portal can be found on the “EDI Process” tab.

What do I do if my claims submitted through HHAeXchange have not reached RiverSpring?

First, confirm that your invoices were successfully exported from HHAeXchange (the visits have passed the Prebilling and Billing Review validation checks and the invoice is in a Billed status). Second, check the claim status of the visit from the HHAX portal (Billing > Invoice Search > By Visit). If an ‘accepted’ response has not been received, then reach out to our Client Support Portal for investigation of the claim status.

Provider Services in Scope: Please see below all the provider services in scope for this implementation.

Service Code                            Description

97001 PT eval
97001:U5 PT eval, outer county
97003 OT eval
97161 PT eval low complexity
97161:U5 PT eval low complexity, outer county
97162 PT eval moderate complexity
97162:U5 PT eval moderate complexity, outer county
97163 PT eval high complexity
97163:U5 PT eval high complexity, outer county
97165 OT eval low complexity
97165:U5 OT eval low complexity, outer county
97166 OT eval moderate complexity
97166:U5 OT eval moderate complexity, outer county
S9128 Speech Therapy visit/ routine
S9128:U5 Speech Therapy visit/ routine, outer county
S9129 OT visit/ routine
S9129:U5 OT visit/ routine, outer county
S9131 PT visit/ routine
S9131:U5 PT visit/ routine, outer county
92521 Evaluation of speech fluency
92522 Evaluation of speech production
97110 Therapeutic exercises
97112 Neuromuscular Reduction
97124 Massage Therapy
97140 Manual therapy Techniques, 15min
97530 Therapeutic Activities
97167 OT eval high complexity
97167:U5 OT eval high complexity, outer county
92506 Speech Therapy eval
S5180 Respiratory therapy eval.
S5181 Respiratory therapy routine
S9127 SW
S9123 RN
S9124 LPN
S9470 Nutritional Counseling
T1001 RN
T1003 LPN, 15 min
 S5125 Home Attendant, 15 min
 S5125:U2 Home Attendant, 15 min, shared
 S5125:U4 Home Attendant, 15 min, outer county
 S5125:U5 Home Attendant, 15 min, shared, outer county
 S5126 HHA live in, 15 min
 S5126:U2 HHA live in, 15 min, shared
 S5126:U4 HHA live in, 15 min, outer county
 S5126:U5 HHA live in, 15 min, shared, outer county
S5130 House keeper
T1019:U1 PCA, 15 min
T1019:U2 PCA, 15 min, shared
T1019:U4 PCA, 15 min, outer county
T1019:U5 PCA, 15 min, shared, outer county
T1020 PCA live in, 15 min
T1020:U2 PCA live in, 15 min, shared
T1020:U4 PCA live in, 15 min, outer county
T1020:U5 PCA live in, 15 min, shared, outer county
T1019:U6 CDPAS, 15 min
T1019:U7 CDPAS 15 min, shared
T1019:U6 U4 CDPAS 15 min, outer county
T1019:U7 U4 CDPAS 15 min, shared, outer county
T1020:U6 CDPAS live in, 15 min
T1020:U7 CDPAS live in, 15 min, shared
T1020:U6 U4 CDPAS live in, 15 min, outer county
T1020:U7 U4 CDPAS live in, 15 min, shared, outer county
T2024 UAS
T2024:95 UAS Telephonic

RiverSpring Direct Contact Information:

Contact Jack Nunez at 800-370-3600 ext. 7602 for any questions/concerns regarding this Implementation.

HHAeXchange:

All providers can use our Client Support Portal to find answers to questions and create support requests.