RiverSpring Health Plans Information Center

 

At HHAeXchange, we believe that healthcare should be simple, effective, and transparent. Our mission is to provide better outcomes for members 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 member outcomes. Today, HHAeXchange is the premier homecare management software solution for the Medicaid LTSS population. We act as the single source of truth in connecting payers, providers, and members through our intuitive web-based platform, enabling unparalleled communication, transparency, and visibility.

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 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 Existing EDI 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 New EVV Provider Welcome Packet

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

 

Important Milestone Dates for Providers 

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

System User Training Sessions: May 16, 2022 – May 20, 2022

Go-Live Date for Providers: July 5, 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, Fidelis Care will be implementing HHAeXchange.

 

The Information Sessions will be held for all in scope providers to share key details regarding this implementation, including workflow changes, system benefits, and next steps. The dates and times for each Information Session is outlined below:

 

May 2, 2022 at 11:00am

May 4, 2022 at 2:00pm

May 5, 2022 at 3:00pm

May 11, 2022 at 1:00pm

May 13, 2022 at 9:00am

 

 

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. Please Click Here to register for the upcoming webinar series. 

 

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 Welcome Letters sent from RiverSpring on Wednesday, April 20, 2022 for important information regarding the RiverSpring Implementation and the registration link to the Provider Information Sessions. 

 
RECORDED WEBINARS

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

Recording | Slides

 

New Providers: System User Training

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. The link to your Learning Management System will be provided to you soon. 

 

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 any questions or concerns, please reach out to Support@hhaexchange.com

 

Existing Enterprise Providers: Enhanced Linked Contract Experience 

RiverSpring has partnered with HHAeXchange to implement the Professional Platform and Linked Contract Functionality by 07/05/2021. 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. 

 

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.

EDI Onboarding Webinar 

    • May 9, 2022 at 12:00 PM EST
    • May 19, 2022 at 3:00 PM EST

EDI Post Integration Training Webinar

    • June 16, 2022 at 9:00 AM EST
    • June 21, 2022 at 12:00 PM EST
    • June 30, 2022 at 3:00 PM EST
  •  

If you have not done so already, please reach out to EDISupport@hhaexchange.com with the subject line “RiverSpring NY Integration” to discuss your next steps or visit the “EDI PROCESS” tab.

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
  • Send the file to HHAeXchange (EDISupport@hhaexchange.com) for File Processing

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

EDI Onboarding Webinars 

  • May 9, 2022 at 12:00 PM EST
  • May 19, 2022 at 3:00 PM EST

Please register here for the EDI Onboarding Webinar

 

EDI Post Integration Training Webinar

  • June 16, 2022 at 9:00 AM EST
  • June 21, 2022 at 12:00 PM EST
  • June 30, 2022 at 3:00 PM EST

Please register here for the EDI Post Integration Webinar

Please reach out to EDISupport@hhaexchange.com with the subject line “RiverSpring NY Integration” to discuss your next steps or visit the “EDI PROCESS” tab.

Here is a look at some of the benefits you will get from 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.

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.

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.

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.

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 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 or contact EDISupport@hhaexchange.com.

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.

All claims will be created through the HHAeXchange Portal and sent electronically via an 837 eBilling file. Once the claim is received by RiverSpring, standard adjudication process will follow. 

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.

Yes. You will need a Portal to connect to RiverSpring for placements, authorizations, 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 RiverSpring, or through automatic creation of schedules based on EVV data imported into the HHAeXchange Portal from your 3rd party EVV system.

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

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.

Processes for importing and exporting data from the HHAeXchange Portal can be found on the “EDI Process” tab. You can also contact EDISupport@hhaexchange.com for further details and concerns.

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 support@hhaexchange.com 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:

For questions and support please Contact Us using one of the following options below: 

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. 

All providers can contact us by phone 1-855-400-4429 or email at Support@hhaexchange.com.