Sending Updates Through The Provider Healthcare Portal. Indiana Health Coverage Programs DXC Technology October 2017

Transcription

1 Sending Updates Through The Provider Healthcare Portal Indiana Health Coverage Programs DXC Technology October 2017

2 Agenda Features of Electronic Enrollment Updates and Reminders Provider Maintenance Navigation Updates that can be made on the Portal Revalidation and Recertification Helpful Tools Questions 2

3 Features of Electronic Enrollment Updates and Reminders 3

4 Features of Electronic Enrollment Updates Faster and more convenient than mailing paper applications or forms Transmissions can be saved and returned to later for submission Personal information is secure Required supporting enrollment documentation attachments can be directly uploaded for submission Real-time status of some submitted updates Some updates made on the Portal are immediate 4

5 Immediate Changes Contact and Delegate Administrator changes Address changes (other than Home address) Specialty changes that do not require documentation Presumptive Eligibility election EFT add (18 day paper check during change period) EFT deletion Language 590 and MRT election Rendering Provider Termination Taxonomy removal Medicare participation 5

6 Reminder Providers are reminded that the Provider Agreement states updates and changes to the provider enrollment information are to be reported within 30 days of the change Medicare and Medicaid compare enrollment data Differences in reported information can cause audits to occur 6

7 Provider Maintenance Portal Navigation 7

8 Need to Know Review instructions and information provided on each page before submission When viewing only, no changes are made Changes are electronically submitted to DXC when clicking Submit The following confirmation window appears when clicking Cancel 8

9 Electronic Attachments Any changes that require documentation trigger the attachment screen 9

10 Attachments by Mail Attachments are able to be sent by mail also 10

11 Updates that can be made on the Provider Healthcare Portal 11

12 12 Provider Maintenance

13 13 Update Options Available

14 14 Change Tax ID

15 Contact and Delegated Administrator Changes Person who can answer questions regarding the location 15

16 16 Delegated Administrator Changes

17 17 Address Changes

18 18 Specialty Changes

19 19 Presumptive Eligibility

20 20 Electronic Funds Transfer

21 21 Language Changes

22 Electronic Remittance Advice Changes Can Cancel or Change ERA 22

23 23 Other Information Changes

24 24 Other Information Changes

25 Rendering Provider Changes - Add 25 Click Add and Submit

26 26 Rendering Provider Changes Attachments

27 27 Rendering Provider Changes - Remove

28 Provider Identification Changes Changes that fall under this category: Provider Legal Name Organizational Structure Provider Identification (NPI) Taxonomy Information License Information Medicare Participation Patient Population CLIA Certification DEA Number 28

29 29 Provider Identification Changes

30 30 Provider Identification Changes

31 Provider Identification Changes Include all taxonomy codes that reflect the services provided at the location. 31

32 Provider Identification Changes 32 When Recertifying - use this screen and attach required documents

33 33 Provider Identification Changes

34 Provider Identification Changes Attachment is required 34

35 Disclosure Changes Managing Individuals 35

36 36 Disclosure Changes

37 37 Disclosure Changes

38 38 Disclosure Changes

39 39 Tracking Number

40 Checking Change Request Status After transaction is submitted, the status of the transaction can be checked any time in the Portal, without calling Customer Service. IMPORTANT: For security reasons, the application tracking number (ATN), password, and the federal taxpayer identification number (TIN) or employer identification number (EIN) are required to view the submitted transaction status 40

41 41 Pending Updates

42 42 Check Status

43 Return to Provider Additional Information Requests If information is missing or inaccurate on an electronic submission, you have 21 days to correct and resubmit the transaction. Contact listed on application will receive notification Notification will be sent to the Mail To address listed on application or group location Follow instructions on letter and resubmit 43

44 Check Status Status Code and Description What does it mean? A-Approved The enrollment transaction request has been approved F-Completed D-Denied The enrollment transaction maintenance task has been completed. The enrollment application has been denied. This status also appears when an RTP as not been returned and has expired (21-days old). I-Incomplete W-Provider Corrections Required K-Ready For Review The enrollment transaction request has been denied or had inaccurate or missing information which was not corrected in the 21-day timeframe. The enrollment transaction has been partially completed by the user and saved but not yet submitted The transaction has missing or inaccurate information and must be corrected and resubmitted within 21 days. The enrollment transaction was received but has not yet entered the review process due to date of receipt, pending attachments sent by mail, or an error. S-Resubmit Application The corrected enrollment transaction has been received timely but has not yet entered into the review process. L-Under 44 Review The enrollment transaction or maintenance task is currently being reviewed.

45 45 Revalidation and Recertification

46 Revalidation Revalidation letters are sent to the MAIL TO address 60 and 90 days prior to the revalidation due date Yellow triangle appears under the Provider portion of the Home Page Notifies of revalidation due for that particular location Check status from the service location account Revalidation application is prepopulated with provider service location information Rendering provider agreements are REQUIRED for electronic and paper revalidation TO PREVENT CLOSURE OF THE SERVICE LOCATION FOR FAILURE TO REVALIDATE, SUBMIT THE REVALIDATION AS SOON AS THE FIRST NOTIFICATION IS RECEIVED. 46

47 Revalidation Choose the Re-Validation link on the left side of the My Home page. 47

48 Recertification Certain provider types are required to recertify by updating expiring licenses, insurance information, and certifications (as applicable) with the IHCP. Provider type 01 - Hospitals that are out of state (OOS) Provider type 26 - Transportation providers of all specialties Provider type 28 - Out-of-state Laboratory providers with Specialty Mobile Lab or Mobile Independent Diagnostic Testing Facility (IDTF) Provider type 29 - Out-of-state Radiology providers with Specialty Mobile X-Ray Clinic. Notification is sent to the provider Mail To address 60 business days before the end date of the provider's eligibility to participate Failure to recertify timely will require a full re-enrollment with the IHCP 48

49 Provider Identification Changes When Recertifying - use this screen and attach required documents 49

50 50 Helpful Tools

51 Helpful Tools IHCP website at indianamedicaid.com IHCP Provider Reference Modules Medical Policy Manual Customer Assistance available 8am-6pm EST Monday Friday IHCP Provider Relations Field Consultants See the Provider Relations Field Consultants page at indianamedicaid.com Secure Correspondence via the Provider Healthcare Portal Written Correspondence DXC Technology Provider Written Correspondence P.O. Box 7263 Indianapolis, In

52 52 Questions Following this session please review your schedule for the next session you are registered to attend