Sending Updates Through The Provider Healthcare Portal Indiana Health Coverage Programs DXC Technology October 2017
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
Features of Electronic Enrollment Updates and Reminders 3
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
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
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
Provider Maintenance Portal Navigation 7
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
Electronic Attachments Any changes that require documentation trigger the attachment screen 9
Attachments by Mail Attachments are able to be sent by mail also 10
Updates that can be made on the Provider Healthcare Portal 11
12 Provider Maintenance
13 Update Options Available
14 Change Tax ID
Contact and Delegated Administrator Changes Person who can answer questions regarding the location 15
16 Delegated Administrator Changes
17 Address Changes
18 Specialty Changes
19 Presumptive Eligibility
20 Electronic Funds Transfer
21 Language Changes
Electronic Remittance Advice Changes Can Cancel or Change ERA 22
23 Other Information Changes
24 Other Information Changes
Rendering Provider Changes - Add 25 Click Add and Submit
26 Rendering Provider Changes Attachments
27 Rendering Provider Changes - Remove
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 Provider Identification Changes
30 Provider Identification Changes
Provider Identification Changes Include all taxonomy codes that reflect the services provided at the location. 31
Provider Identification Changes 32 When Recertifying - use this screen and attach required documents
33 Provider Identification Changes
Provider Identification Changes Attachment is required 34
Disclosure Changes Managing Individuals 35
36 Disclosure Changes
37 Disclosure Changes
38 Disclosure Changes
39 Tracking Number
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 Pending Updates
42 Check Status
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 email notification Notification will be sent to the Mail To address listed on application or group location Follow instructions on letter and resubmit 43
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 Revalidation and Recertification
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
Revalidation Choose the Re-Validation link on the left side of the My Home page. 47
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 281 - Mobile Lab or 283 - Mobile Independent Diagnostic Testing Facility (IDTF) Provider type 29 - Out-of-state Radiology providers with Specialty 291 - 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
Provider Identification Changes When Recertifying - use this screen and attach required documents 49
50 Helpful Tools
Helpful Tools IHCP website at indianamedicaid.com IHCP Provider Reference Modules Medical Policy Manual Customer Assistance available 8am-6pm EST Monday Friday 1-800-457-4584 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 46207-7263 51
52 Questions Following this session please review your schedule for the next session you are registered to attend