WEBVTT 1 "Brigman, Emily" (3307792896) 00:00:04.075 --> 00:00:24.169 This is one of many Illinois EVV town hall webinars we've had over the last two, three years now. E statewide EVV implementation has been a work in progress, right? But it may surprise some people to know we are further along. 2 "Brigman, Emily" (3307792896) 00:00:24.169 --> 00:00:43.800 Long than some other states. Illinois recently went through a certification review with federal CMS, and even federal CMS and their partners recognize how complex our Medicaid landscape is relevant to electronic visit verification requirements. 3 "Brigman, Emily" (3307792896) 00:00:43.800 --> 00:01:03.800 On the call with me today is Colby Ward with HHA exchange. HHA Exchange is our statewide EVV vendor and aggregator. We do allow provider agencies subject to EVV requirements to use their own EVV vendors or 3rd party EV. 4 "Brigman, Emily" (3307792896) 00:01:03.800 --> 00:01:27.290 EVV vendors under, with the understanding that those vendors are capable of communicating successfully visit data to HHA exchange for aggregation. HFS must have access to EVV data for all of our providers because we are required to record. 5 "Brigman, Emily" (3307792896) 00:01:27.290 --> 00:01:52.100 Report on at least a quarterly basis to federal CMS. We also have representatives from our Bureau of managed Care on the call. As some of you, provider representatives know, you are billing HFS, doors, DOA or managed care organizations for service provision to. 6 "Brigman, Emily" (3307792896) 00:01:52.100 --> 00:02:12.100 To their customers. We have representation from each of our Illinois Medicaid programs. I'm going to use the word program to describe programs like the community care program through department on aging, the home services program through. 7 "Brigman, Emily" (3307792896) 00:02:12.100 --> 00:02:40.350 Vision of rehabilitation services, our division of specialized care for children, DSCC, and division of developmental disabilities or DDD. All of the content from our previous webinars is available through the HFS EVV website. If you just google HFS EVV, you will find our website, but we we have included that as a resource today. 8 "Brigman, Emily" (3307792896) 00:02:40.350 --> 00:03:00.350 I want to call up that we recently went through implementation for division of rehabilitation services and department on aging providers. So I recognize that a good portion of attendees today are from, those programs or. 9 "Brigman, Emily" (3307792896) 00:03:00.350 --> 00:03:21.517 Serving those programs. And this is brand new, right? You were operating, EVV processes in a way that aligned with state legislation for a number of years, the Smart Act. The federal 21st century Cares Act is a lot more prescriptive. 10 "Bridgit Lehman" (900212480) 00:03:21.517 --> 00:03:25.602 Okay I'm gonna make sure everybody's muted. 11 "Brigman, Emily" (3307792896) 00:03:25.602 --> 00:03:54.560 To there, in that there the federal government is focused on ensuring that states collect data on who's receiving services, who provided the services, where the services are located, and that is all reported to federal CMS. Manually edited visits, are, are observe. 12 "Brigman, Emily" (3307792896) 00:03:54.560 --> 00:04:10.260 By the state and considered out of compliance, out of compliance. If there's consistent manually edited or or entered visits, that's, that can be a red flag for Illinois Medicaid programs. 13 "Brigman, Emily" (3307792896) 00:04:10.260 --> 00:04:27.119 Yes, this is a recorded session. We are going to be sharing materials at a later date. So if you are not signed up for the list serve, please do so. You can, you can sign up for the list serve by going through the HFS provider notice website. 14 "Brigman, Emily" (3307792896) 00:04:27.119 --> 00:04:47.119 Clicking on the electronic visit verification category and submitting your email address. That's how you get signed up for EBV related provider notices and list serve communications. Many of you have already noticed there is a Q and A box in the lower right hand. 15 "Brigman, Emily" (3307792896) 00:04:47.119 --> 00:05:11.629 In corner, please feel free to submit questions. I would encourage you to submit questions as we are going through content. If you have a follow up question, go ahead and submit it. This is not a forum for HFS or HHA exchange to provide technical assistance. However, if you have gone through. 16 "Brigman, Emily" (3307792896) 00:05:11.629 --> 00:05:31.629 To HHA Exchange's client support portal and feel as though you are not getting adequate feedback and assistance, please enter the ticket number associated with with the request that you submitted to HHA exchange. And we can ensure that that ticket. 17 "Brigman, Emily" (3307792896) 00:05:31.629 --> 00:05:55.099 Is escalated for, for further investigation. All of the content today is based on questions and concerns that were submitted during the registration process. So you you you if you submitted a questionnaire concern relevant to electronic visit verification, you, you should. 18 "Brigman, Emily" (3307792896) 00:05:55.099 --> 00:06:16.979 Recognize content during today's presentation. We're going to start with some messaging from the state, and then Colby will take over, offering guidance related to compliance monitoring, technical issues, et cetera. 19 "Brigman, Emily" (3307792896) 00:06:16.979 --> 00:06:36.979 There have been a lot of questions rate recently especially from the DOA indoors pop provider population on policy. Across the state, all of our Medicaid programs are. 20 "Brigman, Emily" (3307792896) 00:06:36.979 --> 00:07:09.049 Updating EVV policies effective 1 April. HFS cannot address the nooks and crannies of all of those policies today. So if you have lingering questions, know that the expectation for our Illinois Medicaid programs is release of these updated policies NO later than 1 April, and we would encourage you to outreach those programs specifically. 21 "Brigman, Emily" (3307792896) 00:07:09.049 --> 00:07:19.769 For follow up questions on policies. There are some common themes throughout these policy updates that I will go into. 22 "Brigman, Emily" (3307792896) 00:07:19.769 --> 00:07:38.579 We at HFS did push for consistency in policy recognizing, number one that provider agencies may serve more than one Illinois Medicaid program and also may offer. 23 "Brigman, Emily" (3307792896) 00:07:38.579 --> 00:07:58.579 More than one type of service that's subject to EVV requirements. E.g., we have provider agencies in Illinois that offer both homemaker services and home health services. They maybe serving both the home services program through doors and the community care. 24 "Brigman, Emily" (3307792896) 00:07:58.579 --> 00:08:35.558 Program through IDOA and, offering home health services under state plan Medicaid. So we wanted to ensure consistency in policy, and align policy with requirements under the 21st century Cares act. Sorry I skipped ahead there a bit. We implemented EVV for division of developmental disabilities, DDD, personal care services, two and a half years ago now. And it at the. 25 "Winsel Pamela" (2832236800) 00:08:35.558 --> 00:08:38.557 At the. 26 "Brigman, Emily" (3307792896) 00:08:38.557 --> 00:08:54.419 I would say approximately a year later at the end of 2023, we implemented EVV for home health care providers, billing state plan medica, under state plan Medicaid, so either billing HFS. 27 "Brigman, Emily" (3307792896) 00:08:54.419 --> 00:09:14.419 Or our managed care organizations. Managed care, we recognized MMA I recently transitioned to dual eligible special needs plans. If you are billing a dual eligible special needs plan for home healthcare. 28 "Brigman, Emily" (3307792896) 00:09:14.419 --> 00:09:29.489 Services under state plan or for DRS waiver or elderly waiver services, those services are subject to EVV. So homemaker services and home health build. 29 "Brigman, Emily" (3307792896) 00:09:29.489 --> 00:09:48.749 For a waiver customer or understate plan to a fighty snip or D snip MCO are subject to EVV requirements. On 2nd of March, we implemented EVV for. 30 "Brigman, Emily" (3307792896) 00:09:48.749 --> 00:10:05.969 DOA endores providers, and backing up a bit, I missed, I missed covering implementation of home health or four home health providers serving DDD and DSCCC. So. 31 "Brigman, Emily" (3307792896) 00:10:05.969 --> 00:10:21.899 One big theme with our updated EVV policies across the state is going to transition to quarterly compliance monitoring. When we say quarter we mean state fiscal year quarter. 32 "Brigman, Emily" (3307792896) 00:10:21.899 --> 00:10:38.519 I'd said that these policies would become effective 1 April, so the Q1 in which we will monitor compliance across all provider agencies will be the 1 April through 30 June state fiscal year quarter. 33 "Brigman, Emily" (3307792896) 00:10:38.519 --> 00:10:55.949 If you all attended recent compliance monitoring trainings hosted by HHA exchange, there was one just earlier this week and we've linked two in this presentation the slides and recording for that training. 34 "Brigman, Emily" (3307792896) 00:10:55.949 --> 00:11:13.349 But if you've been monitoring that, you'll know that provider agency administrators, those folks at each agency who have administrative roles in HHA Exchange receive on a monthly basis what we refer to as Know Your numbers reports. 35 "Brigman, Emily" (3307792896) 00:11:13.349 --> 00:11:31.889 And those reports break down your overall compliance percentage quarter to date. So at the end of June, well, specifically 15 July, all provider agencies will receive a. 36 "Brigman, Emily" (3307792896) 00:11:31.889 --> 00:11:51.889 Know your numbers report for each program they serve that shows their overall compliance percentage for that quarter. I, I want to remind DSCCC, DDD, and HFS providers, those those state plan. 37 "Brigman, Emily" (3307792896) 00:11:51.889 --> 00:12:17.209 Home health providers and personal care service providers under DDD that we previously had policy in place that reflected an expectation for 50 % overall visit compliance within the 1st six months of implementation then transitioned to 75 % overall visit compliance within one year. 38 "Brigman, Emily" (3307792896) 00:12:17.209 --> 00:12:39.319 Year or by one year of implementation. We distributed recently compliance or corrective action plans to providers who were under the 75 % compliance threshold. I'll talk a little bit more about that shortly. That is specific to DSCCC. 39 "Brigman, Emily" (3307792896) 00:12:39.319 --> 00:13:07.499 DDD and HFS state plan providers. Moving forward effective 1 April, all providers will be subject to the same level of compliance monitoring. It is by quarter. As we onboarded department on aging and doors provider agencies, we ensured that post implementation, that that March second implementation date, they would have policy. 40 "Brigman, Emily" (3307792896) 00:13:07.499 --> 00:13:23.789 Reflective of the same requirements for providers who have already got undergone implementation. And that is mostly because DOA endorsed providers have been subject to EVB requirements because of the Illinois Smart Act. 41 "Brigman, Emily" (3307792896) 00:13:23.789 --> 00:13:41.819 For over a decade now. So what does quarterly compliance monitoring look like per each Illinois Medicaid program? What, what are our programs looking at? 42 "Brigman, Emily" (3307792896) 00:13:41.819 --> 00:14:01.819 We're looking at, does your visit data support the claim that you submitted? Whether you submitted the claim to HFS, DDD, DSCCC, DOA or Doors or a managed care organization. Does your visit data that's, that's. 43 "Brigman, Emily" (3307792896) 00:14:01.819 --> 00:14:29.359 Either been entered in the HHA exchange system or transmitted to HHA from a 3rd party system aligned with the claim that you submitted to the to the payer. All state Medicaid program administrators are receiving or will be receiving weekly reports on provider performance EVV compliance performance for past and current state fiscal year quarter. 44 "Brigman, Emily" (3307792896) 00:14:29.359 --> 00:14:32.879 1st beginning in April. 45 "Brigman, Emily" (3307792896) 00:14:32.879 --> 00:14:52.879 Did your visit capture all six elements required under the federal 21st century Cures Act? This has been reviewed in trainings leading up to this including the recent HHA exchange compliance monitoring training, but those six elements basically monitor did. 46 "Brigman, Emily" (3307792896) 00:14:52.879 --> 00:15:10.139 The caregiver or the the the homemaker aid clock in through a mobile application at the start and end of a visit at both the start and end was the location of service delivery captured. 47 "Brigman, Emily" (3307792896) 00:15:10.139 --> 00:15:30.139 Did the visit capture the individual providing the service and the individual receiving the service? It was there a manual edit to the visit? Was the visit manually entered? The overarching goal of EVV requirements, whether state. 48 "Brigman, Emily" (3307792896) 00:15:30.139 --> 00:15:47.579 Or federal legislation is to ensure that people are getting the services they need. Vulnerable people with disabilities are getting the services that were authorized by the respective Medicaid program or managed care organization. And. 49 "Brigman, Emily" (3307792896) 00:15:47.579 --> 00:16:07.579 Is there evidence of that service provision as authorized? When it's manually edited or entered, that's caused for concern. We recognize that there will always be technological issues, and that's why we're not requiring. 50 "Brigman, Emily" (3307792896) 00:16:07.579 --> 00:16:41.029 A hundred percent compliance at all times. But when there are consistent manually edited or entered visits, that will lend to an Illinois Medicaid program exercising some additional scrutiny of that respective provider agency, right? What's going on that there's consistently edited or entered manually edited or entered visits? State Medicaid programs receive similar reports as what's sent. 51 "Brigman, Emily" (3307792896) 00:16:41.029 --> 00:17:11.869 To the provider agencies. So we get the same know your numbers reports that provider agencies get. For some programs like home health offered under state plan, on the HFS end, we're receiving a wrap up of visits billed to HFS and our managed care organizations. And we're looking at overall compliance percentage for all of. 52 "Brigman, Emily" (3307792896) 00:17:11.869 --> 00:17:31.869 For those visits. We expect on the provider side you to be accounting for visits under each Illinois Medicaid program, whether they're billed to HFS or MCO, and looking at your overall compliance percentage. 53 "Brigman, Emily" (3307792896) 00:17:31.869 --> 00:18:00.559 We're also looking at, we have access directly in the HHA exchange system and through reporting whether your claims for services subject to EVV align with your visit data within the HHA exchange system. One one theme that federal CMS has been hammering with states lately and most recently with Illinois on our. 54 "Brigman, Emily" (3307792896) 00:18:00.559 --> 00:18:17.459 Our certification review is that states should be moving toward scrutiny of claim alignment with visit data, meaning does the claim that you submitted for payment support the visit data? 55 "Brigman, Emily" (3307792896) 00:18:17.459 --> 00:18:37.459 Within the HHA exchange system. There's a s everyone on this call I'm sure is aware of the increased heightened scrutiny of Medicaid services from federal CMS. There is a strong push for states to transition to payment based on e. 56 "Brigman, Emily" (3307792896) 00:18:37.459 --> 00:18:56.579 VVV data. That has not occurred yet in Illinois. I'll talk a little bit about that. We are not ready to implement that statewide, but it is something that we plan on exploring. As I alluded to earlier, Illinois is very complex. We have. 57 "Brigman, Emily" (3307792896) 00:18:56.579 --> 00:19:16.579 Nine different waiver programs, the majority of which furnished services subject to EVV requirements. We also have managed care enrolleyes who are also receiving waiver services or services home health services under state plan. 58 "Brigman, Emily" (3307792896) 00:19:16.579 --> 00:19:36.579 They could be paid for by the state, they could be paid for by a managed care organization, and it's a complex territory to navigate. Know that if we transitioned to payment based on EVV data, you will receive very advanced notice of that. 59 "Brigman, Emily" (3307792896) 00:19:36.579 --> 00:19:56.659 We're we're not there yet, but it is being pushed by federal CMS. Overall quarterly compliance expectations. We expect per state fiscal year quarter provider agencies to attain at least. 60 "Brigman, Emily" (3307792896) 00:19:56.659 --> 00:20:22.399 75 % overall visit compliance. Pretty straightforward. Some of the policies that you'll receive from each Illinois Medicaid program will will offer additional details. I highly encourage you to access the recent compliance monitoring trainings from HHA Exchange to get a better sense of reports you you should be running within the. 61 "Brigman, Emily" (3307792896) 00:20:22.399 --> 00:20:50.129 HHA exchange system, and that you'll be receiving to, to complete self monitoring of compliance. We again will also be monitoring whether claims for services in scope for EVV align with visit data in the HHA exchange system. We've been saying this a lot lately, but if you have a 3rd party vendor. 62 "Brigman, Emily" (3307792896) 00:20:50.129 --> 00:21:10.129 It behooves you to ensure that visit data within your 3rd party system aligns with visit data in HHA exchange. Everyone subject to EVV requirements has access to their portal in HHA exchange. 63 "Brigman, Emily" (3307792896) 00:21:10.129 --> 00:21:36.919 Change whether or not you're using a 3rd party vendor. And through recent CAP dissemination in the fall of 2025, we've identified pretty consistent concerns across provider agencies with 3rd party vendors who were primarily looking at visit data in their 3rd party system rather than. 64 "Brigman, Emily" (3307792896) 00:21:36.919 --> 00:21:53.399 Then how it looked after it was after it was aggregated by HHA exchange within their HHA exchange portal. There can be a number of issues that lend to visit data looking compliant in a 3rd party system. 65 "Brigman, Emily" (3307792896) 00:21:53.399 --> 00:22:13.399 And not looking compliant in HHA exchange. There maybe some level of programming going on by the 3rd party vendor that once that visit data is received by HHA exchange, it looks non compliant when it may not actually be. So please, please check consistent. 66 "Brigman, Emily" (3307792896) 00:22:13.399 --> 00:22:23.009 To ensure your visit data and HHA exchange looks the same as it does in your 3rd party system. 67 "Brigman, Emily" (3307792896) 00:22:23.009 --> 00:22:39.839 We've changed up non compliance penalties a little bit for for those DDD HFS state plan and DSCC providers that have, that have been subject to EVV requirements. 68 "Brigman, Emily" (3307792896) 00:22:39.839 --> 00:22:59.839 As prescribed by the 21st century Cures Act over the last couple of years, the, this looks a little bit different. The harshest penalty remains a referral to HFS OIG for investigation. If there is perpetual or or seemingly willy. 69 "Brigman, Emily" (3307792896) 00:22:59.839 --> 00:23:22.319 The full non compliance on the provider agencies part. Know that any timelines in EVV policies are business days, ok? So within ten business days or within 20 business days of approval, you'll see on 2nd bullet point. 70 "Brigman, Emily" (3307792896) 00:23:22.319 --> 00:23:42.319 Ten and 20. That's business days. The, the 1st instance of provider agencies either being under 75 % in a state fiscal year quarter or having claims that do not align with visit data. 71 "Brigman, Emily" (3307792896) 00:23:42.319 --> 00:24:07.309 That within the HHA exchange system will warrant a notice from the respective Medicaid program to complete learning management system modules within 30 business days. This this means the Illinois Medicaid program will tell you your provider agency that it. 72 "Brigman, Emily" (3307792896) 00:24:07.309 --> 00:24:27.309 Administrators within your agency need to go through specific trainings within the HHA Exchange Learning management system. The Illinois Medicaid program will tell you which trainings you need to complete. If any of you have already gone through learning management system. 73 "Brigman, Emily" (3307792896) 00:24:27.309 --> 00:24:49.999 And modules, you'll know that there are administrator specific trainings. Coming up here soon, HHA Exchange will have an electronic data interchange or EDI specific LMS training, and that is what will be required of provider agencies with 3rd party. 74 "Brigman, Emily" (3307792896) 00:24:49.999 --> 00:25:24.769 Vendors to go through if they are of under 75 % compliance or have claims that don't align with visit data in one state fiscal year quarter. If you have one ding for a quarter and then in the next quarter, you're still under 75 % compliance or you're still struggling with ensuring visit data alignment with claims submitted, will require you. 75 "Brigman, Emily" (3307792896) 00:25:24.769 --> 00:25:44.769 You to complete a compliance action plan or corrective action plan within ten business days. What this means is we want you to tell us what you've identified as the issue lending to your non compliance and how, what's your process for remediating that? A lot of times that might. 76 "Brigman, Emily" (3307792896) 00:25:44.769 --> 00:26:19.489 Include retraining caregivers. We recognize that administration and caregiver employment across our provider agencies can change frequently. So there maybe retraining needed. There may need to be some collaborative discussions between provider and 3rd party vendor if there are visit transmission issues. The state can only gauge your level of compliance based on visit data within the HHA exchange system. So I talked. 77 "Brigman, Emily" (3307792896) 00:26:19.489 --> 00:26:38.519 Earlier about ensuring that you look at whether visit data in your 3rd party system aligns with visit data in the HHA exchange system. Part of that is ensuring that your actu your 3rd party vendor is successfully transmitting that visit data. 78 "Brigman, Emily" (3307792896) 00:26:38.519 --> 00:26:58.519 If you don't have visit data in HHA exchange, our Illinois Medicaid programs think you're not using EVV. Now, this can be remediated through collaborate collaboration with the 3rd party vendor and potentially HHA exchange as well. But. 79 "Brigman, Emily" (3307792896) 00:26:58.519 --> 00:27:27.919 But again, please ensure with your 3rd party vendor that you're actually sending visit data to HHA exchange, and that it's showing up in the same way, the same way it looks in your 3rd party system. For if you're non compliant for three consecutive quarters, that warrants a referral to our Office of inspector general. That's fairly straightforward. Perpetual or ongoing non compliance. 80 "Brigman, Emily" (3307792896) 00:27:27.919 --> 00:27:43.649 So the state is a sign that there maybe potential fraud that services aren't being furnished as authorized, and that is an issue for our Office of Inspector General to investigate, to look into. 81 "Brigman, Emily" (3307792896) 00:27:43.649 --> 00:28:08.869 Some additional requirements which which some of the provider agencies on this call are are have been aware of for two years now. We do require provider agencies to track full caregiver social security numbers in HHA exchange. 82 "Brigman, Emily" (3307792896) 00:28:08.869 --> 00:28:28.869 Change. There are different ways of, of, of communicating full caregiver social security numbers for provider agencies with 3rd party vendors. HHA Exchange has gone over that in compliance trainings, and we also link to additional guidance in this space. 83 "Brigman, Emily" (3307792896) 00:28:28.869 --> 00:29:02.479 Document. The reason we are requiring full caregiver social security numbers similar to what I talked about earlier in the presentation, we have provider agencies that bill multiple Illinois Medicaid programs. We also have caregivers who work for different Illinois Medicaid programs. An example being, personal assistance through doors may also work for DDD as a personal care service provider. 84 "Brigman, Emily" (3307792896) 00:29:02.479 --> 00:29:24.439 Personal or excuse me, a personal support worker. A personal support worker might also work for a homemaker agency that serves department on aging customers or community care program customers. If there's an issue with a caregiver, for one Illinois Medicaid program. 85 "Brigman, Emily" (3307792896) 00:29:24.439 --> 00:29:51.709 Say e.g., an allegation of fraudulent billing, we would want to be able to examine how that caregiver, that individual caregiver is performing across programs. Another theme within our updated EVV policy statewide is promoting mobile applications as the preferred method of visit verification. 86 "Brigman, Emily" (3307792896) 00:29:51.709 --> 00:30:13.789 A lot of provider agencies especially those DOA and doors providers are familiar with calling in and calling out. The reason we are heavily promoting mobile application usage is because of the Cares Act requirement to capture location of. 87 "Brigman, Emily" (3307792896) 00:30:13.789 --> 00:30:38.539 Service delivery at the start and end of a visit. It calling in and out does not really capture that location. It doesn't inform the Illinois Medicaid program that the service was performed in a location that is allowed or it like the customer's home. 88 "Brigman, Emily" (3307792896) 00:30:38.539 --> 00:30:58.539 Or if allowed by the respective Illinois Medicaid program when performing service in the community. We know and recognize that division of developmental disabilities appro and additional programs like like DOA and DSCCC. 89 "Brigman, Emily" (3307792896) 00:30:58.539 --> 00:31:18.539 They do allow caregivers to perform services in the community. That is if you're performing service in the community, it is fine for the GPS location to be in the community versus the individual customer participant member, members home, ok? 90 "Brigman, Emily" (3307792896) 00:31:18.539 --> 00:31:45.539 But the state needs to have insight into the visit location to ensure adequate and appropriate service delivery as authorized. We are also transitioning to only allowing IVR. And I want to be specific here. Interactive voice response is calling in and out, calling a visit in and out by telephone. 91 "Brigman, Emily" (3307792896) 00:31:45.539 --> 00:32:05.539 HFS and Division of specialized Care for children do not allow IVR usage. Effective 1 April. Only mobile applications can be used. There are some caveats carved out within division of rehabilities. 92 "Brigman, Emily" (3307792896) 00:32:05.539 --> 00:32:25.539 Patient services, department on aging, and DDD, EVV policy. We encourage you to refer to those policies and those programs for specifics on requesting an exception to mobile application usage. Some of those specifics might be you can only. 93 "Brigman, Emily" (3307792896) 00:32:25.539 --> 00:32:44.279 Only use IVR if the individual you're serving has a landline telephone. Now we've already fielded a lot of feedback on this new requirement because of recent policy training and compliance training. 94 "Brigman, Emily" (3307792896) 00:32:44.279 --> 00:33:04.279 E.g., we perform services in a rural area, and, there's poor cell service. HHA exchange mobile application has an offline mode that curves those poor cellular services. 95 "Brigman, Emily" (3307792896) 00:33:04.279 --> 00:33:23.069 Issues. That allows a caregiver to log in and out and for the visit to be communicated once service is regained. It still is able to capture the GPS location. If you have a 3rd party vendor, we encourage you to explore. 96 "Brigman, Emily" (3307792896) 00:33:23.069 --> 00:33:43.069 Whether their mobile application has an offline mode. The state can't divine across all 3rd party vendors, whether that's a feature or not, that would be up to the provider to explore with their 3rd party vendor. If there are consistent issues with inability. 97 "Brigman, Emily" (3307792896) 00:33:43.069 --> 00:34:03.069 To capture location of service delivery or the the the other features of the visit, start and end et cetera, from a provider agency with a 3rd party vendor in non compliance communications, the, the respective Illinois Medicaid program will work with. 98 "Brigman, Emily" (3307792896) 00:34:03.069 --> 00:34:19.109 Care provider agency to explore alternate options and that may include transitioning to HHA exchange for free simply to use their mobile application with an offline mode, for. 99 "Brigman, Emily" (3307792896) 00:34:19.109 --> 00:34:39.109 Logging service provision, but know that each policy relevant to, allowed usage of IVR is different. So again, please refer to the respective. 100 "Brigman, Emily" (3307792896) 00:34:39.109 --> 00:35:06.169 Illinois Medicaid program and the updated policy after 1 April for specifics on that. When IVR is allowed, interactive voice response is allowed, the phone number used to call in and out must belong to the individual receiving the service. So the participant. 101 "Brigman, Emily" (3307792896) 00:35:06.169 --> 00:35:26.169 The customer, the member, whatever, whatever your respective Illinois Medicaid program refers to as the individual receiving services. In addition to this, caller ID must be present. At HFS, we've taken a cursory look at I visit. 102 "Brigman, Emily" (3307792896) 00:35:26.169 --> 00:35:53.959 Logged through IVR in the last quarter, and we have noticed there are blocking features in at play, meaning on our end we see all nines for the phone number. That could be because the caregiver is pressing star six seven before calling in and out, but the number is being blocked, whatever the. 103 "Brigman, Emily" (3307792896) 00:35:53.959 --> 00:36:13.959 The Method used for blocking is. That is not allowed if IVR is permitted for your provider agency. We have to know that the number used belongs to the customer. Please refer to your poli your Illinois Medicaid program policy. 104 "Brigman, Emily" (3307792896) 00:36:13.959 --> 00:36:35.779 For specifics on how states are monitoring or how those programs are monitoring that the number used aligns with the customers, the the phone line that belongs to the customer. We want to ensure and reiterate. 105 "Brigman, Emily" (3307792896) 00:36:35.779 --> 00:37:08.449 Right for provider agencies who have already been receiving non compliance notices, are those new to the statewide aggregation process? EVV, what steps there are for EVV readiness? Ensure your agency is active in impact. And if you are billing a waiver program like division of developmental disabilities, that you are enrolled in impact. 106 "Brigman, Emily" (3307792896) 00:37:08.449 --> 00:37:29.089 With the approval to bill divi division of developmental disabilities. I won't go on or on and on about the Noox and crannies of data exchange between the state and HHA exchange, but I will say that HHA Exchange becomes aware of provider agency's. 107 "Brigman, Emily" (3307792896) 00:37:29.089 --> 00:37:56.659 Subject to EVV requirements through a file that the state sends to HHA exchange. And that file is based on agency impact enrollment. Is your agency enrolled in impact to perform home health services or homemaker services or PSW services for DDD? And are you active? Have you gone. 108 "Brigman, Emily" (3307792896) 00:37:56.659 --> 00:38:16.659 Through revalidation as prescribed. Is your public health licensure up to date? And are you approved to bill respective Illinois Medicaid programs? If there are issues with any of those things that may lend to your agency not being communicated. 109 "Brigman, Emily" (3307792896) 00:38:16.659 --> 00:38:36.659 Updated to HHA exchange. So please keep your impact enrollment up to date. And if you have any concerns with your impact enrollment that you believe might prevent you from successfully using EVV, please real reach out. Reach out to the respective Illinois Medicaid program and if they need support from. 110 "Brigman, Emily" (3307792896) 00:38:36.659 --> 00:39:00.300 HFS or our impact team at HFS, we will collaborate together to get it resolved, ok? This is mostly catered toward DOA and doors provider agencies who, who had our, we had a soft go live date on March second, right? If you have not completed the HHA exchange provider enrollments. 111 "Brigman, Emily" (3307792896) 00:39:00.300 --> 00:39:20.300 Survey, please do so as soon as possible. The provider enrollment survey is necessary in order for you to successfully use HHA exchange or communicate visit data to HHA Exchange from your 3rd party EVV system. All of. 112 "Brigman, Emily" (3307792896) 00:39:20.300 --> 00:39:39.990 These steps must be done as reflected in updated policy before you bill for services subject to EVV requirements. So, after 1 April of 2026, any new homemaker agency or home health agency. 113 "Brigman, Emily" (3307792896) 00:39:39.990 --> 00:39:59.990 Needs to show that the respective Illinois Medicaid program that they are ready to use EVV before they can bill for services. For 3rd party vendors, that would include successful integration with HHA exchange. 114 "Brigman, Emily" (3307792896) 00:39:59.990 --> 00:40:05.460 Before billing for services. 115 "Brigman, Emily" (3307792896) 00:40:05.460 --> 00:40:25.460 And regarding impact enrollment, as always, you cannot bill an agency like DOA or an MCO for elderly waiver services without being actively enrolled in impact and approved to bill. 116 "Brigman, Emily" (3307792896) 00:40:25.460 --> 00:40:48.080 Those programs or those payers. We've had a lot of questions lately regarding MCO responsibilities. And as I mentioned, we have Bureau of managed Care presence on the call today. HFS worked internally to collaborate with our managed care organizations, who pay for. 117 "Brigman, Emily" (3307792896) 00:40:48.080 --> 00:41:05.340 Services under state plan and for waiver services like elderly waiver services and doors waiver services. The managed care organizations are required to communicate authorization data to HHA exchange. 118 "Brigman, Emily" (3307792896) 00:41:05.340 --> 00:41:25.340 When authorizations are required. And for doors and DOA, authorizations are required. It varies under state plan home health. So a huge managed care organization responsibility is to ensure succes. 119 "Brigman, Emily" (3307792896) 00:41:25.340 --> 00:41:51.560 Successful transmission of authorization to HHA exchange. We have weekly meetings with HHA exchange and representatives from our managed care organizations relative to authorizations, and the, and resolution of any authorization transmission concerns. HFS has a policy for our. 120 "Brigman, Emily" (3307792896) 00:41:51.560 --> 00:42:17.360 Our managed care organizations that requires the managed care organizations to adequately monitor successful transition of authorization data to HHA exchange, to consistently remediate authorization issues and concerns and to support providers who have concerns with using EVV due to lack of. 121 "Brigman, Emily" (3307792896) 00:42:17.360 --> 00:42:49.010 Of an authorization. Colby is going to talk more about what providers can do to use EVV in the absence of an authorization later in this presentation. But please note that on the HFS EVV website, there is a contact listing for managed care organizations when there's an issue with an authorization within the HHA exchange system or you're seeing that the MCO has not communicated an authorization. 122 "Brigman, Emily" (3307792896) 00:42:49.010 --> 00:43:09.710 In addition, the managed care organizations are required to support state EVV requirements, and that includes education to provider agencies they authorize to bill for services, on EVV policy. 123 "Brigman, Emily" (3307792896) 00:43:09.710 --> 00:43:40.250 As well as EVV readiness, right? Ensuring active and appropriate enrollment in impact. Policy compliance monitoring pertains to all visit data. That includes visits that are billed to managed care organizations. If you've reached out to a managed care organization via the contact listed on our HFS EVV web. 124 "Brigman, Emily" (3307792896) 00:43:40.250 --> 00:44:01.620 Site and you feel like you're not getting adequate support or you haven't received a response within several business days, please forward that conf that that email that you sent to hFS.EVV letting us know a general summary of of what the issue is. 125 "Brigman, Emily" (3307792896) 00:44:01.620 --> 00:44:17.190 And we will escalate that to, our staff at HFS through our Bureau of managed Care who oversee and are liaise with each managed care organization for investigation. 126 "Brigman, Emily" (3307792896) 00:44:17.190 --> 00:44:37.190 HHA Exchange and the Illinois Medicaid programs cannot remediate MCO authorization issues, but the state can help investigate authorization concerns if you're not getting help from the respective managed care. 127 "Brigman, Emily" (3307792896) 00:44:37.190 --> 00:44:40.200 Organization. 128 "Brigman, Emily" (3307792896) 00:44:40.200 --> 00:44:59.790 I've said it several times already and I'm sure it's probably been covered in the Q and A box again, but, these slides today and the recording will eventually be made available. We had two, two attendees and to those folks who weren't able to attend today. 129 "Brigman, Emily" (3307792896) 00:44:59.790 --> 00:45:19.790 We will communicate the materials as available on our EVV website through our list serve notice. It may take us some time to publish the slides. We have to meet five oh eight accessibility requirements as prescribed by, by the feds and. 130 "Brigman, Emily" (3307792896) 00:45:19.790 --> 00:45:39.660 It May take us some time to ensure accessibility of the PowerPoint slides. So know that these slides will be published, ok? And the recording as well. We've included in the content MCO EVV contacts that are also available at the HFS EVV website. 131 "Brigman, Emily" (3307792896) 00:45:39.660 --> 00:45:59.660 In addition to HFS policy for managed care organizations, managed care organizations also updated their provider agreements to include provider requirements for compliance with state EVV requirements. The it also. 132 "Brigman, Emily" (3307792896) 00:45:59.660 --> 00:46:25.310 Provider agencies, I believe it's every five years have to go through impact revalidation or if they modify their enrollment, they have to acknowledge impact terms and agreements and within the last couple of years HFS updated our impact terms and agreements to include a requirement for providers to attest to compliance with state. 133 "Brigman, Emily" (3307792896) 00:46:25.310 --> 00:46:43.260 EV requirements. EVV policy contacts, we talked about common themes across the the 4126 EVV policy, but please refer to the respective Illinois. 134 "Brigman, Emily" (3307792896) 00:46:43.260 --> 00:46:58.890 Medicaid program for details that weren't covered today. Or, e.g., whether IVR is allowed and under what circumstances, how to request an exception for IVR usage. 135 "Brigman, Emily" (3307792896) 00:46:58.890 --> 00:47:18.890 Please refer to the Illinois Medicaid program. Again, HFS and DSCCC for state plan and DSCCC services will not allow IVR. And HFS cannot offer clarification on IVR allowance for in. 136 "Brigman, Emily" (3307792896) 00:47:18.890 --> 00:47:46.280 Any other Illinois Medicaid programs, please refer to the contacts on this slide. Real quickly before I hand this over to my friend Colby Ward at HHA exchange. I want to talk a little bit about compliance action plans for state plan, division of state plan home health, division of special. 137 "Brigman, Emily" (3307792896) 00:47:46.280 --> 00:48:06.280 As care for children, excuse me, and division of developmental disability providers. Over the fall, provider agencies who did not have claims that aligned with visit data or were under the 75 % compliance threshold, those provider agencies. 138 "Brigman, Emily" (3307792896) 00:48:06.280 --> 00:48:30.030 Agencies received non compliance notices and a requirement to develop compliance action plans for respective program approval. So for HFS DSCCC or DDD to approve, and and from that point, provider agencies were given a timeline to come into compliance. 139 "Brigman, Emily" (3307792896) 00:48:30.030 --> 00:48:45.990 On the back end HFS DSCCC and DDD have been monitoring performance improvement for those provider agencies who received caps. Are are they steadily improving from month to month? 140 "Brigman, Emily" (3307792896) 00:48:45.990 --> 00:49:05.990 To determine whether provider agencies fulfilled performance improvement as they outlined and attested to in their approved compliance action plans, HFS and DSCC, NBDD will look at your overall compliance per. 141 "Brigman, Emily" (3307792896) 00:49:05.990 --> 00:49:22.740 Percentage for the 1 January through 31 March state fiscal year quarter. We will have access to that data by 15 April and we'll be reviewing that data to determine whether or not provider agencies have. 142 "Brigman, Emily" (3307792896) 00:49:22.740 --> 00:49:38.970 Reached the 75 % compliance threshold have claims that have are now aligning with visit data and if not need to be referred to HFS Office of inspector General for investigation. 143 "Brigman, Emily" (3307792896) 00:49:38.970 --> 00:50:02.090 Some lessons learned as we implemented EVV in different phases. Again, we started with DDD, PSW. Then we transitioned to implementation for home health providers, billing, under state plan Medicaid DSCCC or. 144 "Brigman, Emily" (3307792896) 00:50:02.090 --> 00:50:28.260 For DDD and most recently we implemented four DOA indoors. Mobile applications stressing this again as as covered in the the updated EBV policy slides that are not capable of offline mode in rural areas or poor cell service et cetera. 145 "Brigman, Emily" (3307792896) 00:50:28.260 --> 00:50:48.260 The state is not responsible for costs associated with alternate visit verification methods like fobs or technology used by caregivers like tablets. That is a provider agency responsibility. 146 "Brigman, Emily" (3307792896) 00:50:48.260 --> 00:51:16.760 If there are cost concerns relative to fur furnishing technology, through a 3rd party EVV vendor, we encourage your agency to explore usage of the free HHA exchange solution. Again, electronic data interchange, please ensure that your, your. 147 "Brigman, Emily" (3307792896) 00:51:16.760 --> 00:51:45.320 You're looking at visit data in your 3rd party system and HHA exchange to ensure the two align. With electronic data interchange, the 1st part of onboarding is completing that HHA exchange enrollment survey and in a 3rd party EVV attestation. After that, you receive credentials from HHA exchange that need to be shared with your 3rd party. 148 "Brigman, Emily" (3307792896) 00:51:45.320 --> 00:52:15.510 Party vendor in order to successfully transmit visit data to HHA exchange for aggregation. We learned through the recent CAP distribution process that somehow these steps were missed during initial onboarding, meaning provider agencies with 3rd party vendors never shared credentials with their 3rd party vendor and the 3rd party vendor never started transmitting visit data to HHA exchange. 149 "Brigman, Emily" (3307792896) 00:52:15.510 --> 00:52:35.510 The provider agency administrator who completed enrollment and attestation with HHA Exchange receives those credentials and needs to share them with their 3rd party vendor representative. We've, we've also learned a lot about administrative oversight at the provider level. 150 "Brigman, Emily" (3307792896) 00:52:35.510 --> 00:52:57.020 I highly encourage provider agencies who are new to statewide EVV aggregation to implement internal policies. Some of our Illinois Medicaid programs have prescribed that provider agencies do implement internal policies for monitoring caregivers. 151 "Brigman, Emily" (3307792896) 00:52:57.020 --> 00:53:17.020 Compliance. I would all, I would also suggest consistent in ongoing training to caregivers, especially those caregivers who are struggling, struggling to learn how to use a mobile application and what constitutes a compliant visit. We recognize again that there is. 152 "Brigman, Emily" (3307792896) 00:53:17.020 --> 00:53:37.020 Fluidity in caregivers employed by provider agencies. Caregivers come and go. They may move from one agency to another. In the caregiver onboarding process, we encourage provider agencies to train that caregiver before allowing that caregiver to begin on EVVB excuse me. 153 "Brigman, Emily" (3307792896) 00:53:37.020 --> 00:53:44.340 Before allowing that caregiver to begin serving customers. 154 "Brigman, Emily" (3307792896) 00:53:44.340 --> 00:53:59.730 A reminder that provider agencies receive reports on a monthly basis that show your compliance percentage for the program and payer you build. 155 "Brigman, Emily" (3307792896) 00:53:59.730 --> 00:54:19.730 Please look at all of these reports. We've had some experiences through CAP distribution where provider agencies were billing HFS for state plan and managed care organizations and low only looked at their visit compliance for the managed care organizations instead of what they were billing HFS. Please look at all. 156 "Brigman, Emily" (3307792896) 00:54:19.730 --> 00:54:28.500 All of those reports. The state is looking at visit data across the board to assess your compliance. 157 "Brigman, Emily" (3307792896) 00:54:28.500 --> 00:54:48.500 I'm gonna hand it over to Colby Ward with HHA Exchange to cover remaining content. I recognize that we have limited time, know that we're looking over the Q and A box. If we have lingering unanswered questions today, we will. 158 "Brigman, Emily" (3307792896) 00:54:48.500 --> 00:55:02.279 To address those through a list serve communication and probably an FAQ on our public facing website. Colby, I'm gonna hand it over to you. 159 "Colby Ward" (719450624) 00:55:02.279 --> 00:55:22.160 All right. Thank you. Good morning, everybody. My name is Colby Wards Senior Director of customer Success with HHA exchange. I'm gonna take us through the slides here today that are gonna cover some of those key questions that came in through registration as Emily mentioned earlier. Before I get started. 160 "Colby Ward" (719450624) 00:55:22.160 --> 00:55:42.160 Just a quick rundown of some of the acronyms that I may use throughout my my portion of this presentation so that everybody's on the same page. EVV, of course referring to electronic visit verification. HHCS is referring to our skilled home healthcare. 161 "Colby Ward" (719450624) 00:55:42.160 --> 00:56:04.680 Services. EDI is referring to electronic data interchange, which I may also refer to as alternate EVV or 3rd party EVV. API is the application Programming interface, that is the method by which alternate EVV vendors are communicating data to HHA exchange. 162 "Colby Ward" (719450624) 00:56:04.680 --> 00:56:23.520 The RIN is the recipient identification number. I may also refer to it as Medicaid ID as that is how it is referred to in the HHA exchange system. HFS, Healthcare and Family Services, ddds, the Division of developmental disabilities. 163 "Colby Ward" (719450624) 00:56:23.520 --> 00:56:39.420 DSCC is the division of specialized care for children, DOA, department on Aging, and DRS Department of Rehabilitation Services. Next slide. 164 "Colby Ward" (719450624) 00:56:39.420 --> 00:56:57.600 Alright, as far as terminology goes, these are a couple of. 165 "Colby Ward" (719450624) 00:56:57.600 --> 00:57:16.320 A couple of cases that I may refer to in different ways throughout my presentation. So payer is referring to also state MCO or contract in HHA exchange. Member, you may refer to as a client, a customer, a patient. 166 "Colby Ward" (719450624) 00:57:16.320 --> 00:57:33.300 Whenever I say provider, that also indicates agency. I know oftentimes folks say provider in reference to caregiver, but if I do say provider, I'm referring to agency, I will try to be as clear as possible throughout my presentation. 167 "Colby Ward" (719450624) 00:57:33.300 --> 00:57:53.300 Caregiver may also be referred to as worker, service provider or nurse, and then as I mentioned before, if I say EDI, I could also be referring to 3rd party EVV or alternate EVV. So we have several different terms for each of these, but, I will do my best to try to be as quick. 168 "Colby Ward" (719450624) 00:57:53.300 --> 00:57:56.490 There is possible throughout. 169 "Colby Ward" (719450624) 00:57:56.490 --> 00:58:14.550 As far as our agenda today, we're gonna be looking to start at EBV program reminders, a couple of the things that Emily covered, but from an HHA exchange lens. 170 "Colby Ward" (719450624) 00:58:14.550 --> 00:58:34.550 We'll be covering effective use of our technical customer care team, and what that support portal looks like. We'll go into member placement review. I think there have been a lot of questions about missing members and how to address those within the portal especially for our DOA indoors providers who are. 171 "Colby Ward" (719450624) 00:58:34.550 --> 00:59:00.230 Just starting, so that'll be something that we'll spend time on. We'll also spend some time on alternate EVV, what that setup process looks like and what happens if you're switching EVV systems at any point. And then we do have a recently recorded webinars section and resources for providers, and I do want to mention that we always include recently. 172 "Colby Ward" (719450624) 00:59:00.230 --> 00:59:20.230 Recorded webinars and resources in these town hall presentations. So if you're looking for some of these links like the support portal or like the info hub, you're welcome to refer back to previous slides that have been shared from the town halls while we're waiting to get these up to date current slides out to everybody. 173 "Colby Ward" (719450624) 00:59:20.230 --> 00:59:40.640 Alright, so we'll start out with our EBV program reminders. 1st up is provider enrollment. Emily mentioned this. We have the link listed at the bottom of the slide. 174 "Colby Ward" (719450624) 00:59:40.640 --> 01:00:00.640 If you do not have a portal with HHA Exchange today and you have not filled out this form, please go ahead and do so. This is the form that allows us to know who you are, what the identifiers are for your agency, what system you're going to be using, so that we can get your portal set up correctly. 175 "Colby Ward" (719450624) 01:00:00.640 --> 01:00:20.640 And ready to go. If you're using HHA EVV, we give you the permissions to be able to start doing that. And if you're using a 3rd party, we give you the instructions to begin that setup process with your 3rd party vendor. So please again make sure you fill out this enrollment form if you have not already. Otherwise, the portal. 176 "Colby Ward" (719450624) 01:00:20.640 --> 01:00:40.640 Will not be able to be created for you. And just a quick note listed on the screen as well as when you fill out the survey, just make sure you have some of this key information, your agency's identifiers, which EVV system you're gonna be using, and then if it's an alternate EVV system, you. 177 "Colby Ward" (719450624) 01:00:40.640 --> 01:00:48.120 Giving us the contact information for that alternate EVV system is very helpful in case we need to reach out to them. 178 "Colby Ward" (719450624) 01:00:48.120 --> 01:01:03.194 Oh Emily mentioned this as well, but, just to reiterate, oops, sorry. There we go. Oh. 179 "Brigman, Emily" (3307792896) 01:01:03.194 --> 01:01:07.202 Toby I'm sorry, what slide should we be on? I apologize. 180 "Colby Ward" (719450624) 01:01:07.202 --> 01:01:10.242 No problem, on the impact slide, please. 181 "Brigman, Emily" (3307792896) 01:01:10.242 --> 01:01:11.920 So I think it's a couple heads. 182 "Colby Ward" (719450624) 01:01:11.920 --> 01:01:33.080 No worries. There we go. Okay, so, as Emily mentioned, status and impact is important for HHA exchange. We receive a file from the state for each of the programs that tells us who the providers are who are in scope based on impact enrollment. 183 "Colby Ward" (719450624) 01:01:33.080 --> 01:01:53.080 So if your impact enrollment is incorrect, is not valid, if you're not enrolled, if you don't have the right specialties, your information may not be communicated to us, which means that we wouldn't be able to automatically get you linked to the right payers. So please, please double check that your enrollment. 184 "Colby Ward" (719450624) 01:01:53.080 --> 01:02:13.080 Status is correct in impact. If it is correct in impact and you've double checked that and you're still not linked to the right contracts, you're welcome to submit a ticket to us through our technical customer care portal or reach out to the respective operating agency and we will, work together with the state. 185 "Colby Ward" (719450624) 01:02:13.080 --> 01:02:36.290 To ensure that we get you set up correctly. Okay, and then maintaining your HHA exchange admin user list is very important. The person who fills out the survey in HHA Exchange is the 1st person who receives credentials to the portal. So. 186 "Colby Ward" (719450624) 01:02:36.290 --> 01:02:56.290 So whoever has filled out the survey, make sure you know who that person is, and that they're aware, of course, that they will be receiving credentials. It does mention that when the survey is completed. And then that person's responsibility will be to add other users to the system. There is a video that's linked here. 187 "Colby Ward" (719450624) 01:02:56.290 --> 01:03:21.530 That shows how to create additional users within the portal. So again, very important that whoever receives those credentials 1st to your portal goes ahead and sets up other users. I recommend having at least two admin users in the portal at all times. Make sure that if somebody leaves your organization or gets set to inactive became. 188 "Colby Ward" (719450624) 01:03:21.530 --> 01:03:41.530 Because they haven't logged in in 30 days, e.g., you have backup so that you're not having to reach out to technical customer care every time somebody changes in your organization. So have at least two admin users that will make your life a whole lot easier when it comes to managing who has access to Haj and it. 189 "Colby Ward" (719450624) 01:03:41.530 --> 01:04:05.570 Ensuring that everybody from your agency can get into the system. And then another reminder is along with the policy for all caregivers needing to have the full social security number listed in HHA exchange. We did enhance one of our reports last year to allow for. 190 "Colby Ward" (719450624) 01:04:05.570 --> 01:04:25.570 For a filter that helps you identify if there are any caregivers in the system that don't appear to have a valid social security number. This is the report path of how to get there within your provider portal. This works for both HHA Exchange users and alternate EVV users. 191 "Colby Ward" (719450624) 01:04:25.570 --> 01:04:52.040 So both of both types of providers have this port, have this report available. Excuse me. You just want to be sure that when you run this report, you check the box that is highlighted here that says only include caregivers with invalid SSN, and then make sure that you select SSN below. That will show you any caregivers who may have invalid SSNs that you need to correct. We are not checking. 192 "Colby Ward" (719450624) 01:04:52.040 --> 01:05:12.040 Against a social security number database or anything of that nature, but we are looking for patterns that would identify that a social security number maybe incorrect. E.g., all the same number starting with three zeros, things of that nature that are not valid, social security number. 193 "Colby Ward" (719450624) 01:05:12.040 --> 01:05:14.610 Numbers. 194 "Colby Ward" (719450624) 01:05:14.610 --> 01:05:34.610 Okay, we'll move into effective use of technical customer care, and I'm going to actually steal the screen from Emily here for a few minutes to go into our support portal and demo a new feature that we have. 195 "Colby Ward" (719450624) 01:05:34.610 --> 01:06:02.859 Have available for providers to use. It's called our collaborate feature. So I will go ahead and attempt to share my screen and then Emily, I will ask you to confirm if you can see it for me. 196 "Brigman, Emily" (3307792896) 01:06:02.859 --> 01:06:06.119 I can see it, Colby. Perfect. 197 "Colby Ward" (719450624) 01:06:06.119 --> 01:06:24.530 Okay, so right now I am on the screen, the login screen for our customer support portal. There is a link to this portal that will be shared at the end of the presentation. Again, it is also in the previous slides that we've shared for town halls before, so feel free to refer back to that. 198 "Colby Ward" (719450624) 01:06:24.530 --> 01:06:44.530 That in the immediate term if you need it. One thing to note before I log in is if you do not have access to the customer support portal today, you can request to be a new user to the support portal. There's a button right here at the bottom of the home screen, request a new user that you can fill out to. 199 "Colby Ward" (719450624) 01:06:44.530 --> 01:06:57.210 To get your access to the support portal. Now I do already have access, so I'm gonna go ahead and log in and show you a couple of things within the portal. 200 "Colby Ward" (719450624) 01:06:57.210 --> 01:07:17.210 When you log into the portal, you're going to be directed to ah home screen may include a case that you have recently added. I'm just gonna go click on the home screen real quick. If it's your 1st time logging in, you're gonna see this home screen, and there is. 201 "Colby Ward" (719450624) 01:07:17.210 --> 01:07:37.210 A brief video posted right here that shows you how to use the customer portal, so definitely recommend if it's your 1st time logging in, checking out that video it's short, it's less than 5 min, but it goes through how to create cases and how to review your cases over time. So certainly watch that. 202 "Colby Ward" (719450624) 01:07:37.210 --> 01:08:00.530 If you're creating a case for the 1st time, that is going to be under this more section and then get support. That will pop up a screen where you can start filling out details about the issue that you're experiencing so that you can get support from our team. 203 "Colby Ward" (719450624) 01:08:00.530 --> 01:08:18.450 I'm going to go ahead and go through the process to create a new ticket, and then I'm gonna explain the collaborate feature that's new here. So, just bear with me here while I fill this out quickly for us. And I'm just going to fill this out. 204 "Colby Ward" (719450624) 01:08:18.450 --> 01:08:38.450 Very quickly with not a lot of detail just as a test ticket for us so you can see what this looks like. It will ask for categories when you fill out the ticket, please be specific and try to use the one that best fits what you need. So. 205 "Colby Ward" (719450624) 01:08:38.450 --> 01:08:51.810 That, we can best assist you depending on what you put into these fields will tell us where this ticket needs to go within our teams. 206 "Colby Ward" (719450624) 01:08:51.810 --> 01:09:11.810 Okay, so I am just filling out details here and then my case is being submitted. Okay, so now my case has been submitted. I get a confirmation. 207 "Colby Ward" (719450624) 01:09:11.810 --> 01:09:31.810 And up at the top, under quick links is where I can review my cases. I can review all of my open cases if I'm affiliated with an organization that has other folks who are using this support portal who are also submitting cases, I can see other cases from my organization. I can see. 208 "Colby Ward" (719450624) 01:09:31.810 --> 01:09:58.590 See my closed cases and then we'll explain the collaborator cases here in a moment. So I'm just gonna go to my open cases to look at the one that I just submitted. And if I click the case number, that will open that up. Over here on the right hand side is where I can type in any update that I want to share with, the HHA exchange support team. 209 "Colby Ward" (719450624) 01:09:58.590 --> 01:10:18.590 I can also close the case if it has been resolved. And then this is the new feature over here, add collaborator. Adding a collaborator is essentially allowing somebody outside of your organization access to your ticket so that they can view it and also post up. 210 "Colby Ward" (719450624) 01:10:18.590 --> 01:10:37.560 Dates onto the ticket. The way that we intend this to be used is for you to add the appropriate operating agency to the ticket in the event that either you're not getting the support you feel you need or you may need their input on the ticket in order to get it resolved. So. 211 "Colby Ward" (719450624) 01:10:37.560 --> 01:10:57.560 Each of the operating agencies has an EVV email inbox. That email is set up here in the support portal so that it can be added. So e.g., I'm going to use the HFS inbox, which is HFS.EVV@Illinois.gov. We have all of these listed within the slides as well. 212 "Colby Ward" (719450624) 01:10:57.560 --> 01:11:01.560 And I'm gonna hit search. 213 "Colby Ward" (719450624) 01:11:01.560 --> 01:11:21.560 It will make sure that we typed in the valid email address and will ask me to select that the correct contact and then I'll click next. It asks me if I want to add another collaborator. I'm gonna say NO at this time, but you could add multiple. 214 "Colby Ward" (719450624) 01:11:21.560 --> 01:11:46.040 To pull operating agencies if you needed to for some reason and then click next. And now this HFS.EVV email has been successfully added as a collaborator. The EVV inbox will get a notification letting them know that they've been added as a collaborator to a ticket so that they can log in and view it. Each of the operating agencies has. 215 "Colby Ward" (719450624) 01:11:46.040 --> 01:12:06.040 Access to the support portal where they can then go up here and view this My collaborator cases that's gonna show them any case that they're included as a collaborator on. And then they have access to this exact view of your ticket so that they can see anything that you have posted or our support team has. 216 "Colby Ward" (719450624) 01:12:06.040 --> 01:12:26.040 Posted back onto the ticket and they also are able to post within the ticket as well so that everybody can collaborate together and try to get to a correct resolution, a best resolution for your ticket. So this is a new feature that's recently been enabled, and it is fully functional, so you're welcome to. 217 "Colby Ward" (719450624) 01:12:26.040 --> 01:13:06.956 Include the operating agency as needed on your ticket again in cases of escalation where you're not getting the support you need or if you think that you may need their input in order to have the case resolved appropriately alright, and we can go ahead and go back to the slides here and Emily, if you want to move on to the next one, that'd be great. 218 "Brigman, Emily" (3307792896) 01:13:06.956 --> 01:13:10.958 Colby, are you seeing it? Move? 219 "Colby Ward" (719450624) 01:13:10.958 --> 01:13:16.574 No, I see that I see demo I still see the demo slide on my end. Interesting. 220 "Brigman, Emily" (3307792896) 01:13:16.574 --> 01:13:24.241 Let me try to share the presentation again. Apologies folks, this won't take too long. 221 "Colby Ward" (719450624) 01:13:24.241 --> 01:13:42.210 There we go. Oh, you see it now? I see it now. Yep. I see it on case follow up. Maybe if you want to go back one, I can just yeah go back. Yep. Okay. This is just a, a reminder on submitting tickets in general, that. 222 "Colby Ward" (719450624) 01:13:42.210 --> 01:14:02.210 In order to get the best support that we can provide and as quickly as possible, it's recommended to make sure that you include the information listed here and please be as specific and detailed as possible. It helps us so that we don't have to do a lot of back and forth with you to try to understand the situation before we really look into. 223 "Colby Ward" (719450624) 01:14:02.210 --> 01:14:22.210 To it. So make sure to include things like member identifiers if that's relevant, if there's an a specific example that we can look at. Any steps that we can do to reproduce the issue. If you just say you're getting an error message and without letting us know which page it's on or what. 224 "Colby Ward" (719450624) 01:14:22.210 --> 01:14:42.210 Steps you took to get that message or what that error message says, we're gonna have to do a lot of back and forth to try to understand it more in order to troubleshoot. If you have screenshots of things like error messages, those can be attached to the tickets. If you're a 3rd party EVV user. 225 "Colby Ward" (719450624) 01:14:42.210 --> 01:15:16.550 And your question is regarding a rejection, we'll need the transaction ID, which your alternate EVV vendor will be able to provide. That helps us look at the visit rejection itself. And then this one's an important one, the payer who the issue is associated with. Oftentimes if there's an issue where you say I'm not linked to a payer, but you don't tell us necessarily who the payer is that you need to be linked with or if you're saying your payer's not seeing your EVV. 226 "Colby Ward" (719450624) 01:15:16.550 --> 01:15:31.710 E compliance, but we don't know who the payer is that should be seeing it. We have a hard time identifying what the specific issue is, so please include any relevant information about what payer your issue is associated with as well. 227 "Colby Ward" (719450624) 01:15:31.710 --> 01:15:51.710 And then this is just a bit about our case followup. Agents leave comments within the tickets. Those case comments are viewable within that user interface that I just showed within that support portal, as well as emailed to the reporter and any other issue. 228 "Colby Ward" (719450624) 01:15:51.710 --> 01:16:11.710 Any other users who are associated with that case, so you will get it a couple of different ways, but highly recommend using the support portal for follow up and tracking. It's a nice user interface and it really shows you which cases are still open, which cases are kind of in your court to respond. 229 "Colby Ward" (719450624) 01:16:11.710 --> 01:16:37.790 Which two and which ones are in our court to respond to. So it's, it's nice for tracking. And then as far as auto closing cases, we do send three auto reminders, one on each subsequent business day. If we have not heard back from you on a case and we need more information in order to continue to assist you. On the 5th business day of NO response, then the case is auto closed. 230 "Colby Ward" (719450624) 01:16:37.790 --> 01:16:53.670 And closed cases cannot be reopened, but if you do realize you still need assistance, you can always open a new case and you can refer to, the case that was previously closed so that we can pull in the details from that case for a quicker response. 231 "Colby Ward" (719450624) 01:16:53.670 --> 01:17:15.120 Alright, next slide. Emily, I'm seeing the case follow up slides still. 232 "Colby Ward" (719450624) 01:17:15.120 --> 01:17:35.120 On my end. There we go. Okay. Member placement review. No problem. So for member placement review, we're going to go into some details about how members are entered into the HHA exchange system, and I will do a demo of of something within this section as well. 233 "Colby Ward" (719450624) 01:17:35.120 --> 01:18:04.850 But really quickly before we get into that, this is a table that just shows you by contract and HHA exchange, who has responsibility for member placement? And you'll see that it's, it's pretty, generous on purpose that really it can be in your hands as the provider agency as much as needed, for. 234 "Colby Ward" (719450624) 01:18:04.850 --> 01:18:24.850 All of the home health care services contracts, so develop DDD, developmental disabilities, DSCC, state plan Medicaid, and then the mcos who are supporting state plan home health. In all of those cases, the provider agenc. 235 "Colby Ward" (719450624) 01:18:24.850 --> 01:18:56.300 MC is able to make the member placement and it's generally expected as in most cases an authorization is not required or an authorization is not being sent. In the home health space in particular, typically there's a threshold that is met of visits before an authorization is required. But even if an authorization is required for services, it is not required for placement in HHA exchange. So I do want to just make that note. 236 "Colby Ward" (719450624) 01:18:56.300 --> 01:19:16.300 Note that, you know, provider agency always has the capability to, start the placement even if technically authorizations are required for billing. We're not doing billing within HHA exchange through, the state portal, so, therefore provider agencies are always able. 237 "Colby Ward" (719450624) 01:19:16.300 --> 01:19:41.180 Able to do placement if, if an authorization is, is missing, e.g.. And that the same goes for DOA and doors and the MCO authorizations associated with those as well. Oftentimes you will see because DOA and doors do require prior authorization for services that your member will likely come through from the payer. 238 "Colby Ward" (719450624) 01:19:41.180 --> 01:20:10.460 But in the event it doesn't, you can do the provider driven placement process to keep things moving on your end and be able to add visits. This is a little more about that provider driven placement process. For HHA providers, there is a workflow within the system that I'm going to demonstrate here in a few minutes, where you'd be able to create that new member via your portal. You'll add the. 239 "Colby Ward" (719450624) 01:20:10.460 --> 01:20:30.460 Medicaid ID, then you'll add the contract, and then you'll add the service code and you can start adding services. This is a manual process to add the member and all these details, but this part is just for those using HHA for EVV, those users who are already in the portal, supporting EVV. 240 "Colby Ward" (719450624) 01:20:30.460 --> 01:20:45.600 And then on the right side is a little bit about 3rd party providers. You do not need to do the manual entry process. When you, when your vendor submits your visit for that member. 241 "Colby Ward" (719450624) 01:20:45.600 --> 01:21:05.600 The system is going to automatically look up in the background that members details to see if the state has sent them to us yet. And if they have, then we will be able to pull them into your portal. So again, for 3rd party providers, you do not need to do manual entry. That all happens in the background. 242 "Colby Ward" (719450624) 01:21:05.600 --> 01:21:12.540 When your vendor submits your visits to us. 243 "Colby Ward" (719450624) 01:21:12.540 --> 01:21:32.540 There are a couple of, screenshots here, just that indicate successful member placement versus unsuccessful member placement as reference, and I'll show these when we demo this in a few minutes as well. But there are a few things to look for that will indicate. 244 "Colby Ward" (719450624) 01:21:32.540 --> 01:21:50.220 That there has been a successful placement once you have gone through the steps, those are highlighted here in green. 1st and foremost, there's NO error at the top of the screen, showing that there was an unsuccessful placement, so you don't want to see errors, so that's. 245 "Colby Ward" (719450624) 01:21:50.220 --> 01:22:10.220 Indicated here with that top box. Second is that the alt patient ID is populated. That is the patient ID that's coming from the payer record. So if that is populated, that means that that has gone through successfully. And then 3rd is that the history itself indicates that there was a successful payer placement. So the. 246 "Colby Ward" (719450624) 01:22:10.220 --> 01:22:18.390 There's several places on this screen where you're gonna see indication of success. 247 "Colby Ward" (719450624) 01:22:18.390 --> 01:22:38.390 And then for unsuccessful member placement, there are several, areas here where you're going to see that there are issues. So when you have an unsuccessful placement that you've initiated from the HHA portal, you're gonna see 1st and foremost at the top that in that red box that there is a. 248 "Colby Ward" (719450624) 01:22:38.390 --> 01:22:55.620 Yellow error message indicating that the placement was not successful. You're also gonna see that that all patient ID is not populated, and then in the history it will also not show that there was a successful payer placement. And these are just a few steps to verify that. 249 "Colby Ward" (719450624) 01:22:55.620 --> 01:23:15.620 Your identifiers are correct. So especially in the case of mcos, state plan home health, DSCC DD, where Medicaid ID is the primary identifier. These are kind of your steps to checking to make sure that you have the right REN on the. 250 "Colby Ward" (719450624) 01:23:15.620 --> 01:23:35.620 On the members record. Number one, the most common error I see is that the RING wasn't populated on the member record at all, which can lead to an unsuccessful member placement. So that's, that's always my very 1st spot that I recommend folks go is just make sure that 1st and foremost, that the ring is pop. 251 "Colby Ward" (719450624) 01:23:35.620 --> 01:23:40.950 And I'm gonna show that here in just a moment. 252 "Colby Ward" (719450624) 01:23:40.950 --> 01:24:00.950 Alright, so I will go ahead and steal the screen back to demo our provider driven placement process and Emily one more time if you can just verify for me that you're seeing. 253 "Colby Ward" (719450624) 01:24:00.950 --> 01:24:03.396 My screen, that'd be great. 254 "Brigman, Emily" (3307792896) 01:24:03.396 --> 01:24:07.201 I can see it Colby. Thank you. Great, ok. 255 "Colby Ward" (719450624) 01:24:07.201 --> 01:24:22.970 So I'm going to, as I mentioned, go through this provider driven placement process. This is for users of the HHA exchange system. So again, 3rd party providers do not need to perform manual entry. I'm going to. 256 "Colby Ward" (719450624) 01:24:22.970 --> 01:24:49.640 You consider a patient who is named Jonathan Jones. This is a pure demo environment, so none of this information is real. If I realize that that member has not come through from my payer yet, I can go ahead and click on this new patient button at the top of my screen and go ahead and enter his details to start. 257 "Colby Ward" (719450624) 01:24:49.640 --> 01:25:11.780 So, there are fields throughout this form that have a red asterisk associated with them. Those are required fields. Anything without a red asterisk is not required to be entered at the time that I entered the members details. One thing to note too is that a member can be looked at. 258 "Colby Ward" (719450624) 01:25:11.780 --> 01:25:31.780 Up in our system by name and date of birth, 1st name, last name and date of birth, excuse me, or the Medicaid ID. Most commonly the Medicaid ID, of course, but I do know that for DOA and doors, there are cases where we have folks who do not have a Medicaid ID. So in that instance. 259 "Colby Ward" (719450624) 01:25:31.780 --> 01:25:58.800 That Medicaid ID is not needed and, and it would be looked up by 1st name, last name and date of birth, though it does have to be consistent with how that record is in the payer system. So I'm my, again, my member who my example is, is Jonathan Jones. For the sake of 1st showing an error message, I'm just gonna put in John Jones, which isn't gonna be a match, of course. 260 "Colby Ward" (719450624) 01:25:58.800 --> 01:26:17.670 I'll put in his details here quickly. So just filling out some of the demographic details. This is the field for the RIN, the Medicaid ID. Again, just to show an error to start with, I'm gonna leave this blank and then I'm gonna go back and edit this after the fact to correct it. 261 "Colby Ward" (719450624) 01:26:17.670 --> 01:26:39.140 It will ask you to select a coordinator. Everyone is set up with a default coordinator if you've not set up other coordinators. Accepted services is required. This I do recommend, of course, if making sure that you select the correct ones, otherwise you may. 262 "Colby Ward" (719450624) 01:26:39.140 --> 01:27:03.780 Have trouble with scheduling for this member, so just make sure that you select the correct ones. For S51 30 services in particular, those have an HMK as the service type, so you'd want to make sure that's selected. I know I also in this demo portal have PCA and then you know skilled services, anything else that that member receives, go ahead and select those as well. 263 "Colby Ward" (719450624) 01:27:03.780 --> 01:27:19.710 It will ask for some address details. I'm just going to put in a fake address here for the sake of the demo. 264 "Colby Ward" (719450624) 01:27:19.710 --> 01:27:36.540 Everything else on this screen is optional, so you can just scroll to the bottom, NO need to add anything else unless you'd like, and then you hit save. Oops. I guess I missed something on the address here. 265 "Colby Ward" (719450624) 01:27:36.540 --> 01:27:52.860 Oh, there we go, ok. Okay. Okay. 266 "Colby Ward" (719450624) 01:27:52.860 --> 01:28:12.860 Now that I have entered John Jones, I, this is the profile that was created when I hit save, and the next step that I'll need to do in this auto placement process is add a contract. So I'll go under our contracts tab. In your portal, this may say payer slash. 267 "Colby Ward" (719450624) 01:28:12.860 --> 01:28:45.080 Mcos, depending on your portal setup, you may have slightly different terminology, but contract payer MCO are all the same. It leads you to the same place. And then once you're here, you'll go ahead and click this add contract button over to the right. This contract is going to tell us who the payer is that's associated with this member. So I'm gonna use my demo payer for you all. This would be maybe something like Illinois Department on Aging. 268 "Colby Ward" (719450624) 01:28:45.080 --> 01:29:02.160 Aetna Fightie Snipp, Malina Meridian, so that will be your contract, will be who the payer is that's associated with that member. And then you can enter a service start date. I'm just gonna say that this one maybe was at the beginning of this month. 269 "Colby Ward" (719450624) 01:29:02.160 --> 01:29:22.160 And I don't need to add anything else. So I am all set here. I'm just gonna go ahead and click save. Oh, ok. It is giving me an a validation that I do need to enter a Medicaid number, so I'm gonna actually go ahead and go back and do that really quick. 270 "Colby Ward" (719450624) 01:29:22.160 --> 01:29:51.060 And I'm going to make it something that is not valid so that it can still show our error message. So the Medicaid number is stored under the members profile here. Medicaid ID listed here, so I'm gonna go ahead and edit that. I'm going to again add a Medicaid ID that is not correct. 271 "Colby Ward" (719450624) 01:29:51.060 --> 01:30:07.440 Just to show that error message. So my my member here actually his Medicaid ID ends in a five instead of a six. So on purpose though, I'm going to leave it as a six again to show the error message. Hit save. 272 "Colby Ward" (719450624) 01:30:07.440 --> 01:30:24.000 If you're adding this for a D a DOA or DOORS number who does not have a Medicaid ID, you can enter all nines for the Medicaid ID. Go back to our contracts tab and attempt to add that again. 273 "Colby Ward" (719450624) 01:30:24.000 --> 01:30:39.480 Okay, Hit save. 274 "Colby Ward" (719450624) 01:30:39.480 --> 01:31:02.240 Okay, as you can see, this request is in process. It says that it's, the request was sent, the auto placement request, it hasn't been processed yet, so I can go ahead and click refresh page, and that should let me know where. 275 "Colby Ward" (719450624) 01:31:02.240 --> 01:31:23.820 What it found or didn't find here. 276 "Colby Ward" (719450624) 01:31:23.820 --> 01:31:45.380 Oh, ok. I must have put in the correct Medicaid ID instead of the incorrect one. It does say, please note that the provider placement has been updated, new payer placement was sent by the payer. Outpatient ID is here as that, one ending in 6666. So I apologize. 277 "Colby Ward" (719450624) 01:31:45.380 --> 01:32:05.380 As I meant to type in the incorrect one 1st, but I typed in the correct one. So this is how it will look when it is correct. So that's good news. It did go through successfully and now it does say that the placement has been updated. So that's what it will look like when it is correct. 278 "Colby Ward" (719450624) 01:32:05.380 --> 01:32:39.559 As I showed on the slide with the yellow status bar that indicated that it didn't find a placement, that's what it's gonna look like if you have incorrect information there, that you need to go ahead and go back and correct. So, so that's how the provider driven placement process works within the HHA exchange system. You will, again, not need to do that if you are using a 3rd party system, your 3rd party system when they send over the visit, it looks up that information automatically. So again. 279 "Colby Ward" (719450624) 01:32:39.559 --> 01:33:11.834 No need to do that, if you're a 3rd party user. And then you only need to do this process if you, do not receive the member from the payer as expected or you're using the, or you're performing home health services, then you'll of course want to use this process to get your members into the portal. Alright, and then I think we can go back to the slides. 280 "Brigman, Emily" (3307792896) 01:33:11.834 --> 01:33:17.205 Give me just a second. Sure. Oh, ok. No problem. You see it? I see. 281 "Colby Ward" (719450624) 01:33:17.205 --> 01:33:30.699 See the demo slide. So if we can go to the next one, that would be great. 282 "Brigman, Emily" (3307792896) 01:33:30.699 --> 01:33:33.262 Are you seeing the next slide, Colby? 283 "Colby Ward" (719450624) 01:33:33.262 --> 01:33:36.576 Not yet. I still see the demo slide. 284 "Brigman, Emily" (3307792896) 01:33:36.576 --> 01:33:39.361 Fooy, give me just a second. 285 "Colby Ward" (719450624) 01:33:39.361 --> 01:34:12.969 There we go. I see the unsuccessful member placement EDI slide, so I think there we go. Okay. We do have a report within the system for our HHA EDV users that can identify in bulk all of the members who you may have unsuccessful auto placement with. So if you're looking at this and you're thinking, gosh, I may not have done something correctly, how do I figure out which patients I have an. 286 "Colby Ward" (719450624) 01:34:12.969 --> 01:34:32.969 Error on, this is the report that you want to use. So you'll navigate to your report menu, under patients, there's an auto placement report. That report will tell you if you have failures for auto placement. So, highly recommend if you have done this process in your portal, run that report to make sure. 287 "Colby Ward" (719450624) 01:34:32.969 --> 01:34:52.969 Sure that you don't have any errors, and if you do have errors, go back to those records, check Medicaid IDs, check names and date of birth, make sure that everything is, is correct, and then on that contract page, you'll be able to refresh your request for auto placement and try again. So this is a great resource to make. 288 "Colby Ward" (719450624) 01:34:52.969 --> 01:35:17.749 Make sure that you don't have any errors when you do those auto placement requests. Next slides. And then for as far as compliance reports go, if there are auto placement failures, the payer is not able to see your visits, and they will not count towards compliance until those errors. 289 "Colby Ward" (719450624) 01:35:17.749 --> 01:35:37.749 Are resolved. We had this come up a few times on the home health side, so this is kind of a, a a warning, if you will, for DOA indoors providers, is to just, again, make sure that those auto placement failures are corrected. Otherwise the visits that you put on those records won't be visible to the payer. However. 290 "Colby Ward" (719450624) 01:35:37.749 --> 01:35:55.799 However, once you do correct the auto placement, those visits will automatically show up to the payer. You don't have to do anything else. So it's pretty straightforward to correct, but just, you know, again, make sure that you're monitoring that and reviewing those possible failures and getting those corrected. 291 "Colby Ward" (719450624) 01:35:55.799 --> 01:36:11.159 Okay, so moving on to the EDI process, we have a few slides here to go through, to help out folks who maybe kind of in the midst of getting integrated. So next slide. 292 "Colby Ward" (719450624) 01:36:11.159 --> 01:36:31.159 We do have a checklist that is linked at the bottom of this slide, that should help for anybody who is just starting the process and unsure of what the process entails. It goes step by step through how you get your 3rd party vendor integrated with HHA exchange. 293 "Colby Ward" (719450624) 01:36:31.159 --> 01:36:51.159 We are integrated with a lot of vendors already. I think we've probably got over 25 vendors in the state who were integrated with, that make up the bulk of agencies, but you know if your vendor is brand new, they're gonna need to go through all of the steps here on this site, walks through what those steps are, get. 294 "Colby Ward" (719450624) 01:36:51.159 --> 01:37:03.809 As you links and how to perform each of the steps. So highly recommend this as a resource so that you know what steps you're gonna have to go through to get integrated. 295 "Colby Ward" (719450624) 01:37:03.809 --> 01:37:23.809 In general, the data flow here is for 3rd party providers is that HFS and the operating agencies are sending us information that flows into the payer side of the system, depending on the operating agency and the payer that may include member information. 296 "Colby Ward" (719450624) 01:37:23.809 --> 01:37:43.809 Provider information and even authorization information. We know we get authorizations for DOA indoors and some home health services, so those are coming in from the payer side into HHA Exchange, identifying, at least at an authorization level who the agency is, who's servicing that member. 297 "Colby Ward" (719450624) 01:37:43.809 --> 01:38:03.809 And then on the right hand side of this slide is you and your 3rd party vendor. Your 3rd party vendor is sending us your caregiver records, you're sending us your visit records, and we're trying to match all that data together in the background. So you have a visit record for John Jones, service. 298 "Colby Ward" (719450624) 01:38:03.809 --> 01:38:23.809 Matched by a caregiver, Colby Ward. We're trying to match that up against what the payer side has, and if we find a match, great. At the top here is the response status. You'd get a response status of success. If we have anything within those records that doesn't quite jive, you'll get a failure and we will. 299 "Colby Ward" (719450624) 01:38:23.809 --> 01:38:43.809 To provide a reason back to your 3rd party system as to why that visit has failed or why that caregiver record has failed. And it's very important that you are aware that not every visit that you send to us is likely to be a success on the 1st time through. There will. 300 "Colby Ward" (719450624) 01:38:43.809 --> 01:39:14.959 Will always be rejections, and you need to understand with your 3rd party vendor how to monitor those. So on the next slide we talk a little bit more about that. So, again, your 3rd party is going to submit all of your EVV data to the HHA exchange aggregator. Not all of those visits are going to import successfully, most likely, we do see, you know, a handful here and there that have everything successful if they don't have a lot of visits, but other. 301 "Colby Ward" (719450624) 01:39:14.959 --> 01:39:49.819 Otherwise you will get visit rejections back that will tell you why it rejected, and it is your responsibility with assistance from your 3rd party, of course, and HHA exchange on occasion to review and resolve those import rejections. And these are just some steps on how you wanna do that. So, 1st and foremost, make sure you know how you're getting those rejections back from your 3rd party. That's a conversation with your 3rd party to understand how they're going to display that. I've seen some 3rd parties that have a. 302 "Colby Ward" (719450624) 01:39:49.819 --> 01:40:22.909 Rejection dashboard. I've seen some that kind of make it into a report for you, so talk to your 3rd party and understand how you're going to get those rejections back. It differs by every system. Step two in the process is based on the import rejection reason, you may need to change certain data points on that visit import. So you may need to work with your 3rd party to make some modifications to records in the system, to have them submit successfully. 303 "Colby Ward" (719450624) 01:40:22.909 --> 01:40:42.909 So work with your 3rd party to understand the rejections and see if there's something that you need to change on your end to have those visits be successful. And then if you and your 3rd party are unable to identify a resolution for those visits, then absolutely submit a support ticket to HHA exchange. 304 "Colby Ward" (719450624) 01:40:42.909 --> 01:40:58.529 I mentioned this earlier, but be sure to be specific and include the transaction ID for the records that you are, that are in question so that we can look at those quickly and get you a quick response. 305 "Colby Ward" (719450624) 01:40:58.529 --> 01:41:18.529 And then, we do also, where we have been getting questions about DOA indoors, member qualifiers, so I just wanted to include this as a helpful link, within the specifications, we did update the member qualifier field in partition. 306 "Colby Ward" (719450624) 01:41:18.529 --> 01:41:45.109 Particular to have different values for DOA and doors. This has been published for a while now, but we just wanted to call it out for this group. For department on aging, we want to see the client ID as the member qualifier, and for doors we want to see the case number as the member qualifier. That is used as the primary ID for those member. 307 "Colby Ward" (719450624) 01:41:45.109 --> 01:42:05.109 Members because we do have members who do not have a Medicaid ID, we needed to use an alternate Medicaid or an alternate ID for those members. So this is what has been identified as the member ID to use for those two payers. For everybody else, it will still remain the medic. 308 "Colby Ward" (719450624) 01:42:05.109 --> 01:42:09.479 Kid IDs. 309 "Colby Ward" (719450624) 01:42:09.479 --> 01:42:29.479 And then we do have just a helpful tip on how to switch EVB systems, how to let us know if you're switching EVV systems. So if you are switching from EDI to HHA. 310 "Colby Ward" (719450624) 01:42:29.479 --> 01:42:49.479 EVV or vice versa, please submit a ticket to our technical customer care team letting them know that you're intending to switch. If you have been using a 3rd party vendor and you just decide to start using your HHA portal for EVV and you don't tell us, you may not have the right permission. 311 "Colby Ward" (719450624) 01:42:49.479 --> 01:43:09.479 To get your caregivers set up on the mobile app and to schedule services and confirm visits. So you definitely want to make sure to let us know so that we can switch your portal to the right version so you get all the right permissions. We also have the steps in the state info hub linked here. 312 "Colby Ward" (719450624) 01:43:09.479 --> 01:43:32.749 Which is in our detailed FAQ as well. And then, another common thing that we see is, you know, if you switch from one alternate EVV vendor to a different alternate EVV vendor, that is going to require a new integration, of course. So please fill out a new attestation form that will let us know that you're getting a new vendor and that will open up a ticket. 313 "Colby Ward" (719450624) 01:43:32.749 --> 01:43:41.159 With our EDI team so that we can guide your new vendor through the steps for integrations. 314 "Colby Ward" (719450624) 01:43:41.159 --> 01:44:01.159 And then finally, we've got some information on recently recorded webinars and resources, so I'll go through these. 1st, we did do a webinar last spring about getting started with HHA and EVV best practices. 315 "Colby Ward" (719450624) 01:44:01.159 --> 01:44:21.159 For folks who are using the HHA system, still very relevant, so certainly if you are just starting on your journey and you're trying to understand how best to optimize EVV with your agency, this is a great webinar to refer back to. The recording and slides are linked here. All of these are. 316 "Colby Ward" (719450624) 01:44:21.159 --> 01:44:26.159 But also linked on our info hub as well. 317 "Colby Ward" (719450624) 01:44:26.159 --> 01:44:46.159 Next is the compliance monitoring, webinar that was just hosted a few days ago, so we already have the recording and slides posted for that in case you missed it. So please go ahead and, and refer back to that. If you missed that, that talks more about what's coming 1 April and the various. 318 "Colby Ward" (719450624) 01:44:46.159 --> 01:45:18.619 Ways that you can report on EVV compliance both through the Know Your numbers report that Emily mentioned at the beginning as well as the reports that are available through the Haj system. If you are a doors or DOA provider who is using a 3rd party vendor and you have not yet integrated with us, we did an onboarding session back in January that was recorded, goes through those same steps that are listed in that getting started checklist. 319 "Colby Ward" (719450624) 01:45:18.619 --> 01:45:27.959 But of course there's someone walking through it from our team in a little more detail, so feel free to refer to that session. 320 "Colby Ward" (719450624) 01:45:27.959 --> 01:45:47.959 And then we have several training sessions that were done, throughout February. One of those is system setup and data readiness for those using HHA Exchange EVV to get you ready for the go live. That was back in or back on March second, that again recorded. 321 "Colby Ward" (719450624) 01:45:47.959 --> 01:46:11.329 And and slides are available if you need to go back there. Same with scheduling and visit capture, going a level deeper, and then visit maintenance. This is a great one if you have not yet gone to that and you are capturing. 322 "Colby Ward" (719450624) 01:46:11.329 --> 01:46:31.329 In EVV data within HHA exchange. I highly recommend going to that. That talks about the various exceptions that you might see for EVV, how to resolve those correctly, how to stay on top of visit maintenance on a regular basis. All of that is important to maintaining good EVBV. 323 "Colby Ward" (719450624) 01:46:31.329 --> 01:46:56.509 The compliance. So certainly take a look at that if you did not attend. And then this one is specific for those users of our enterprise version of HEJA exchange. This training that happened back in February was designed to give you an overview of how to move off of your internal contracts. 324 "Colby Ward" (719450624) 01:46:56.509 --> 01:47:15.599 Onto your linked contracts, how to merge members, how to make sure that if you have any billing in place that that's set up, so, if you're an enterprise user and you missed this training, certainly refer to that. That will help you get onto your linked contracts appropriately. 325 "Colby Ward" (719450624) 01:47:15.599 --> 01:47:35.599 Alright, and then we've got our resources here that I'll quickly run through. 1st we have our 1st, we have two state info hubs. Well the 1st of them is our state plan DDD and DSCC info hub. This is really specific to skilled home. 326 "Colby Ward" (719450624) 01:47:35.599 --> 01:47:55.599 Healthcare services and then personal support worker services with DD. This has all of the information related to our implementation back in 2023 for all of those programs, as well as, you know, trainings that we did for these programs, specifications for EDI providers. 327 "Colby Ward" (719450624) 01:47:55.599 --> 01:47:58.559 Better us? 328 "Colby Ward" (719450624) 01:47:58.559 --> 01:48:18.559 And then, we added a new info hub at the inception of the implementation for DOA indoors. So this info hub is your guide if you are doing those homemaker services on how to get set up with HHA, what's coming for compliance, what training. 329 "Colby Ward" (719450624) 01:48:18.559 --> 01:48:34.619 We've done specific for DOA indoors, which services are in scope, etc. So certainly if you are working with DOA indoors customers for EVV, then refer to this info hub, please. 330 "Colby Ward" (719450624) 01:48:34.619 --> 01:48:54.619 HHA Exchange does have a learning management system. This is where you can find self paced training of the HHA exchange system. It is self registration, so, you do not need to ask us for credentials. If you go to this web link at the bottom of the page. 331 "Colby Ward" (719450624) 01:48:54.619 --> 01:49:12.089 You're able to fill out a form to receive credentials on your own. So anybody can sign up as many people from your agency as you want to sign up for the LMS is great and everybody can take self paced courses to learn how to use the AJJ exchange system. 332 "Colby Ward" (719450624) 01:49:12.089 --> 01:49:29.309 And this is just an example of that self registration page asks for some basic information about you and then what agency you're associated with, and then you'll get credentials sent straight to you. 333 "Colby Ward" (719450624) 01:49:29.309 --> 01:49:46.679 HHA Exchange does have two different knowledge bases. The 1st of which is for HHA users, those doing EVV through HHA. This is fully searchable by keyword. 334 "Colby Ward" (719450624) 01:49:46.679 --> 01:50:06.679 Brings up various, job aids and videos on how to use the system. This is accessible from within your portal. It's called the support center at the top of the page or you can use this link to get there. There is also a virtual assistant now who is within, the knowledge. 335 "Colby Ward" (719450624) 01:50:06.679 --> 01:50:26.679 Her name is Carrie. It's a little pop pop up bubble in the lower right hand corner. She is an AI assistant who if you type in a question, she can help pull back job aids and resources that maybe applicable to what you need. So she's been great. We've gotten a lot of good feedback, so highly recommend. 336 "Colby Ward" (719450624) 01:50:26.679 --> 01:50:51.229 Taking advantage of that virtual assistant within the knowledge base as well. And then this is that second knowledge base which is specific to 3rd party users. This goes through things like common rejection reasons, how to fix them, also houses the specifications for Illinois, and the code tables and anything else that your vendor may need related to the integration. 337 "Colby Ward" (719450624) 01:50:51.229 --> 01:50:58.049 Is housed here, so this is a good resource for 3rd party providers. 338 "Colby Ward" (719450624) 01:50:58.049 --> 01:51:18.049 And then finally, we have our contact information, so state info hub, again, is linked here. The support portal link is listed here as well. On top of the support portal, providers can also email IL support at Hha exchange.com and. 339 "Colby Ward" (719450624) 01:51:18.049 --> 01:51:38.049 That will create a ticket with our team in the support portal. My only recommendation is if you are going to do that, also create support portal credentials because it's much easier to track the ticket within the support portal than trying to, do all of your updates through email. That can just sometimes get con. 340 "Colby Ward" (719450624) 01:51:38.049 --> 01:51:57.119 Confusing with back and forth. So, if you want to start a ticket through email, great, but highly recommend still having access to the support portal for continued tracking just for your own ease of use. And then that phone number at the bottom is the direct Illinois support line with our team. 341 "Colby Ward" (719450624) 01:51:57.119 --> 01:52:17.119 Use that one, you'll get quicker assistance than using our general support phone number. So, certainly write that one down if you plan to call in. And then on the right hand side are all of the operating agency emails again, as Emily had listed in her slides earlier as well. But as a reminder. 342 "Colby Ward" (719450624) 01:52:17.119 --> 01:52:36.423 These are the email addresses that you'll want to use if you choose to use that collaborate feature within, the support portal. These are the operating agency emails to type in as native. Alright. 343 "Brigman, Emily" (3307792896) 01:52:36.423 --> 01:52:39.726 Thank you. Sorry, go ahead Colby. 344 "Colby Ward" (719450624) 01:52:39.726 --> 01:52:43.662 Nope I was just gonna say I'll hand it back over to you Emily. 345 "Brigman, Emily" (3307792896) 01:52:43.662 --> 01:53:02.899 So we have 5 min left and as I indicated at the start of this call, we'll review all of the Q and A from today of which there was an abundance, and likely develop an FAQ or a Q and A doc that will go on our public facing web. 346 "Brigman, Emily" (3307792896) 01:53:02.899 --> 01:53:22.899 Website and or be sent via our list serve communication. I want to acknowledge there have been a lot of questions, concerns regarding MCO authorizations along the lines of I did reach out to the MCO contact and I didn't get feedback as. 347 "Brigman, Emily" (3307792896) 01:53:22.899 --> 01:53:42.899 As we discussed earlier, if you're using the MCO contact for EVV authorizations as reflected on the HFS EVV website and you've not received feedback within two to three business days, please forward that communication to hFS.EVV. 348 "Brigman, Emily" (3307792896) 01:53:42.899 --> 01:53:51.389 At Illinois.gov. We cannot address it with the MCO if we don't know anything about the situation. 349 "Brigman, Emily" (3307792896) 01:53:51.389 --> 01:54:11.389 So alert us if you've not received feedback or assistance from the MCO with your authorization issue, and on the HFS.EVV side, we will escalate to the respective HFS account manager for that MCO to investigate an outreach MCO leadership. 350 "Brigman, Emily" (3307792896) 01:54:11.909 --> 01:54:31.909 Any questions regarding billing? There's, which there have been several. The free HHA exchange solution does not offer billing right now. There's been some similar questions regarding edits to visit time to align. 351 "Brigman, Emily" (3307792896) 01:54:31.909 --> 01:54:44.489 With what is the claim that is submitted. E.g., a caregiver spent more time than was authorized there, but the respective agency only wants to bill. 352 "Brigman, Emily" (3307792896) 01:54:44.489 --> 01:55:03.209 What, what has, what was authorized? That is not something that HFS or HHA Exchange can assist with at this time as billing is not available through HHA exchange. We are not. 353 "Brigman, Emily" (3307792896) 01:55:03.209 --> 01:55:23.209 Applying business rules or billing rules from each of our Illinois Medicaid program for development of claims submissions by provider agencies with HHA exchange at this time. There are a variety of visit rounding rules. 354 "Brigman, Emily" (3307792896) 01:55:23.209 --> 01:55:25.319 And billing rounding rules. 355 "Brigman, Emily" (3307792896) 01:55:25.319 --> 01:55:45.319 Across all of our Illinois Medicaid payers as well as our managed care organizations. If you have a question regarding billing requirements for a specific population of customers, e.g., division of rehabilitation or DSCCC or D. 356 "Brigman, Emily" (3307792896) 01:55:45.319 --> 01:55:50.339 Go away, please reach out to your contacts at that organization. 357 "Brigman, Emily" (3307792896) 01:55:50.339 --> 01:56:10.339 Again, we will make the slides and recording and Q and A from today available, probably within the next couple of weeks. We also had developed, some additional Q and A based on frequently asked questions that. 358 "Brigman, Emily" (3307792896) 01:56:10.339 --> 01:56:11.909 We've been fielding. 359 "Brigman, Emily" (3307792896) 01:56:11.909 --> 01:56:31.909 And know that included in that Q and A which will be made available after today, is an acknowledgment or a statement regarding scheduling. We've received tons and tons of questions and concerns regarding scheduling. Scheduling is not required in Elleno. 360 "Brigman, Emily" (3307792896) 01:56:31.909 --> 01:56:42.719 Right, as it relates to EVV. If a caregiver performs a visit outside of the normal schedule, that does not count as non compliant. 361 "Brigman, Emily" (3307792896) 01:56:42.719 --> 01:57:01.199 For EVV. We are at the state, we are not monitoring visit alignment with schedule, whatever was scheduled. That maybe something that provider agencies are monitoring internally, and of course on the Illinois Medicaid program side. 362 "Brigman, Emily" (3307792896) 01:57:01.199 --> 01:57:20.069 Those programs are looking at whether claims align with service, with service authorizations on their end. But again, scheduling is not required. If you elect to use it within the HHA exchange system or your 3rd party system, that's fine, but we're not looking at. 363 "Brigman, Emily" (3307792896) 01:57:20.069 --> 01:57:36.119 Visit alignment with schedules to determine EVV compliance. We thank you all very much for attending today. I'm sure there are lingering questions and concerns. Please leverage the contacts shared today for each Illinois Medicaid program. 364 "Brigman, Emily" (3307792896) 01:57:36.119 --> 01:57:51.264 And we will provide additional resources based on today's discussion, probably within the next couple of weeks. Thank you so much.