FAQ

Onboarding

State and Federal Policies

Cost

• Interested providers can begin the subscription process by completing a short survey.

Please access the survey at: https://www.surveymonkey.com/r/8T87FTX

To watch a short video on how to complete the HealthChoice Illinois ADT Survey:

• Onboarding packages will be sent to those providers who complete the survey

The onboarding packet requires the facility to complete a Discovery Form.  This helps the vendor (PointClickCare, formerly known as Collective Medical Technologies) to gather important information for implementation and clinical user onboarding.

To watch a short video on how to complete the HealthChoice Illinois ADT Discovery Form:

​The onboarding packet will be provided to the contact referenced in the survey. Providers may also request this information by contacting HFS directly at HFS.HealthChoiceIllinoisADT@illinois.gov​. 

The vendor has integrated with over three dozen different EHR platforms. HFS has extensively vetted the vendor's capabilites, and has full confidence that it will be able to work with most major EHRs for integration. A list of common EHR's with which the vendor has connected is provided.

The PointClickCare platform uses a customary set of demographic data points to positively identify patients. Its algorithms have been developed in house and are based on years of experience and best practice. There are many nuances to the solution, though the basic data items include: MRN, SSN, DOB, Name, Phone Number and Address: 

• MRN: A patient’s MRN (Medical Record Number), coupled with a unique assigning authority, is by far the most accurate way of identifying patients. Patients may have several MRNs even within a single facility.
• SSN & DOB: SSN and DOB combinations are a tried-and-true method for identifying patients. PCC takes special precaution in handling SSNs, due to their sensitive nature. SSNs are NEVER stored in the EDIE (Emergency Department Information Exchange) database in plain text. When received, the PointClickCare/Collective platform salts and encrypts all SSNs, and removes them from all archived messages. Doing this enables EDIE to use SSNs to match patients, but will never reveal SSNs to users, even in the event of a breach.
  
• Patient Name, DOB, Address & Phone: A combination of a patient’s name, DOB, and address or phone number, will also yield a match when an SSN or MRN are unavailable.
  
• Patient First Name, DOB, & Insurance Policy Number: Selected insurers may be eligible to use policy number to supplement demographic matching. 
  

It is important that a facility provide all data items available in order to ensure the highest possible match accuracy. In particular, PointClickCare/Collective safeguards Social Security Numbers with additional precaution. Social Security Numbers are never stored in their original form and are instead passed through a salt-and-hash encryption process that provides an irreversible hash value. During the matching process, incoming SSNs are salted and hashed in the same manner so as to yield the correct hash if the patient is a match. The plain text SSN is immediately discarded from memory. 

Although the PointClickCare/Collective platform merging algorithm is accurate to a very high degree, every so often—generally due to fraud, mis-clicks (such as selecting the wrong gender in a drop down), registrar typos, and other mistakes—patients can be accidentally merged together. When this occurs, PointClickCare maintains careful accounting of the origin, date, and time, as well as the method of creation for each piece of data stored within the platform. This enables meticulous auditing of data and also allows for precise unmerging when a mis-merge is detected by a client or by the system (more likely). If a mis-merge is identified by a user at your facility, your assigned Application Specialist at PointClickCare/Collective will review and unmerge the record. 

Patient Matching is a critical component of the vendor's platform. The system used by PointClickCare/Collective is built and maintained in-house, has been extensively vetted by hundreds of Hospitals, Health Plans and Clinics across the country, and has processed over billions of transactions spanning nearly 500M patient encounters for ~90M patients with high accuracy (low false positive, low false negative) levels. For additional details, please contact the PointClickCare/Collective Illinois Implementation Team.

PointClickCare requires you to complete a ticket to modify facility name, NPI or facility address on the HFS HealthChoice Illinois ADT Platform.  Please email support@collectivemedicaltech.com or call 801-285-0770 and provide the following information. 

•  Current Name on platform     
•  Current NPI on platform
•  Current Address on platform
•  Medicaid/IMPACT registered Facility Name         ​
•  NPI Registered with Medicaid/IMPACT       ​
•  Address registered with Medicaid/IMPACT ​
•  Please explain what needs to be changed.

• All Illinois hospitals that serve Medicaid customers must connect as data contributors and receive encounter notifications.
• Skilled Nursing Facilities (SNFs), Supportive Living Facilities, Intermediate Care Facilities for individuals with intellectual disabilities/mental retardation (ICF/MR), Specialized Mental Health Rehabilitation Facilities (SMHRF) with existing ADT/HL7 capabilities will also connect.​
• Managed Care Organizations (MCOs) will provide member panels in addition to receiving encounter notifications.
• Federally Qualified Health Centers (FQHCs), Community Mental Health Centers (CMHCs), Behavioral Health Clinics (BHCs), and Substance Use, Prevention and Recovery (SUPR) providers must subscribe to HealthChoice Illinois ADT to receive notifications for their customers.
• All other providers enrolled in the IMPACT system and engaged in direct patient care or providing services to Medicaid customers are highly encouraged to subscribe as the agency is working toward full provider participation.

“Illinois FQHCs, CMHCs, BHCs, and SUPR providers enrolled in the IMPACT system and engaged in direct patient care or providing services to Medicaid customers must subscribe to HealthChoice Illinois ADT to receive notifications for their customers. The agency is working toward full provider participation, increasing care coordination, and improving Managed Care Organization (MCO) P4P (pay for performance) metrics to increase Medicaid customers Healthcare Effectiveness Data and Information (HEDIS) measures as established by the National Committee for Quality Assurance (NCQA).”

Provider Notice, August 10, 2023

Hospital Data Quality and Completeness Requirements

Provider Notice, January 19, 2022

HealthChoice Illinois ADT Participation - All Illinois providers enrolled in the IMPACT system.

Provider Notice, January 18, 2022

REMINDER - HealthChoice Illinois ADT Mandatory Participation - Skilled Nursing Facilities, Supportive Living Program Providers and Specialized Mental Health Rehabilitation Facilities

Provider Notice, December 06, 2021

Reminder - HealthChoice Illinois ADT Mandatory Participation - Skilled Nursing Facilities, Supportive Living Program Providers and Specialized Mental Health Rehabilitation Facilities

Provider Notice, August 17, 2021

Final Reminder - HealthChoice Illinois ADT Mandatory Hospital Participation

Provider Notice, July 15, 2021

HealthChoice Illinois ADT Mandatory Hospital Participation Reminder

Provider Notice, June 07, 2021

HealthChoice Illinois ADT Long Term Care Participation

Provider Notice, March 22, 2021

“All hospitals that are enrolled in the IMPACT system to serve Medicaid participants will be required to transmit electronic notifications of admissions, discharges, and transfers for Medicaid participants in an HL7 format to the HFS technology platform by September 30, 2021.”

•  The Federal Register references ADT requirements on pages 25586-25603 including the statement “We proposed to revise the CoPs for Medicare- and Medicaid-participating hospitals at 42 CFR 482.24 by adding a new standard at paragraph (d), ‘‘Electronic Notifications,’’ that would require hospitals to send electronic patient event notifications of a patient’s admission, discharge, and/or transfer to another health care facility or to another community provider or practitioner.” 

•  Centers for Medicare & Medicaid Services (CMS) helpful links:
  

1. ​​​​​Interoperability and Patient Access Website: https://www.cms.gov/Regulations-and-Guidance/Guidance/Interoperability/index
2. Final Rule (PDF): https://www.cms.gov/files/document/cms-9115-f.pdf
3. ​Federal Register:https://www.govinfo.gov/content/pkg/FR-2020-05-01/pdf/2020-05050.pdf   (ADT referenced on pages 25586-25603)
4. ​Fact Sheet: https://www.cms.gov/newsroom/fact-sheets/interoperability-and-patient-access-fact-sheet
1. ​Additional Links:
2. https://www.cms.gov/files/document/interoperability-and-patient-access-final-rule-presentation.pdf 

The cost of the software, licensing and support for connecting to the HealthChoice Illinois ADT system is fully covered by HFS and is offered at no cost to the provider for all patients, regardless of patient insurance / line of business.   

HFS had a limited amount of funds available to reimburse hospitals for allowable expenses through September 30, 2021. HFS intends to request federal approval for future funding to help offset provider costs to connect to the HealthChoice Illinois ADT platform. Additional information about the provider eligibility for such funding and allowable expenses will be posted if and when the funding is approved.

HFS had a limited amount of funds available to reimburse Long-Term Care facilities for allowable expenses through September 30, 2021. HFS intends to request federal approval for future funding to help offset provider costs to connect to the HealthChoice Illinois ADT platform. Additional information about the provider eligibility for such funding and allowable expenses will be posted if and when the funding is approved

The cost of subscribing to the ADT notification service, allowing Medicaid providers to have access to admission, discharge and transfer data for their patients, is fully covered by HFS and is offered at no cost to the provider.