HP Enterprise Services HomeTown Health Presentation Physician Lunch and Learn

HP Enterprise Services

HomeTown Health Presentation

Physician Lunch and LearnSeptember 21, 2010

Partnering for Success!

2 / Georgia MMIS Presentation September 2010 HP Enterprise Services

Provider Beta Testing

August 16 – August 20 TuckerAugust 30 – September 3 Cordele

Feedback from Participants?

BETA Testing and Workshops


Web Portal PIN Letters

• Each current Georgia Medicaid provider will receive a Georgia Health Partnership Web Portal registration information letter, mailed last week, indicating their login and temporary password.

• The Georgia Health Partnership Web Portal registration information letter will be sent to the “mail to” address on file.

• Each provider must create a username and password prior to accessing the Georgia Health Partnership Web Portal for any claims related functionality available via the secure area of the Georgia Health Partnership Web Portal.

• Web Portal User Account Management Guide

• Provider Change of Information Form available on readiness website.


Provider Readiness Web Portal

Web Portal Address

http://providerinfo.mmis.georgia.gov/providerprereadiness/home.aspx

CBTs for web portal training and PES software training

Workshop Dates/Locations

Workshop presentations and Institutional Audio (new)

Address changes to reissue PIN (new)

Interim Provider Payments (new)


EDI Helpdesk

EDI Services Phone Number Available after September 1, 2010770-325-9590 or toll free 1 877-261-8785

EDI Email Address: [email protected]

EDI PES CBT will be on readiness website by end of week

PES software, which replaces WINASAP, will be available on readiness website on October 1, 2010

Provider Assistance


Billing Manuals will be available via the web portal. The current billing information contained in the DCH Part I Policy and Procedures Manual will be removed.

All Billing Manuals are on the readiness website for review.

Transition Information


Podcast

• DCH has completed the first in a series of stakeholder updates

• The next podcast in this series will cover the topic of DCH’s Interim Payment Plan which DCH may activate should significant payment issues arise.


Professional Header (NEW)

• Related Cause Code 3 Removed.

• Release of Information values removed, leaving I (Informed Consent) and Y (Yes) as the only values.

• Accident Date will be required if Related Cause Code = AA (Auto Accident) or OA (Other Accident).

• Accident State will be required if Related Cause Code = AA (Auto Accident).

• Related Cause Code will be required if Accident State or Accident Date are entered.

5010 and Web Portal-Professional


Professional Detail (NEW)

• Medicare Allowed Amount field removed. This value is being pre-calculated by the system.

• Drug Unit Count and Drug Unit of Measure fields are being added.

• Diagnosis Pointer values changed from 1-8 to 1-12. 5010 will now allow up to 12 diagnosis codes on professional.



Member Professional Detail (NEW)

• Medicare Allowed Amount field removed. This value is being pre-calculated by the MMIS. Value cannot be displayed that isn’t permitted by HIPAA.



Other Payer Header - all claim types (NEW)

• Date of Birth, Gender and Allowed Amount removed. Allowed Amount is pre-calculated by the MMIS.

• Payer Responsibility with 5010 will allow more values. For 4010, we display Primary, Secondary, Tertiary. 5010 expands that to fourth, fifth, sixth, etc.

• Group or Policy Number is becoming an optional field.

• Insurance Company Name is becoming an optional field.

• Relationship and Claim Filing values changing.

5010 and Web Portal-All Claim Types


5010 and Web Portal-All Claim Types Institutional

Professional


Member Other Payer Header - all claim types (OLD)

Member Other Payer Header - all claim types (NEW)

Medicare Allowed Amount field removed. This value is being pre-calculated by the MMIS. A Value cannot be displayed that isn’t permitted by HIPAA.

5010 and Web Portal-All Claim Types


Any questions?

HP Enterprise Services HomeTown Health Presentation Physician Lunch and Learn

Documents

Transcript of HP Enterprise Services HomeTown Health Presentation Physician Lunch and Learn